Efficacy and safety of repetitive Transcranial Magnetic Stimulation and transcranial Direct Current Stimulation in memory deficits in patients with Alzheimer's disease: Meta-analysis and systematic review

IF 5.3 1区心理学 Q1 PSYCHOLOGY, CLINICAL International Journal of Clinical and Health Psychology Pub Date : 2024-03-01 DOI:10.1016/j.ijchp.2024.100452

Sara M. Fernandes , Augusto J. Mendes , Pedro F.S. Rodrigues , Ana Conde , Magda Rocha , Jorge Leite

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Abstract

Repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) are two of the most used non-pharmacological interventions for Alzheimer's Disease (AD). However, most of the clinical trials have focused on evaluating the effects on global cognition and not on specific cognitive functions. Therefore, considering that memory loss is one of the hallmark symptoms of AD, we aim to assess the efficacy and safety of tDCS and rTMS in memory deficits. For that, multilevel random effect models were performed considering the standardized mean difference (SMD) between active and sham stimulation. A total of 19 studies with 411 participants demonstrated positive effects in memory after tDCS (SMD=0.20, p = 0.04) and rTMS (SMD=0.44, p = 0.001). Subgroup analysis revealed that tDCS had greater efficacy when administered in temporal regions (SMD=0.32, p = 0.04), whereas rTMS was superior when applied in frontal regions (SMD=0.61, p < 0.001). Therefore, depending on the brain region of stimulation, both interventions produced a positive effect on memory symptoms in AD patients. Finally, the safety of both techniques was observed in the AD population after the reporting of almost no serious events.

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重复经颅磁刺激和经颅直流电刺激对阿尔茨海默病患者记忆障碍的疗效和安全性：元分析和系统综述

重复经颅磁刺激（rTMS）和经颅直流电刺激（tDCS）是治疗阿尔茨海默病（AD）最常用的两种非药物干预方法。然而，大多数临床试验都侧重于评估对整体认知的影响，而不是对特定认知功能的影响。因此，考虑到记忆力减退是阿尔茨海默病的标志性症状之一，我们旨在评估 tDCS 和经颅磁刺激对记忆力减退的疗效和安全性。为此，我们建立了多层次随机效应模型，考虑了主动刺激和假刺激之间的标准化平均差（SMD）。共有 19 项研究的 411 名参与者证明，tDCS（SMD=0.20，p = 0.04）和经频磁刺激（SMD=0.44，p = 0.001）对记忆力有积极影响。分组分析表明，在颞叶区域施用 tDCS 的疗效更好（SMD=0.32，p = 0.04），而在额叶区域施用 rTMS 的疗效更好（SMD=0.61，p < 0.001）。因此，根据刺激脑区的不同，两种干预方法都能对注意力缺失症患者的记忆症状产生积极影响。最后，这两种技术在AD人群中几乎没有发生严重事件，因此安全性得到了认可。

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来源期刊

International Journal of Clinical and Health Psychology PSYCHOLOGY, CLINICAL-

CiteScore

10.70

自引率

5.70%

发文量

审稿时长

33 days

期刊介绍： The International Journal of Clinical and Health Psychology is dedicated to publishing manuscripts with a strong emphasis on both basic and applied research, encompassing experimental, clinical, and theoretical contributions that advance the fields of Clinical and Health Psychology. With a focus on four core domains—clinical psychology and psychotherapy, psychopathology, health psychology, and clinical neurosciences—the IJCHP seeks to provide a comprehensive platform for scholarly discourse and innovation. The journal accepts Original Articles (empirical studies) and Review Articles. Manuscripts submitted to IJCHP should be original and not previously published or under consideration elsewhere. All signing authors must unanimously agree on the submitted version of the manuscript. By submitting their work, authors agree to transfer their copyrights to the Journal for the duration of the editorial process.