PDF(Pubmed)
Abstract：
UNASSIGNED: Executive dysfunction is a core symptom of vascular cognitive impairment (VCI), which seriously affects patients\' prognosis. This paper aims to investigate the effectiveness of rTMS on executive function in VCI.
UNASSIGNED: The databases selected for this study included Pubmed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang, China Science and Technology Journal Database (VIP), and China Biology Medicine Disc (CBM). The screening times were conducted from the time of library construction until August 23, 2023. The inclusion criteria for this meta-analysis were randomized controlled trials (RCTs) on rTMS for VCI, which include executive function scores. The primary metrics were executive subscale scores of the Cognitive Comprehensive Scale and total scores of the Executive Specificity Scale. The secondary metrics were subscale scores of the Executive Specificity Scale. The quality of each eligible study was assessed using the Cochrane Risk of Bias tool. Meta-analysis and bias analysis were performed using Stata (version 16.0) and RevMan (version 5.3).
UNASSIGNED: A total of 20 high-quality clinical RCTs with 1,049 samples were included in this paper. The findings from the primary outcomes revealed that within the rTMS group, there were significantly higher scores observed for the executive sub-item on the cognitive composite scale (SMD = 0.93, 95% CI = 0.77-1.08, p < 0.00001, I 2 = 14%) and the total score on the executive specific scale (SMD = 0.69, 95% CI = 0.44-0.94, p < 0.00001, I 2 = 0%) compared to the control group. As for the secondary outcome measures, as shown by the Trail Making Test-A (time) (MD = -35.75, 95% CI = -68.37 to -3.12, p = 0.03, I 2 = 55%), the Stroop-C card (time) (SMD = -0.46, 95% CI = -0.86 to -0.06, p = 0.02, I 2 = 0%) and the Stroop-C card (correct number) (SMD = 0.49, 95% CI = 0.04-0.94, p = 0.03, I 2 = 0%), the experimental group shorts time and enhances accuracy of executive task in comparison to the control group. Subgroup analysis of the main outcome demonstrated that intermittent theta burst stimulation (iTBS), higher frequency, lower intensity, longer duration, and combined comprehensive therapy exhibited superior efficacy.
UNASSIGNED: rTMS is effective in the treatment of the executive function of VCI. The present study has some limitations, so multi-center, large-sample, objective indicators and parameters are needed to further explore in the future.Systematic review registration:https://www.crd.york.ac.uk/prospero/, CRD42023459669.
UNASSIGNED: The databases selected for this study included Pubmed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang, China Science and Technology Journal Database (VIP), and China Biology Medicine Disc (CBM). The screening times were conducted from the time of library construction until August 23, 2023. The inclusion criteria for this meta-analysis were randomized controlled trials (RCTs) on rTMS for VCI, which include executive function scores. The primary metrics were executive subscale scores of the Cognitive Comprehensive Scale and total scores of the Executive Specificity Scale. The secondary metrics were subscale scores of the Executive Specificity Scale. The quality of each eligible study was assessed using the Cochrane Risk of Bias tool. Meta-analysis and bias analysis were performed using Stata (version 16.0) and RevMan (version 5.3).
UNASSIGNED: A total of 20 high-quality clinical RCTs with 1,049 samples were included in this paper. The findings from the primary outcomes revealed that within the rTMS group, there were significantly higher scores observed for the executive sub-item on the cognitive composite scale (SMD = 0.93, 95% CI = 0.77-1.08, p < 0.00001, I 2 = 14%) and the total score on the executive specific scale (SMD = 0.69, 95% CI = 0.44-0.94, p < 0.00001, I 2 = 0%) compared to the control group. As for the secondary outcome measures, as shown by the Trail Making Test-A (time) (MD = -35.75, 95% CI = -68.37 to -3.12, p = 0.03, I 2 = 55%), the Stroop-C card (time) (SMD = -0.46, 95% CI = -0.86 to -0.06, p = 0.02, I 2 = 0%) and the Stroop-C card (correct number) (SMD = 0.49, 95% CI = 0.04-0.94, p = 0.03, I 2 = 0%), the experimental group shorts time and enhances accuracy of executive task in comparison to the control group. Subgroup analysis of the main outcome demonstrated that intermittent theta burst stimulation (iTBS), higher frequency, lower intensity, longer duration, and combined comprehensive therapy exhibited superior efficacy.
UNASSIGNED: rTMS is effective in the treatment of the executive function of VCI. The present study has some limitations, so multi-center, large-sample, objective indicators and parameters are needed to further explore in the future.Systematic review registration:https://www.crd.york.ac.uk/prospero/, CRD42023459669.
摘要：
■执行功能障碍是血管性认知障碍（VCI）的核心症状，严重影响患者预后。本文旨在探讨rTMS对VCI执行功能的影响。
■本研究选择的数据库包括Pubmed，Embase,科克伦图书馆,中国国家知识基础设施(CNKI),万方,中国科技期刊数据库(VIP),和中国生物医学光盘（CBM）。筛选时间从图书馆建设之时到2023年8月23日进行。该荟萃分析的纳入标准是rTMS用于VCI的随机对照试验（RCTs），其中包括执行功能评分。主要指标是认知综合量表的执行子量表得分和执行特异性量表的总分。次要指标是执行特异性量表的子量表得分。使用Cochrane偏差风险工具评估每个合格研究的质量。使用Stata（16.0版）和RevMan（5.3版）进行Meta分析和偏倚分析。
■本文共纳入20份高质量临床随机对照试验，共1,049份样本。主要结果显示，在rTMS组中，与对照组相比,认知综合量表(SMD=0.93,95%CI=0.77~1.08,p<0.00001,I2=14%)的执行分项目得分和执行专项量表总分(SMD=0.69,95%CI=0.44~0.94,p<0.00001,I2=0%)显著较高.至于次要结果指标，如跟踪测试A（时间）所示（MD=-35.75，95％CI=-68.37至-3.12，p=0.03，I2=55％），Stroop-C卡（时间）（SMD=-0.46，95％CI=-0.86至-0.06，p=0.02，I2=0％）和Stroop-C卡（正确数字）（SMD=0.49，95％CI=0.04-0.94，p=0.03，I2=0％），与对照组相比，实验组缩短了执行任务的时间，提高了执行任务的准确性。对主要结局的亚组分析显示，间歇性θ爆发刺激（iTBS），更高的频率，较低的强度，持续时间较长，综合治疗疗效明显。
■rTMS可有效治疗VCI的执行功能。本研究有一定的局限性，所以多中心，大样本,客观指标和参数需要在未来进一步探索。系统审查注册：https://www。crd.约克。AC.英国/普华永道/，CRD42023459669。
■本研究选择的数据库包括Pubmed，Embase,科克伦图书馆,中国国家知识基础设施(CNKI),万方,中国科技期刊数据库(VIP),和中国生物医学光盘（CBM）。筛选时间从图书馆建设之时到2023年8月23日进行。该荟萃分析的纳入标准是rTMS用于VCI的随机对照试验（RCTs），其中包括执行功能评分。主要指标是认知综合量表的执行子量表得分和执行特异性量表的总分。次要指标是执行特异性量表的子量表得分。使用Cochrane偏差风险工具评估每个合格研究的质量。使用Stata（16.0版）和RevMan（5.3版）进行Meta分析和偏倚分析。
■本文共纳入20份高质量临床随机对照试验，共1,049份样本。主要结果显示，在rTMS组中，与对照组相比,认知综合量表(SMD=0.93,95%CI=0.77~1.08,p<0.00001,I2=14%)的执行分项目得分和执行专项量表总分(SMD=0.69,95%CI=0.44~0.94,p<0.00001,I2=0%)显著较高.至于次要结果指标，如跟踪测试A（时间）所示（MD=-35.75，95％CI=-68.37至-3.12，p=0.03，I2=55％），Stroop-C卡（时间）（SMD=-0.46，95％CI=-0.86至-0.06，p=0.02，I2=0％）和Stroop-C卡（正确数字）（SMD=0.49，95％CI=0.04-0.94，p=0.03，I2=0％），与对照组相比，实验组缩短了执行任务的时间，提高了执行任务的准确性。对主要结局的亚组分析显示，间歇性θ爆发刺激（iTBS），更高的频率，较低的强度，持续时间较长，综合治疗疗效明显。
■rTMS可有效治疗VCI的执行功能。本研究有一定的局限性，所以多中心，大样本,客观指标和参数需要在未来进一步探索。系统审查注册：https://www。crd.约克。AC.英国/普华永道/，CRD42023459669。
