digital therapy

数字治疗
  • 文章类型: Editorial
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  • 文章类型: Journal Article
    In the context of population aging, the growing problem of Alzheimer\'s disease (AD) poses a great challenge to mankind. Although there has been considerable progress in exploring the etiology of AD, i.e., the important role of amyloid plaques and neurofibrillary tangles in the progression of AD has been widely accepted by the scientific community, traditional treatment and monitoring modalities have significant limitations. Therefore novel evaluation and treatment modalities for Alzheimer\'s disease are called for emergence. In this research, we sought to review the effectiveness of digital treatment based on monitoring using functional near-infrared spectroscopy (fNIRS) and electroencephalography (EEG). This work searched four electronic databases using a keyword approach and focused on journals focusing on AD and geriatric cognition. Finally, 21 articles were included. The progress of digital therapy and outcome monitoring in AD was reviewed, including digital therapy approaches on different platforms and different neuromonitoring techniques. Because biomarkers such as theta coherence, alpha and beta rhythms, and oxyhemoglobin are effective in monitoring the cognitive level of AD patients, and thus the efficacy of digital therapies, this review particularly focuses on the biomarker validation results of digital therapies. The results show that digital treatment based on biomarker monitoring has good effectiveness. And the effectiveness is reflected in the numerical changes of biomarker indicators monitored by EEG and fNIRS before and after digital treatment. Increases or decreases in the values of these indicators collectively point to improvements in cognitive function (mostly moderate to large effect sizes). The study is the first to examine the state of digital therapy in AD from the perspective of multimodal monitoring, which broadens the research perspective on the effectiveness of AD and gives clinical therapists a \"reference list\" of treatment options. They can select a specific protocol from this \"reference list\" in order to tailor digital therapy to the needs of individual patients.
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  • 文章类型: Journal Article
    弱视会影响儿童单眼视力和双眼功能的发育,并随着年龄的增长而成为一个棘手的问题。本研究旨在探讨8-13岁儿童屈光参差性弱视的双眼功能并评估数字治疗的疗效。数字治疗组的患者使用数字弱视治疗软件进行训练。视力和双眼功能(感知眼位[PEP],抑制,和立体视)在第一次就诊和治疗后3个月进行检查。对照组23例,数字治疗组25例。结果表明,3个月的数字治疗可以有效提高矫正视力(CDVA)和改善双眼功能,包括PEP,抑制,屈光参差性弱视儿童的二阶立体视,8-13岁。数字治疗弱视可有效改善大龄屈光参差性弱视患儿单眼CDVA及双眼功能。
    Amblyopia affects development of children\'s monocular vision and binocular function and becomes a largely intractable problem with increasing aging. This study is to investigate the binocular function and evaluate efficacy of digital therapy in children 8-13 years of age with anisometropic amblyopia. The patients in the digital therapy group performed the training with the digital amblyopia therapeutic software. The visual acuity and binocular function (perceptual eye position [PEP], suppression, and stereopsis) were examined at the first visit and 3-month post-treatment. Twenty-three cases in the control group and 25 cases in the digital therapy group were enrolled. The results revealed that 3-month digital therapy can effectively improve corrected distance visual acuity (CDVA) and improve the binocular function, including PEP, suppression, and second-order stereopsis in children with anisometropic amblyopia, 8-13 years of age. Digital therapy for amblyopia can effectively improve monocular CDVA of amblyopic eyes and binocular function in older children with anisometropic amblyopia.
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  • 文章类型: Journal Article
    背景:自闭症谱系障碍(ASD)是一种神经发育障碍,可导致沟通和社交互动困难以及复杂的家庭动态。数字健康干预可以降低治疗成本,促进健康生活方式的改变。这些疗法可以是辅助治疗或替代传统治疗。然而,合作和依从性问题阻止ASD学龄前患者应用这些工具。在这个开放标签中,随机对照试验,我们开发了一种非穿戴式数字疗法,称为虚拟现实结合认知行为疗法(VR-CBT).
    目的:本研究的目的是通过比较VR-CBT加学习风格简介(LSP)干预与仅LSP干预对学龄前ASD儿童的影响来评估VR-CBT的辅助功能。
    方法:本试验在中国对78名学龄前儿童(3-6岁,IQ>70)诊断为ASD,随机接受20周VR-CBT加LSP干预(干预组,39/78,50%)或仅LSP干预(对照组,39/78,50%)。主要结果是通过使用父母评估的自闭症行为清单(ABC)评估从基线到第20周的得分变化。次要结果包括儿童自闭症评定量表(CARS),注意缺陷/多动障碍量表-IV(ADHD-RS-IV),和执行/不执行任务中的行为表现数据(准确性和反应时间)。在意向治疗人群中分析所有主要和次要结果。
    结果:干预后,对总ABC(β=-5.528;P<.001)和CARS评分(β=-1.365;P=.02)有干预效果。在ABC子量表中观察到类似的趋势:感觉(β=-1.133;P=0.047),相关(β=-1.512;P=0.03),身体和物体使用(β=-1.211;P=0.03),以及社交和自助(β=-1.593;P=0.03)。干预措施在提高行为表现方面也显示出统计学上显著的效果(去/不去任务,准确度,β=2.923;P=.04)。此外,根据ADHD-RS-IV,在53例患有ADHD的儿童中观察到ADHD多动-冲动症状的显著改善(β=-1.269;P=.02).在ABC的语言分量表(β=-.080;P=.83)中未检测到有统计学意义的干预效果。干预组女孩在ABC量表中有较大的改善,也就是说,感觉和身体和对象的使用以及在CARS评分和准确性的去/不去任务(所有P<0.05)比对照组女孩。与对照组男孩相比,干预组男孩患有多动症的多动症症状的干预效果具有统计学意义(β=-1.333;P=0.03)。
    结论:我们发现非穿戴式数字治疗加LSP对与ASD相关的核心症状有潜在的积极影响,导致感觉功能的适度改善,电机,和反应抑制,同时减少ASD和ADHD学龄前儿童的冲动和多动症。VR-CBT被认为是一种有效且可行的辅助数字工具。
    背景:中国临床试验注册ChiCTR2100053165;http://www.chictr.org.cn/showproj.aspx?proj=137016。
    Autism spectrum disorder (ASD) is a neurodevelopmental disorder that can cause difficulty with communication and social interactions as well as complicated family dynamics. Digital health interventions can reduce treatment costs and promote healthy lifestyle changes. These therapies can be adjunctive or replace traditional treatments. However, issues with cooperation and compliance prevent preschool patients with ASD from applying these tools. In this open-label, randomized controlled trial, we developed a nonwearable digital therapy called virtual reality-incorporated cognitive behavioral therapy (VR-CBT).
    The aim of this study was to assess the adjunctive function of VR-CBT by comparing the effects of VR-CBT plus learning style profile (LSP) intervention with those of LSP-only intervention in preschool children with ASD.
    This trial was performed in China on 78 preschool children (age 3-6 years, IQ>70) diagnosed with ASD who were randomized to receive a 20-week VR-CBT plus LSP intervention (intervention group, 39/78, 50%) or LSP intervention only (control group, 39/78, 50%). The primary outcome was the change of scores from baseline to week 20, assessed by using the parent-rated Autism Behavior Checklist (ABC). Secondary outcomes included the Childhood Autism Rating Scale (CARS), Attention-Deficit/Hyperactivity Disorder Rating Scale-IV (ADHD-RS-IV), and behavioral performance data (accuracy and reaction time) in go/no-go tasks. All primary and secondary outcomes were analyzed in the intention-to-treat population.
    After the intervention, there was an intervention effect on total ABC (β=-5.528; P<.001) and CARS scores (β=-1.365; P=.02). A similar trend was observed in the ABC subscales: sensory (β=-1.133; P=.047), relating (β=-1.512; P=.03), body and object use (β=-1.211; P=.03), and social and self-help (β=-1.593; P=.03). The intervention also showed statistically significant effects in improving behavioral performance (go/no-go task, accuracy, β=2.923; P=.04). Moreover, a significant improvement of ADHD hyperactivity-impulsivity symptoms was observed in 53 children with comorbid ADHD based on ADHD-RS-IV (β=-1.269; P=.02). No statistically significant intervention effect was detected in the language subscale of ABC (β=-.080; P=.83). Intervention group girls had larger improvements in ABC subscales, that is, sensory and body and object use and in the CARS score and accuracy of go/no-go task (all P<.05) than the control group girls. Statistically significant intervention effects could be observed in hyperactivity-impulsivity symptoms in the intervention group boys with comorbid ADHD compared with those in the control group boys (β=-1.333; P=.03).
    We found potentially positive effects of nonwearable digital therapy plus LSP on core symptoms associated with ASD, leading to a modest improvement in the function of sensory, motor, and response inhibition, while reducing impulsivity and hyperactivity in preschoolers with both ASD and ADHD. VR-CBT was found to be an effective and feasible adjunctive digital tool.
    Chinese Clinical Trial Registry ChiCTR2100053165; http://www.chictr.org.cn/showproj.aspx?proj=137016.
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  • 文章类型: Systematic Review
    注意缺陷多动障碍(ADHD)是一种神经发育障碍,通常发生在儿童时期。这项荟萃分析的目的是总结数字疗法在患有ADHD的儿童和青少年中的有效性的可用证据。
    我们搜索了MEDLINE,EMBASE,Cochrane图书馆(Cochrane系统评论数据库),和WebofScience(科学和社会科学引文索引)数据库进行相关研究,并使用Stata15.0软件进行荟萃分析。
    共有31项研究纳入最终分析,涉及2169名4-17岁的参与者(1665名男孩和504名女孩)。荟萃分析结果表明,数字干预改善了注意力不集中的症状,效应值为-0.20(95%置信区间[CI]-0.36,-0.04),并减少了连续绩效任务(CPT)反应时间(效果,-0.40,95%CI-0.73,-0.07)在ADHD患者中。冲动性多动的评分略有下降(效果,-0.07,95%CI-0.23,0.09)。此外,执行功能得到改善(效果,0.71,95%CI0.37,1.04)。工作记忆的能力似乎增加了(效果,0.48,95%CI0.21,0.76)。敏感性分析的视觉评估表明不存在异质性,未发现明显的发表偏倚。
    基于现有的文献证据,我们得出的结论是,数字化治疗可以成为ADHD患者的一种有希望的治疗策略.
    UNASSIGNED: Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that commonly occurs in childhood. The aim of this meta-analysis was to summarize the available evidence for the efficacy of digital therapeutics in children and adolescents with ADHD.
    UNASSIGNED: We searched the MEDLINE, EMBASE, Cochrane Library (Cochrane Database of Systematic Reviews), and Web of Science (science and social science citation index) databases for relevant studies and used Stata 15.0 software to carry out the meta-analysis.
    UNASSIGNED: A total of 31 studies involving 2169 participants (1665 boys and 504 girls) aged 4-17 years old were included in the final analysis. The meta-analysis results showed that digital interventions improved the symptoms of inattention with an effect value of -0.20 (95% confidence interval [CI] -0.36, -0.04) and decreased the continuous performance task (CPT) reaction time (effect, -0.40, 95% CI -0.73, -0.07) in ADHD patients. The score for impulsive hyperactivity was slightly decreased (effect, -0.07, 95% CI -0.23, 0.09). Moreover, executive function was improved (effect, 0.71, 95% CI 0.37, 1.04). The capability of working memory appeared to be increased (effect, 0.48, 95% CI 0.21, 0.76) between the two groups. Visual appraisal of the sensitivity analysis suggested the absence of heterogeneity, and no obvious publication bias was detected.
    UNASSIGNED: Based on the existing literature evidence, we conclude that digital therapy can be a promising therapeutic strategy for ADHD patients.
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