非侵入性神经调控技术在焦虑障碍患者中应用效果的Meta分析
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科技创新2030-“脑科学与类脑研究”重大项目(2021ZD0202004);北京市自然科学基金项目(7222084);北京市科学技术委员会首都特色临床应用项目(Z181100001718077)


Efficacy of non-invasive neuroregulatory techniques on patients with anxiety disorders:a Metaanalysis
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    目的 评价非侵入性神经调控技术在焦虑障碍治疗中的效果。方法 在 PubMed、 Embase、Cochrane Library、中国知网、维普中文科技期刊数据库和万方数据库中检索关于经颅直流电 刺激(tDCS)、重复经颅磁刺激(rTMS)、经颅交流电刺激(tACS)等非侵入性神经调控技术在焦虑障碍患者 中应用疗效的随机对照研究,检索时限为建库至 2022 年 9 月。由 2 名研究人员独立筛选文献、提取资 料、进行质量评价。采用 RevMan 5.4 和 Stata 14 软件进行 Meta 分析。结果 最终纳入 22 项随机对照研 究,5 项应用 tDCS,17 项应用 rTMS,无应用 tACS 的研究。纳入患者共 1 216 例,其中对照组 611 例,试验 组 605 例。Meta 分析结果显示,试验组应用非侵入性神经调控技术(tDCS 及 rTMS)缓解焦虑症状的效果 优于对照组,差异有统计学意义(SMD=0.87,95%CI:0.54~1.21,P< 0.05)。对不同神经调控模式进行 亚组分析,结果显示试验组应用 rTMS 缓解焦虑症状的效果优于对照组,差异有统计学意义(SMD=0.90, 95%CI:0.52~1.28,P< 0.05);而试验组应用 tDCS 缓解焦虑症状的效果与对照组比较,差异无统计学意 义(SMD=0.76,95%CI:-0.00~1.53,P=0.05)。结论 非侵入性神经调控技术能有效改善焦虑障碍患者 的焦虑症状,值得进一步临床验证和推广。

    Abstract:

    Objective To evaluate the efficacy and safety of non-invasive neuroregulatory techniques in the treatment of anxiety disorders. Methods Randomized controlled trials(RCT) on the efficacy of non-invasive neuroregulatory techniques such as transcranial direct current stimulation (tDCS), repetitive transcranial magnetic stimulation (rTMS), and transcranial alternating current stimulation (tACS) in patients with anxiety disorders was searched in PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, VIP Chinese Science and Technology Journal Database, and Wanfang Database. The searching time limitation is from database establishment to September 2022. Two researchers independently screen literature, extract data, and conduct quality evaluation. RevMan 5.4 and Stata 14 software were applied in the Meta-analysis. Results A total of 22 RCTs were included, 5 of which applied tDCS, 17 of which applied rTMS, and none of which applied tACS. A total of 1 216 patients were enrolled, including 611 in the control group and 605 in the experimental group. The results of Meta-analysis showed that the improvement of anxiety symptoms in experimental group treated with non-invasive neuroregulatory techniques (tDCS and rTMS) was better than that in the control group (SMD=0.87, 95%CI=0.54-1.21,P< 0.05). Subgroup analysis of different neuromodulation modes showed that rTMS was better in the experimental group than in the control group (SMD=0.90, 95%CI:0.52-1.28, P< 0.05). However, there was no significant difference in the effect of tDCS on anxiety symptoms between the experimental group and the control group (SMD=0.76,95%CI:-0.00-1.53, P=0.05). Conclusions Non-invasive neuromodulation techniques can effectively improve anxiety symptoms in patients with anxiety disorders. It is worthy of further clinical verification and promotion

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张晓东,杨祥云,杨丽娟,李占江.非侵入性神经调控技术在焦虑障碍患者中应用效果的Meta分析[J].神经疾病与精神卫生,2023,23(4):
DOI :10.3969/j. issn.1009-6574.2023.04.008.

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  • 在线发布日期: 2023-05-30