■我们旨在确定重复经颅磁刺激(rTMS)对神经退行性疾病患者冷漠的影响和耐受性,轻度认知障碍(MCI),中风,通过系统评价和创伤性脑损伤(TBI)。
■我们在主要的电子健康数据库中进行了系统的搜索,包括PubMed,Scopus,和PsycINFO,涵盖从成立到2023年6月的时期。比较临床试验和队列研究,并考虑纳入前后设计的研究。我们使用Cochrane偏差风险和美国国立卫生研究院(NIH)工具来评估方法学质量。
■在确定的258条记录中,14项研究符合我们的资格标准(11项随机对照试验(RCT)和3项研究使用前后设计),共有418名患者(总体男女比例为1:1.17)纳入审查。纳入研究的总体方法学质量被评估为从公平到良好。在研究中使用的刺激参数差异很大。我们综述的总结结果表明,关于rTMS对冷漠的影响的以下观察结果:(1)在阿尔茨海默病的所有纳入研究中调查rTMS对冷漠的影响的结果一直显示出对冷漠的积极影响;(2)在帕金森氏病中进行的大多数研究都没有发现统计学上的显着结果;(3)对患有原发性中风的患者进行的单一研究(RCT)对Tapras的不同研究表明,对Tapra
■本综述提出了利用rTMS治疗冷漠的可行性。总的来说,有限的证据表明,rTMS干预可能有可能改变AD患者的冷漠,PPA,MCI和慢性中风,但在PD和轻度TBI中就不那么明显了.这些发现需要更大规模的确认,精心设计的临床试验。
UNASSIGNED: We aimed to determine the effects and tolerability of repetitive transcranial magnetic stimulation (rTMS) on
apathy in patients with neurodegenerative conditions, mild cognitive impairment (MCI), stroke, and traumatic brain injury (TBI) via systematic
review.
UNASSIGNED: We conducted a systematic search in major electronic health databases, including PubMed, Scopus, and PsycINFO, covering the period from inception to June 2023. Comparative clinical trials and cohort studies, and studies with before-after designs were considered for inclusion. We used the Cochrane Risk of Bias and the National Institutes of Health (NIH) tools to assess methodological quality.
UNASSIGNED: Out of 258 records identified, 14 studies met our eligibility criteria (11 randomized controlled trials (RCT) and 3 studies utilized before-and-after designs) with a total of 418 patients (overall female-to-male ratio 1:1.17) included in the
review. The overall methodological quality of the included studies was assessed to be fair to good. The stimulation parameters used varied considerably across the studies. The summary findings of our
review indicate the following observations on the effects of rTMS on
apathy: (1) the results of all included studies in Alzheimer\'s disease investigating the effects of rTMS on apathy have consistently shown a positive impact on apathy; (2) the majority of studies conducted in Parkinson\'s disease have not found statistically significant results; (3) a single study (RCT) on patients with primary progressive aphasia demonstrated significant beneficial effects of rTMS on apathy; (4) the trials conducted on individuals with MCI yielded varying conclusions; (5) one study (RCT) in chronic stroke suggested that rTMS might have the potential to improve apathy; (6) one study conducted on individuals with mild TBI did not find a significant favorable association on apathy; and (7) the use of different rTMS protocols on the populations described is generally safe.
UNASSIGNED: The feasibility of utilizing rTMS as a treatment for apathy has been suggested in this
review. Overall, limited evidence suggests that rTMS intervention may have the potential to modify apathy among patients with AD, PPA, MCI and chronic stroke, but less so in PD and mild TBI. These findings require confirmation by larger, well-designed clinical trials.