■评价低频(≤1Hz)重复经颅磁刺激(rTMS)联合抗抑郁药对脑卒中后抑郁(PSD)患者抑郁及炎症因子IL-6、TNF-α水平的影响。
■PubMed,Embase,WebofScience,Cochrane图书馆(CBM),中国国家知识基础设施,技术期刊数据库,和万方数据库搜索到2022年10月的随机对照试验。
■卒中后抑郁(PSD)患者参与了研究。
■共纳入16项随机对照试验(RCT),涉及1,463名PSD患者。根据物理治疗证据数据库(PEDro)质量评估,3项研究获得了高质量(8分)结果,13项RCT获得了中等质量(6分)结果.meta分析显示,低rTMS联合抗抑郁药显著降低汉密尔顿抑郁量表(HAMD)评分和美国国立卫生研究院卒中量表(NIHSS)评分,降低IL-6和TNF-α水平,与单独使用抗抑郁药相比,改善了PSD的MMSE评分。
■这项荟萃分析的结果证明了低rTMS联合抗抑郁药治疗PSD患者抑郁症的有效性和安全性。联合治疗可降低抑郁状态和IL-6、TNF-α水平,增强患者的认知功能。此外,低rTMS的不良反应较少,证明安全。然而,有缺点,例如缺乏长期随访,低RTMS的不同干预部位,和不同的干预频率(0.5或1赫兹)。因此,在未来,需要具有更大样本量和更长期观察的RCT来验证低rTMS联合治疗对PSD的有效性。同时,可以分析新的荟萃分析,哪些干预部位和频率更有效地治疗PSD。
■https://www.crd.约克。AC.英国/普华永道/,标识符:CRD42022376845。
UNASSIGNED: To evaluate the effect of low-frequency (≤1 Hz) repetitive transcranial magnetic stimulation (low-frequency rTMS) combined with antidepressants on depression and the levels of inflammatory factors IL-6 and TNF-α in patients with post-stroke depression (
PSD).
UNASSIGNED: PubMed, Embase, Web of Science, Cochrane Library (CBM), China National Knowledge Infrastructure, Technology Periodical Database, and Wanfang Database were searched until October 2022 for randomized controlled trials.
UNASSIGNED: Patients with post-stroke depression (
PSD) participated in the study.
UNASSIGNED: A total of 16 randomized controlled trials (RCTs) involving 1,463 patients with
PSD were included. According to the Physiotherapy Evidence Database (PEDro) quality assessment, three studies received high quality (eight scores) and 13 RCTs received moderate quality (six scores) results. The meta-analysis showed that low-rTMS combined with an antidepressant significantly reduced the Hamilton Depression Scale (HAMD) score and the National Institutes of Health Stroke Scale (NIHSS) score, reduced IL-6 and TNF-α levels, and improved the MMSE score in
PSD compared to an antidepressant alone.
UNASSIGNED: The results of this meta-analysis evidenced the efficacy and safety of low-rTMS combined with antidepressants in the treatment of depression in
PSD patients. The combined therapy could reduce The depression state and the levels of IL-6 and TNF-α, and enhance the cognitive function of patients. In addition, low-rTMS had fewer adverse effects, proving safety. However, there are shortcomings, such as a lack of long-term follow-up, different intervention sites of low-rTMS, and different intervention frequencies (0.5 or 1 Hz). Thus, in the future, RCTs with a larger sample size and longer-term observation are required to verify the efectiveness of low-rTMS combined therapy on PSD. Meantime, a new meta-analysis could be analysized, which intervention sites and frequency are more effective in treating PSD.
UNASSIGNED: https://www.crd.york.ac.uk/prospero/, identifier: CRD42022376845.