■深经颅磁刺激(dTMS)作为精神分裂症干预措施的有效性和安全性尚不清楚。本系统评价了dTMS治疗精神分裂症的疗效和安全性。
■对中文(万方和中文期刊网)和英文数据库(PubMed,EMBASE,PsycINFO,和Cochrane图书馆)进行了。
■在分析中包括包含80名患者的三个随机临床试验(RCT)。活性dTMS在改善总精神病理学方面与假治疗相当,阳性症状,阴性症状,和通过阳性和阴性综合征量表(PANSS)测量的幻听,阳性症状评估量表(SAPS),阴性症状评估量表(SANS),和听觉幻觉评定量表(AHRS),分别。只有一个RCT报告了剑桥神经心理学测试自动电池(CANTAB)对神经认知功能的影响,这表明DTMS可能只会改善剑桥措施的一种丝袜(即,五个移动问题的后续时间)。所有三项研究都报告了总体停药率,从16.7%到44.4%不等。仅在一个RCT中报告了不良事件,最常见的是刺痛/抽搐(30.0%,3/10),头部/面部不适(30.0%,3/10),和背痛(20.0%,2/10).
■这项系统评价表明,dTMS不能减轻精神分裂症患者的精神病症状,但它显示了改善执行功能的潜力。未来的RCT具有更大的样本量,专注于dTMS对精神分裂症精神病性症状和神经认知功能的影响,有必要进一步探索这些发现。
UNASSIGNED: The efficacy and safety of deep transcranial magnetic stimulation (dTMS) as an intervention for schizophrenia remain unclear. This systematic
review examined the efficacy and safety of dTMS for schizophrenia.
UNASSIGNED: A systematic search of Chinese (WanFang and Chinese Journal Net) and English databases (PubMed, EMBASE, PsycINFO, and Cochrane Library) were conducted.
UNASSIGNED: Three randomized clinical trials (RCTs) comprising 80 patients were included in the analyses. Active dTMS was comparable to the sham treatment in improving total
psychopathology, positive symptoms, negative symptoms, and auditory hallucinations measured by the Positive and Negative Syndrome Scale (PANSS), the Scale for the Assessment of Positive Symptoms (SAPS), the Scale for the Assessment of Negative Symptoms (SANS), and the Auditory Hallucinations Rating Scale (AHRS), respectively. Only one RCT reported the effects on neurocognitive function measured by the Cambridge Neuropsychological Test Automated Battery (CANTAB), suggesting that dTMS may only improve one Stockings of Cambridge measure (i.e., subsequent times for five move problems). All three studies reported overall discontinuation rates, which ranged from 16.7% to 44.4%. Adverse events were reported in only one RCT, the most common being tingling/twitching (30.0%, 3/10), head/facial discomfort (30.0%, 3/10), and back pain (20.0%, 2/10).
UNASSIGNED: This systematic
review suggests that dTMS does not reduce psychotic symptoms in schizophrenia, but it shows potential for improving executive functions. Future RCTs with larger sample sizes focusing on the effects of dTMS on psychotic symptoms and neurocognitive function in schizophrenia are warranted to further explore these findings.