超越经颅磁刺激和电痉挛疗法的非侵入性、非惊厥性脑部刺激治疗晚期精神障碍：系统综述

Q3 Psychology

Journal of Affective Disorders Reports Pub Date : 2024-09-23 DOI:10.1016/j.jadr.2024.100844

Christian Wellnhofer , Claudia Preuschhof

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引用次数: 0

摘要

目的本系统综述旨在全面概述有关经颅磁刺激（TMS）和电休克疗法（ECT）之外的非侵入性、非惊厥性神经调控技术的研究，以解决通常发生在 60 岁及以上门诊患者身上的晚年精神障碍：PubMed、EBSCO（APA PsycInfo、APA PsycArticles、Psychology and Behavioral Sciences Collection、PSYNDEX Literature with PSYNDEX Tests）、Cochrane Library 和 Scopus。结果本系统综述共纳入 21 项研究记录，包括 6 项研究试验（其中只有两项是随机对照试验 (RCT)）和从其余 15 项记录中提取的 21 份病例报告。这些研究调查的主要干预措施包括经颅直流电刺激（tDCS）、三叉神经刺激（TNS）和光生物调节（PBM）。这些干预措施主要针对老年抑郁症，但也涉及双相情感障碍、分裂情感障碍、紧张性精神分裂症和创伤后应激障碍（PTSD）、结论针对晚年精神障碍的非侵入性、非抽搐性神经调节技术受到越来越多的研究关注。然而，目前还缺乏针对老年群体的、有充分证据支持的、精心设计的高质量研究。总体而言，tDCS、TNS 和 PBM 似乎是安全且耐受性良好的。考虑到与年龄相关的药物或心理治疗干预所面临的挑战，非侵入性神经调控可能是一种很有前景的治疗选择。

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Non-invasive, non-convulsive brain stimulation beyond TMS and ECT in late-life mental disorders: A systematic review

Objective

This systematic review aims to present a comprehensive overview of research studies investigating non-invasive, non-convulsive neuromodulation techniques, beyond transcranial magnetic stimulation (TMS) and electroconvulsive therapy (ECT), for addressing late-life mental disorders typically occurring in outpatient settings in individuals aged 60 years and older.

Methods

A systematic literature search was performed on four databases yielding 5022 records: PubMed, EBSCO (APA PsycInfo, APA PsycArticles, Psychology and Behavioral Sciences Collection, PSYNDEX Literature with PSYNDEX Tests), Cochrane Library and Scopus.

Results

A total of 21 study records were included in this systematic review, comprising 6 study trials, of which only two were randomized controlled trials (RCTs), and 21 case reports extracted from the remaining 15 records. The predominant interventions investigated across the studies included transcranial direct current stimulation (tDCS), trigeminal nerve stimulation (TNS), and photobiomodulation (PBM). These interventions were primarily explored in the context of geriatric depression, but also in bipolar disorder, schizoaffective disorder, catatonic schizophrenia, and post-traumatic stress disorder (PTSD).

Limitations

The limited amount of data, biases in conducted studies and a lack of generalizability (e.g., many case reports) currently prevent quantitatively supported evaluations of the interventions in the older population.

Conclusions

Non-invasive, non-convulsive neuromodulation techniques for late-life mental disorders receive growing research interest. There is, however, a lack of adequately powered and well-designed high-quality studies for older age groups. Overall tDCS, TNS and PBM appeared to be safe and well-tolerated. Considering age-related challenges in pharmacological or psychotherapeutic interventions, non-invasive neuromodulation could be a promising treatment option.

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