目的:本研究旨在系统回顾有关在表现行为症状的痴呆/严重NCD(神经认知障碍)患者中使用电惊厥治疗(ECT)的文献。
方法:我们对文献进行了PRISMA指导的系统综述。我们搜索了五个主要的数据库,包括PubMed,Medline,Embase,科克伦,和注册表(ClinicalTrials.gov),与“ECT”和“痴呆症/重大NCD”合作作为我们的搜索词。
方法:在445篇发表的论文和4项临床试验中,只有43篇论文和3项临床试验符合标准.有22例病例报告,14个案例系列,4个回顾性图表审查,1项回顾性病例对照研究,1项随机对照试验,和2个正在进行的试验。我们评估了在患有抑郁症状的痴呆/严重NCD患者中使用ECT的现有证据,激动和侵略,精神病症状,紧张症,路易体痴呆/主要非传染性疾病,躁狂症状,以及这些症状的组合。
方法:这些研究是在住院患者环境中进行的。
方法:纳入60岁以上患者790例。
结果:所有综述的研究报告了治疗痴呆/严重NCD患者行为症状的症状获益。虽然短暂的混乱,短期记忆丧失,认知障碍是常见的副作用,大多数研究发现使用ECT没有严重的副作用。
结论:来自46项研究的系统评价的当前证据表明,ECT对患有痴呆/主要NCD和行为症状的特定个体有益,但有时不良事件可能会限制其在这些脆弱的个体中的使用。
OBJECTIVE: This study aims to systematically
review the literature on using electroconvulsive therapy (
ECT) in patients with dementia/major NCD (Neuro cognitive disorder) presenting with behavioral symptoms.
METHODS: We conducted a PRISMA-guided systematic
review of the literature. We searched five major databases, including PubMed, Medline, Embase, Cochrane, and registry (ClinicalTrials.gov), collaborating with \"
ECT\" and \"dementia/major NCD\" as our search terms.
METHODS: Out of 445 published papers and four clinical trials, only 43 papers and three clinical trials met the criteria. There were 22 case reports, 14 case series, 4 retrospective chart reviews, 1 retrospective case-control study, 1 randomized controlled trial, and 2 ongoing trials. We evaluated existing evidence for using ECT in dementia/major NCD patients with depressive symptoms, agitation and aggression, psychotic symptoms, catatonia, Lewy body dementia/major NCD, manic symptoms, and a combination of these symptoms.
METHODS: The studies were conducted in the in-patient setting.
METHODS: Seven hundred and ninety total patients over the age of 60 years were added.
RESULTS: All reviewed studies reported symptomatic benefits in treating behavioral symptoms in individuals with dementia/major NCD. While transient confusion, short-term memory loss, and cognitive impairment were common side effects, most studies found no serious side effects from ECT use.
CONCLUSIONS: Current evidence from a systematic
review of 46 studies indicates that
ECT benefits specific individuals with dementia/major NCD and behavioral symptoms, but sometimes adverse events may limit its use in these vulnerable individuals.