经颅直流电刺激（tDCS）治疗强迫症（OCD）患者的疗效和安全性：随机对照试验的系统回顾和荟萃分析

IF 7.5 1区医学 Q1 BEHAVIORAL SCIENCES

Neuroscience and Biobehavioral Reviews Pub Date : 2025-04-21 DOI:10.1016/j.neubiorev.2025.106171

Reza Moshfeghinia , Amirhossein Najibi , Fahimeh Golabi , Mehrnaz Moradi , Mahdi Malekpour , Saeed Abdollahifard , Konstantin Slavin , Ali Razmkon

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引用次数: 0

摘要

经颅直流电刺激（tDCS）治疗强迫症（OCD）越来越受关注，但其有效性和安全性仍不确定。随机对照试验（rct）的系统评价将评估其减轻症状的临床益处。方法检索scopus、PubMed、Web of Science、Cochrane、PsycINFO、Cochrane central等6个数据库进行相关研究检索。纳入的研究是随机对照试验，评估了tDCS对强迫症症状的影响，以及对焦虑和抑郁的影响，同时也评估了不良事件（ae）。采用rob2工具分析偏倚风险（risk of bias， ROB）。采用Stata-17软件进行meta分析。结果治疗后，与假手术组相比，tDCS显著降低了强迫症患者的Y-BOCS评分（SMD = - 0.56[-0.87, - 0.26]）、焦虑评分（SMD = - 1.11[-1.85, - 0.37]）和抑郁评分（SMD = - 1.57[-2.64, - 0.50]），同时提高了强迫症患者的CGI-S评分（SMD = 0.40[0.08, 0.72]）。在随访期间（治疗后1-2个月），tDCS继续降低Y-BOCS评分（SMD = - 0.69[-1.22, - 0.17]）、焦虑评分（SMD = - 1.13[-3.05, - 0.78]）和抑郁评分（SMD = - 2.02[-3.00, - 1.04]），但与假手术组相比，对CGI-S评分没有影响。此外，分析显示活动tDCS组和假手术组的ae无显著差异（OR: 1.20[0.86, 1.68]）。结论：tDCS可有效缓解强迫症症状及相关抑郁和焦虑，急性期和随访期均可，且不良事件发生率极低。

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Efficacy and safety of transcranial direct current stimulation (tDCS) in patients with obsessive-compulsive disorder (OCD): A systematic review and meta-analysis of randomized controlled trials

Background

Transcranial direct current stimulation (tDCS) is gaining traction for treating obsessive-compulsive disorder (OCD), but its effectiveness and safety remain uncertain. A systematic review of randomized controlled trials (RCTs) will assess its clinical benefits for symptom reduction.

Methods

Six databases—Scopus, PubMed, Web of Science, Cochrane, PsycINFO, and Cochrane Central—were searched to identify relevant studies. The included studies were RCTs that assessed the effects of tDCS on OCD symptoms, as well as its impact on anxiety and depression, while also evaluating adverse events (AEs). The risk of bias (ROB) was analyzed using the ROB-2 tool. A meta-analysis was performed utilizing Stata-17 software.

Results

Immediately following treatment, the analysis revealed that tDCS significantly reduced the Y-BOCS score (SMD = −0.56 [-0.87, −0.26]), anxiety scores (SMD = −1.11 [-1.85, −0.37]), and depression scores (SMD = −1.57 [-2.64, −0.50]), while increasing CGI-S scores (SMD = 0.40 [0.08, 0.72]) in OCD patients compared to the sham group. During the follow-up period (1–2 months post-treatment), tDCS continued to decrease the Y-BOCS score (SMD = −0.69 [-1.22, −0.17]), anxiety scores (SMD = −1.13 [-3.05, −0.78]), and depression scores (SMD = −2.02 [-3.00, −1.04]), but showed no effect on CGI-S scores when compared to the sham group. Additionally, the analysis indicated no significant differences in AEs between active tDCS and the sham group (OR: 1.20 [0.86, 1.68]).

Conclusions

This review suggests that tDCS may effectively alleviate OCD symptoms, along with related depression and anxiety, both acute and at follow-up, while causing minimal AEs.

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来源期刊

Neuroscience and Biobehavioral Reviews 医学-行为科学

CiteScore

14.20

自引率

3.70%

发文量

466

审稿时长

6 months

期刊介绍： The official journal of the International Behavioral Neuroscience Society publishes original and significant review articles that explore the intersection between neuroscience and the study of psychological processes and behavior. The journal also welcomes articles that primarily focus on psychological processes and behavior, as long as they have relevance to one or more areas of neuroscience.