Xinxin Yang , Lijun Ma , Chuan Fan , Huixue Wang , Mi Zhang , He Du , Tiangang Zhou , Xiaoming Li
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Randomized clinical trials that involved deep brain stimulation (DBS), electroconvulsive therapy (ECT), repetitive transcranial magnetic stimulation (rTMS), transcranial direct current stimulation (tDCS), sham therapy, or health control were included for analysis. The primary outcome was efficacy, while acceptability was considered as a secondary outcome.</div></div><div><h3>Results</h3><div>The sample consisted of 1333 patients with various anxiety disorders including social anxiety disorder, general anxiety disorder, panic disorder, social panic, obsessive-compulsive disorder, post-traumatic stress disorder, and agoraphobia, recruited from 41 trials with 86 treatment arms. Network meta-analysis showed that some BSTs had higher efficacy compared to controls, including DBS, ECT, cathodal tDCS, high-frequency rTMS (hf-rTMS), anodal tDCS, and low-frequency rTMS (lf-rTMS). Furthermore, hf-rTMS, lf-rTMS, and ECT had high acceptability in terms of odds ratio (OR).</div></div><div><h3>Limitations</h3><div>This study has limitations, including a focus on specific types of brain stimulation for anxiety disorders, OCD and PTSD and not considering factors like stimulation parameters. Future research should explore a broader range of technologies and parameters across various psychiatric and neurological conditions.</div></div><div><h3>Conclusion</h3><div>The study results suggest that BSTs are effective treatments for anxiety disorders, OCD and PTSD; lf-rTMS may be considered as the most promising option.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"370 ","pages":"Pages 62-75"},"PeriodicalIF":4.9000,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Efficacy and acceptability of brain stimulation for anxiety disorders, OCD, and PTSD: A systematic review and network meta-analysis of randomized controlled trials\",\"authors\":\"Xinxin Yang , Lijun Ma , Chuan Fan , Huixue Wang , Mi Zhang , He Du , Tiangang Zhou , Xiaoming Li\",\"doi\":\"10.1016/j.jad.2024.10.071\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>The present study aimed to conduct a systematic review and network meta-analysis to investigate the efficacy and acceptability of brain stimulation techniques (BSTs) for anxiety disorders, obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD).</div></div><div><h3>Methods</h3><div>A comprehensive search was performed in Embase, PubMed, Web of Science, PsycINFO, Cochrane, <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> and HowNet databases for studies published before September 10, 2023. Randomized clinical trials that involved deep brain stimulation (DBS), electroconvulsive therapy (ECT), repetitive transcranial magnetic stimulation (rTMS), transcranial direct current stimulation (tDCS), sham therapy, or health control were included for analysis. The primary outcome was efficacy, while acceptability was considered as a secondary outcome.</div></div><div><h3>Results</h3><div>The sample consisted of 1333 patients with various anxiety disorders including social anxiety disorder, general anxiety disorder, panic disorder, social panic, obsessive-compulsive disorder, post-traumatic stress disorder, and agoraphobia, recruited from 41 trials with 86 treatment arms. Network meta-analysis showed that some BSTs had higher efficacy compared to controls, including DBS, ECT, cathodal tDCS, high-frequency rTMS (hf-rTMS), anodal tDCS, and low-frequency rTMS (lf-rTMS). Furthermore, hf-rTMS, lf-rTMS, and ECT had high acceptability in terms of odds ratio (OR).</div></div><div><h3>Limitations</h3><div>This study has limitations, including a focus on specific types of brain stimulation for anxiety disorders, OCD and PTSD and not considering factors like stimulation parameters. 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Efficacy and acceptability of brain stimulation for anxiety disorders, OCD, and PTSD: A systematic review and network meta-analysis of randomized controlled trials
Background
The present study aimed to conduct a systematic review and network meta-analysis to investigate the efficacy and acceptability of brain stimulation techniques (BSTs) for anxiety disorders, obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD).
Methods
A comprehensive search was performed in Embase, PubMed, Web of Science, PsycINFO, Cochrane, ClinicalTrials.gov and HowNet databases for studies published before September 10, 2023. Randomized clinical trials that involved deep brain stimulation (DBS), electroconvulsive therapy (ECT), repetitive transcranial magnetic stimulation (rTMS), transcranial direct current stimulation (tDCS), sham therapy, or health control were included for analysis. The primary outcome was efficacy, while acceptability was considered as a secondary outcome.
Results
The sample consisted of 1333 patients with various anxiety disorders including social anxiety disorder, general anxiety disorder, panic disorder, social panic, obsessive-compulsive disorder, post-traumatic stress disorder, and agoraphobia, recruited from 41 trials with 86 treatment arms. Network meta-analysis showed that some BSTs had higher efficacy compared to controls, including DBS, ECT, cathodal tDCS, high-frequency rTMS (hf-rTMS), anodal tDCS, and low-frequency rTMS (lf-rTMS). Furthermore, hf-rTMS, lf-rTMS, and ECT had high acceptability in terms of odds ratio (OR).
Limitations
This study has limitations, including a focus on specific types of brain stimulation for anxiety disorders, OCD and PTSD and not considering factors like stimulation parameters. Future research should explore a broader range of technologies and parameters across various psychiatric and neurological conditions.
Conclusion
The study results suggest that BSTs are effective treatments for anxiety disorders, OCD and PTSD; lf-rTMS may be considered as the most promising option.
期刊介绍：
The Journal of Affective Disorders publishes papers concerned with affective disorders in the widest sense: depression, mania, mood spectrum, emotions and personality, anxiety and stress. It is interdisciplinary and aims to bring together different approaches for a diverse readership. Top quality papers will be accepted dealing with any aspect of affective disorders, including neuroimaging, cognitive neurosciences, genetics, molecular biology, experimental and clinical neurosciences, pharmacology, neuroimmunoendocrinology, intervention and treatment trials.
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