■病理性焦虑是导致焦虑症(AD)的主要功能损害和对常规治疗的抵抗力的原因,创伤后应激障碍(PTSD)和重度抑郁症(MDD)。局灶性神经调节疗法,如经颅磁刺激(TMS),正在开发经颅直流电刺激(tDCS)和深部脑刺激(DBS)来治疗这些疾病。
■我们进行了维度系统评价和荟萃分析,以评估TMS疗效的证据,TDCS和DBS在减少广告中的焦虑症状,PTSD和MDD。报告是通过PubMed/Medline系统搜索确定的,Scopus和Cochrane图书馆(成立至2020年11月),然后根据PRISMA指南进行审查。对照临床试验,检查脑刺激技术对AD患者的一般焦虑症状的有效性,选择PTSD或MDD。
■19项研究(RCT)符合纳入标准,其中包括589名参与者。总的来说,与对照组相比,局灶性脑活动调节干预与焦虑水平降低更大相关[SMD:-0.56(95%CI,-0.93~-0.20,I2=77%].亚组分析揭示了TMS在各种疾病中的积极作用,以及广泛性焦虑症和PTSD的局灶性神经调节。在活动条件下,临床反应和缓解率较高。然而,在大多数研究中,偏倚风险较高.
■有中等质量的证据证明神经调节治疗病理性焦虑的功效。
■https://www.crd.约克。AC.uk/prospro/display_record.php?RecordID=233084,标识符:PROSPEROCRD42021233084。它是1月29日提交的,2021年3月1日注册,2021年。没有对记录的议定书进行修改。根据目标大脑区域对亚组分析进行了更改,我们增加了脑活动调节的假定性质(兴奋性/抑制性)。
UNASSIGNED: Pathological anxiety is responsible for major functional impairments and resistance to conventional treatments in anxiety disorders (ADs), posttraumatic stress disorder (PTSD) and major depressive disorder (MDD). Focal neuromodulation therapies such as transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS) and deep brain stimulation (DBS) are being developed to treat those disorders.
UNASSIGNED: We performed a dimensional systematic review and meta-analysis to assess the evidence of the efficacy of TMS, tDCS and DBS in reducing anxiety symptoms across ADs, PTSD and MDD. Reports were identified through systematic searches in PubMed/Medline, Scopus and Cochrane library (inception to November 2020), followed by review according to the PRISMA guidelines. Controlled clinical trials examining the effectiveness of brain stimulation techniques on generic anxiety symptoms in patients with ADs, PTSD or MDD were selected.
UNASSIGNED: Nineteen studies (RCTs) met inclusion criteria, which included 589 participants. Overall, focal brain activity modulation interventions were associated with greater reduction of anxiety levels than controls [SMD: -0.56 (95% CI, -0.93 to-0.20, I 2 = 77%]. Subgroup analyses revealed positive effects for TMS across disorders, and of focal neuromodulation in generalized anxiety disorder and PTSD. Rates of clinical responses and remission were higher in the active conditions. However, the risk of bias was high in most studies.
UNASSIGNED: There is moderate quality evidence for the efficacy of neuromodulation in treating pathological anxiety.
UNASSIGNED: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=233084, identifier: PROSPERO CRD42021233084. It was submitted on January 29th, 2021, and registered on March 1st, 2021. No amendment was made to the recorded protocol. A change was applied for the subgroup analyses based on target brain regions, we added the putative nature (excitatory/inhibitory) of brain activity modulation.