Sergi López-Rodríguez, David R A Coelho, Christian Renet, Willians Fernando Vieira, Ümit Tural, Paolo Cassano, Joan A Camprodon
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引用次数: 0
摘要
神经发育障碍(ndd)影响大脑发育,导致各种认知、社会、行为和情感障碍。非侵入性脑刺激(NIBS)技术,如经颅磁刺激(TMS)、经颅直流电刺激(tDCS)和经颅光生物调节(tPBM),已被研究作为ndd的潜在治疗方法。本系统综述的作者对NIBS治疗ndd的文献进行了评估,包括双盲、假对照和随机对照试验。根据PRISMA指南和注册方案,作者在PubMed、Embase、Cochrane Central Register of Controlled Trials、PsycInfo和Scopus中进行了全面检索,确定了23项研究。经颅磁刺激有望解决注意力缺陷多动障碍(ADHD)的多动、注意力不集中和工作记忆缺陷,其结果受线圈类型(H5 vs. H6)和刺激部位(右vs.左背外侧前额叶皮层)的影响。tDCS显示出改善ADHD患者注意力不集中和执行功能的潜力,但在减轻自闭症谱系障碍(ASD)和阅读障碍的症状严重程度方面观察到的效果有限。tPBM在减少ASD的易怒方面提供了特定的治疗益处。虽然NIBS通常表现出轻微的、短暂的不良反应,但孤立的癫痫发作事件,如ADHD患者在经颅磁刺激期间发生的一次,强调了严格的安全方案的重要性,特别是在癫痫风险升高的ndd中。本综述确定了某些NIBS方案在ndd中的潜在益处;然而,方法的高度可变性、样本量的限制和对偏倚的担忧强调了进一步研究的必要性,以阐明NIBS对ndd患者的治疗效果和安全性。
Noninvasive Brain Stimulation for Neurodevelopmental Disorders: A Systematic Review.
Neurodevelopmental disorders (NDDs) affect brain development, leading to diverse cognitive, social, behavioral, and affective impairments. Noninvasive brain stimulation (NIBS) techniques, such as transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), and transcranial photobiomodulation (tPBM), have been investigated as potential treatments for NDDs. The authors of this systematic review evaluated the literature on NIBS in NDDs, including double-blind, sham-controlled, randomized controlled trials. Following PRISMA guidelines and a registered protocol, the authors conducted a comprehensive search in PubMed, Embase, Cochrane Central Register of Controlled Trials, PsycInfo, and Scopus, identifying 23 studies. TMS showed promise for addressing hyperactivity, inattention, and working memory deficits in attention-deficit hyperactivity disorder (ADHD), with outcomes influenced by coil type (H5 vs. H6) and stimulation site (right vs. left dorsolateral prefrontal cortex). tDCS showed potential for improving inattention and executive function in ADHD, with limited effects observed on reducing symptom severity in autism spectrum disorder (ASD) and dyslexia. tPBM offered specific therapeutic benefits in reducing irritability in ASD. Although NIBS generally showed mild, transient adverse effects, isolated seizure events, such as one during TMS in ADHD, highlight the importance of rigorous safety protocols, especially in NDDs with elevated epilepsy risk. This review identified potential benefits of certain NIBS protocols in NDDs; however, high variability in methodologies, sample size limitations, and bias concerns underscore the need for further research to clarify the therapeutic efficacy and safety of NIBS among patients with NDDs.
期刊介绍:
As the official Journal of the American Neuropsychiatric Association, the premier North American organization of clinicians, scientists, and educators specializing in behavioral neurology & neuropsychiatry, neuropsychology, and the clinical neurosciences, the Journal of Neuropsychiatry and Clinical Neurosciences (JNCN) aims to publish works that advance the science of brain-behavior relationships, the care of persons and families affected by neurodevelopmental, acquired neurological, and neurodegenerative conditions, and education and training in behavioral neurology & neuropsychiatry. JNCN publishes peer-reviewed articles on the cognitive, emotional, and behavioral manifestations of neurological conditions, the structural and functional neuroanatomy of idiopathic psychiatric disorders, and the clinical and educational applications and public health implications of scientific advances in these areas. The Journal features systematic reviews and meta-analyses, narrative reviews, original research articles, scholarly considerations of treatment and educational challenges in behavioral neurology & neuropsychiatry, analyses and commentaries on advances and emerging trends in the field, international perspectives on neuropsychiatry, opinions and introspections, case reports that inform on the structural and functional bases of neuropsychiatric conditions, and classic pieces from the field’s rich history.