PDF(Pubmed)
Abstract：
Negative symptoms in schizophrenia impose a significant burden with limited effective pharmacological treatment options. Recent trials have shown preliminary evidence for the efficacy of using intermittent theta burst stimulation (iTBS) in treating negative symptoms in schizophrenia. We aim to systematically review the current evidence of iTBS in the treatment of the negative symptoms of schizophrenia as an augmentation therapy. The study protocol was developed and registered on Prospero (registration ID: 323381). MEDLINE, EMBASE, Web of Science (Scopus), PsycINFO and Wan Fang databases were searched for sham-controlled, randomized trials of iTBS among patients with schizophrenia. The mean difference in major outcome assessments for negative symptoms was calculated. The quality of evidence was assessed using the Cochrane Risk of Bias Tool (version 1) and the GRADE system. Moreover, 12 studies including a total of 637 participants were included. Compared to sham treatment, the pooled analysis was in favor of iTBS treatment for negative symptoms (mean weight effect size: 0.59, p = 0.03) but not for positive symptoms (mean weight effect size: 0.01, p = 0.91) and depressive symptoms (mean weight effect size: 0.35, p = 0.16). A significant treatment effect was also observed on the iTBS target site left dorsal prefrontal cortex (mean weight effect size: 0.86, p = 0.007) and for stimulation with 80% motor threshold (mean weight effect size: 0.86, p = 0.02). Thus, our synthesized data support iTBS as a potential treatment for negative symptoms among patients with schizophrenia. However, the long-term efficacy and safety issues of iTBS in a larger population have yet to be examined.
摘要：
精神分裂症的阴性症状给有限的有效药物治疗选择带来了巨大的负担。最近的试验显示了使用间歇性θ爆发刺激（iTBS）治疗精神分裂症阴性症状的初步证据。我们旨在系统地回顾iTBS作为增强疗法治疗精神分裂症阴性症状的当前证据。研究方案在Prospero上开发并注册(注册ID:323381)。MEDLINE,EMBASE,WebofScience(Scopus)搜索了PsycINFO和WanFang数据库中的假对照，iTBS在精神分裂症患者中的随机试验。计算阴性症状的主要结果评估的平均差异。使用Cochrane偏差风险工具（版本1）和等级系统评估证据质量。此外，共纳入12项研究，共637名参与者。与假治疗相比，汇总分析支持iTBS治疗阴性症状(平均体重效应大小:0.59,p=0.03),但不支持阳性症状(平均体重效应大小:0.01,p=0.91)和抑郁症状(平均体重效应大小:0.35,p=0.16).在iTBS靶部位左背前额叶皮质(平均体重效应大小:0.86,p=0.007)和80%运动阈值刺激(平均体重效应大小:0.86,p=0.02)上也观察到显著的治疗效果。因此，我们的综合数据支持iTBS作为精神分裂症患者阴性症状的潜在治疗方法.然而,iTBS在较大人群中的长期疗效和安全性问题尚待研究.
