Efficacy and acceptability of noninvasive brain stimulation for treating posttraumatic stress disorder symptoms: A network meta-analysis of randomized controlled trials

被引：7

作者：

Tseng, Ping-Tao ^{[1
,2
,3
,4
,5
]}

Zeng, Bing-Yan ^{[3
,6
]}

Wang, Hung-Yu ^{[7
]}

Zeng, Bing-Syuan ^{[8
]}

Liang, Chih-Sung ^{[9
,10
,11
]}

Chen, Yang-Chieh Brian ^{[12
,13
]}

Stubbs, Brendon ^{[14
,15
]}

Carvalho, Andre F. ^{[16
]}

Brunoni, Andre R. ^{[17
,18
]}

Su, Kuan-Pin ^{[14
,19
,20
,21
,22
]}

Tu, Yu-Kang ^{[23
,24
]}

Wu, Yi-Cheng ^{[25
]}

Chen, Tien-Yu ^{[26
,27
,28
]}

Li, Dian-Jeng ^{[29
]}

Lin, Pao-Yen ^{[12
,13
,30
,31
]}

Chen, Yen-Wen ^{[2
]}

Hsu, Chih-Wei ^{[12
,13
]}

Hung, Kuo-Chuan ^{[32
]}

Shiue, Yow-Ling ^{[1
,3
]}

Li, Cheng-Ta ^{[5
,33
,34
,35
,36
]}

机构：

[1] Natl Sun Yat Sen Univ, Inst Precis Med, 70 Lienhai Rd, Kaohsiung 80424, Taiwan

[2] Prospect Clin Otorhinolaryngol & Neurol, Kaohsiung, Taiwan

[3] Natl Sun Yat Sen Univ, Inst Biomed Sci, Kaohsiung 80424, Taiwan

[4] Asia Univ, Coll Med & Hlth Sci, Dept Psychol, Taichung, Taiwan

[5] Taipei Vet Gen Hosp, Dept Psychiat, Taipei, Taiwan

[6] I Shou Univ, E Da Dachang Hosp, Dept Internal Med, Kaohsiung, Taiwan

[7] Kaohsiung Municipal Kai Syuan Psychiat Hosp, Kaohsiung, Taiwan

[8] I Shou Univ, E Da Hosp, Dept Internal Med, Kaohsiung, Taiwan

[9] Triserv Gen Hosp, Dept Psychiat, Beitou Branch, Taipei, Taiwan

[10] Natl Def Med Ctr, Sch Med, Taipei, Taiwan

[11] Natl Def Med Ctr, Grad Inst Med Sci, Taipei, Taiwan

[12] Kaohsiung Chang Gung Mem Hosp, Dept Psychiat, 123 Dapi Rd, Kaohsiung 833401, Taiwan

[13] Chang Gung Univ, Coll Med, 123 Dapi Rd, Kaohsiung 833401, Taiwan

[14] Inst Psychiat Psychol & Neurosci, Dept Psychol Med, London, England

[15] South London & Maudsley NHS Fdn Trust, Physiotherapy Dept, London SE5 8AZ, England

[16] Deakin Univ, Sch Med, Innovat Mental & Phys Hlth & Clin Treatment IMPACT, Barwon Hlth, POB 281, Geelong, Vic 3220, Australia

[17] Univ Sao Paulo, Natl Inst Biomarkers Psychiat, Fac Med, Dept & Inst Psiquiatria,Serv Interdisciplinary Neu, Sao Paulo, Brazil

[18] Univ Sao Paulo, Fac Med, Dept Ciencias Med, Sao Paulo, Brazil

[19] China Med Univ Hosp, Dept Psychiat, Taichung, Taiwan

[20] China Med Univ Hosp, Mind Body Interface Lab MBI Lab, Taichung, Taiwan

[21] China Med Univ, Coll Med, Taichung, Taiwan

[22] China Med Univ, An Nan Hosp, Tainan, Taiwan

[23] Natl Taiwan Univ, Inst Hlth Data Analyt & Stat, Coll Publ Hlth, Taipei, Taiwan

[24] Natl Taiwan Univ Hosp, Dept Dent, Taipei, Taiwan

[25] Landseed Int Hosp, Dept Sports Med, Taoyuan, Taiwan

[26] Triserv Gen Hosp, Dept Psychiat, Taipei, Taiwan

[27] Natl Def Med Ctr, Sch Med, Taipei, Taiwan

[28] Natl Yang Ming Chiao Tung Univ, Inst Brain Sci, Hsinchu, Taiwan

[29] Kaohsiung Municipal Kai Syuan Psychiat Hosp, Dept Addict Sci, Kaohsiung, Taiwan

[30] Kaohsiung Chang Gung Mem Hosp, Inst Translat Res Biomed Sci, Kaohsiung, Taiwan

[31] Chang Gung Univ, Coll Med, Kaohsiung, Taiwan

[32] Chi Mei Med Ctr, Dept Anesthesiol, 901 Zhonghua Rd, Tainan 710, Taiwan

[33] Natl Yang Ming Chiao Tung Univ, Sch Med, Div Psychiat, Taipei, Taiwan

[34] Natl Yang Ming Chiao Tung Univ, Inst Brain Sci, Sch Med, Hsinchu, Taiwan

[35] Natl Yang Ming Chiao Tung Univ, Brain Res Ctr, Sch Med, Hsinchu, Taiwan

[36] Taipei Vet Gen Hosp, Dept Psychiat, Div Community & Rehabil Psychiat, 201,Sec2,Shipai Rd, Taipei 11267, Taiwan

来源：

ACTA PSYCHIATRICA SCANDINAVICA | 2024年 / 150卷 / 01期

关键词：

network meta-analysis; non-invasive brain stimulation; post-traumatic stress disorder; rTMS; tDCS; TRANSCRANIAL MAGNETIC STIMULATION; DORSOLATERAL PREFRONTAL CORTEX; NERVE-STIMULATION; DOUBLE-BLIND; REPETITIVE TMS; BRIEF EXPOSURE; MOTOR CORTEX; SCHIZOPHRENIA; EXCITABILITY; GUIDELINES;

D O I：

10.1111/acps.13688

中图分类号：

R749 [精神病学];

学科分类号：

100205 ;

摘要：

IntroductionDespite its high lifetime prevalence rate and the elevated disability caused by posttraumatic stress disorder (PTSD), treatments exhibit modest efficacy. In consideration of the abnormal connectivity between the dorsolateral prefrontal cortex (DLPFC) and amygdala in PTSD, several randomized controlled trials (RCTs) addressing the efficacy of different noninvasive brain stimulation (NIBS) modalities for PTSD management have been undertaken. However, previous RCTs have reported inconsistent results. The current network meta-analysis (NMA) aimed to compare the efficacy and acceptability of various NIBS protocols in PTSD management.MethodsWe systematically searched ClinicalKey, Cochrane Central Register of Controlled Trials, Embase, ProQuest, PubMed, ScienceDirect, Web of Science, and to identify relevant RCTs. The targeted RCTs was those comparing the efficacy of NIBS interventions, such as transcranial direct current stimulation (tDCS), repetitive transcranial magnetic stimulation (rTMS), and transcutaneous cervical vagal nerve stimulation, in patients with PTSD. The NMA was conducted using a frequentist model. The primary outcomes were changes in the overall severity of PTSD and acceptability (to be specific, rates of dropouts for any reason).ResultsWe identified 14 RCTs that enrolled 686 participants. The NMA demonstrated that among the investigated NIBS types, high-frequency rTMS over bilateral DLPFCs was associated with the greatest reduction in overall PTSD severity. Further, in comparison with the sham controls, excitatory stimulation over the right DLPFC with/without excitatory stimulation over left DLPFC were associated with significant reductions in PTSD-related symptoms, including depression and anxiety symptoms, and overall PTSD severity.ConclusionsThis NMA demonstrated that excitatory stimulation over the right DLPFC with or without excitatory stimulation over left DLPFC were associated with significant reductions in PTSD-related symptoms. Trial registration: PROSPERO CRD42023391562.ConclusionsThis NMA demonstrated that excitatory stimulation over the right DLPFC with or without excitatory stimulation over left DLPFC were associated with significant reductions in PTSD-related symptoms. Trial registration: PROSPERO CRD42023391562.

引用

页码：5 / 21

页数：17

共 83 条

[1] Hippocampal dysfunction effects on context memory: Possible etiology for posttraumatic stress disorder [J].