{"title":"青少年抑郁症的非侵入性神经调节治疗:系统回顾和荟萃分析。","authors":"Mingcong Tang, Yi Zheng, Xiwen Zhang, Xiwang Fan","doi":"10.1016/j.psychres.2024.116329","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Synthesized evidence regarding the effectiveness of non-invasive neuromodulation treatment for adolescents remains scarce. This study aimed to perform the first meta-analysis of the impact of neuromodulation treatment on depressive symptoms in adolescents.</div></div><div><h3>Methods</h3><div>According to the PRISMA guidelines, a comprehensive review covering databases in English and Chinese from their inception to November 30, 2023, was conducted. Data were pooled to compute the standardized mean difference (SMD) and risk ratio (RR), along with their respective 95 % confidence intervals (CI).</div></div><div><h3>Results</h3><div>A total of 27 studies involving 2075 participants were included and examined. Noninvasive neuromodulation treatment demonstrated significant positive effects on depression symptoms compared with controlled conditions (Hamilton Depression Scale (HAMD) 17: SMD = 3.503, 95 % CI = 2.404–4.602, <em>p</em> < 0.001; HAMD 24: SMD = 3.375, 95 % CI = 2.437–4.314, <em>p</em> < 0.001). High heterogeneity was observed (I<sup>2</sup> = 95.2 % and 97.2 %, <em>p</em> < 0.01), along with a substantial risk of publication bias (<em>p</em> < 0.05). In terms of the treatment response, the RR reached 1.39 (95 % CI = 1.29–1.50, <em>p</em> < 0.001), with low heterogeneity (I<sup>2</sup> = 35 %, <em>p</em> = 0.07).</div></div><div><h3>Conclusions</h3><div>Noninvasive neuromodulation treatment significant alleviated depressive symptoms in adolescents. Future research should prioritize conducting high-quality clinical trials to determine the suitable selection of adolescent patients for this treatment. In addition, these trials can help guide precision medicine approaches for stimulation protocols.</div></div>","PeriodicalId":20819,"journal":{"name":"Psychiatry Research","volume":"344 ","pages":"Article 116329"},"PeriodicalIF":4.2000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Non-invasive neuromodulation treatment for depression in adolescents: A systematic review and meta-analysis\",\"authors\":\"Mingcong Tang, Yi Zheng, Xiwen Zhang, Xiwang Fan\",\"doi\":\"10.1016/j.psychres.2024.116329\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Synthesized evidence regarding the effectiveness of non-invasive neuromodulation treatment for adolescents remains scarce. This study aimed to perform the first meta-analysis of the impact of neuromodulation treatment on depressive symptoms in adolescents.</div></div><div><h3>Methods</h3><div>According to the PRISMA guidelines, a comprehensive review covering databases in English and Chinese from their inception to November 30, 2023, was conducted. Data were pooled to compute the standardized mean difference (SMD) and risk ratio (RR), along with their respective 95 % confidence intervals (CI).</div></div><div><h3>Results</h3><div>A total of 27 studies involving 2075 participants were included and examined. Noninvasive neuromodulation treatment demonstrated significant positive effects on depression symptoms compared with controlled conditions (Hamilton Depression Scale (HAMD) 17: SMD = 3.503, 95 % CI = 2.404–4.602, <em>p</em> < 0.001; HAMD 24: SMD = 3.375, 95 % CI = 2.437–4.314, <em>p</em> < 0.001). High heterogeneity was observed (I<sup>2</sup> = 95.2 % and 97.2 %, <em>p</em> < 0.01), along with a substantial risk of publication bias (<em>p</em> < 0.05). In terms of the treatment response, the RR reached 1.39 (95 % CI = 1.29–1.50, <em>p</em> < 0.001), with low heterogeneity (I<sup>2</sup> = 35 %, <em>p</em> = 0.07).</div></div><div><h3>Conclusions</h3><div>Noninvasive neuromodulation treatment significant alleviated depressive symptoms in adolescents. Future research should prioritize conducting high-quality clinical trials to determine the suitable selection of adolescent patients for this treatment. In addition, these trials can help guide precision medicine approaches for stimulation protocols.</div></div>\",\"PeriodicalId\":20819,\"journal\":{\"name\":\"Psychiatry Research\",\"volume\":\"344 \",\"pages\":\"Article 116329\"},\"PeriodicalIF\":4.2000,\"publicationDate\":\"2025-02-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Psychiatry Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0165178124006140\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PSYCHIATRY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Psychiatry Research","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0165178124006140","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHIATRY","Score":null,"Total":0}
引用次数: 0
摘要
背景:关于青少年非侵入性神经调节治疗有效性的综合证据仍然很少。本研究旨在对神经调节治疗对青少年抑郁症状的影响进行首次荟萃分析。方法:根据PRISMA指南,对该数据库自成立至2023年11月30日的中英文数据库进行综合评价。将数据合并计算标准化平均差(SMD)和风险比(RR),以及它们各自的95%置信区间(CI)。结果:共纳入27项研究,涉及2075名受试者。与对照组相比,无创神经调节治疗对抑郁症状有显著的积极作用(汉密尔顿抑郁量表(HAMD) 17: SMD = 3.503, 95% CI = 2.404 ~ 4.602, p < 0.001;HAMD 24: SMD = 3.375, 95% CI = 2.437 ~ 4.314, p < 0.001)。观察到高度异质性(I2 = 95.2%和97.2%,p < 0.01),以及相当大的发表偏倚风险(p < 0.05)。在治疗反应方面,RR为1.39 (95% CI = 1.29-1.50, p < 0.001),异质性较低(I2 = 35%, p = 0.07)。结论:无创神经调节治疗可显著缓解青少年抑郁症状。未来的研究应优先进行高质量的临床试验,以确定青少年患者的合适选择。此外,这些试验可以帮助指导刺激方案的精准医学方法。
Non-invasive neuromodulation treatment for depression in adolescents: A systematic review and meta-analysis
Background
Synthesized evidence regarding the effectiveness of non-invasive neuromodulation treatment for adolescents remains scarce. This study aimed to perform the first meta-analysis of the impact of neuromodulation treatment on depressive symptoms in adolescents.
Methods
According to the PRISMA guidelines, a comprehensive review covering databases in English and Chinese from their inception to November 30, 2023, was conducted. Data were pooled to compute the standardized mean difference (SMD) and risk ratio (RR), along with their respective 95 % confidence intervals (CI).
Results
A total of 27 studies involving 2075 participants were included and examined. Noninvasive neuromodulation treatment demonstrated significant positive effects on depression symptoms compared with controlled conditions (Hamilton Depression Scale (HAMD) 17: SMD = 3.503, 95 % CI = 2.404–4.602, p < 0.001; HAMD 24: SMD = 3.375, 95 % CI = 2.437–4.314, p < 0.001). High heterogeneity was observed (I2 = 95.2 % and 97.2 %, p < 0.01), along with a substantial risk of publication bias (p < 0.05). In terms of the treatment response, the RR reached 1.39 (95 % CI = 1.29–1.50, p < 0.001), with low heterogeneity (I2 = 35 %, p = 0.07).
Conclusions
Noninvasive neuromodulation treatment significant alleviated depressive symptoms in adolescents. Future research should prioritize conducting high-quality clinical trials to determine the suitable selection of adolescent patients for this treatment. In addition, these trials can help guide precision medicine approaches for stimulation protocols.
期刊介绍:
Psychiatry Research offers swift publication of comprehensive research reports and reviews within the field of psychiatry.
The scope of the journal encompasses:
Biochemical, physiological, neuroanatomic, genetic, neurocognitive, and psychosocial determinants of psychiatric disorders.
Diagnostic assessments of psychiatric disorders.
Evaluations that pursue hypotheses about the cause or causes of psychiatric diseases.
Evaluations of pharmacologic and non-pharmacologic psychiatric treatments.
Basic neuroscience studies related to animal or neurochemical models for psychiatric disorders.
Methodological advances, such as instrumentation, clinical scales, and assays directly applicable to psychiatric research.