Noninvasive brain stimulation for behavioural and psychological symptoms of dementia: A systematic review and meta-analysis
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo de conferência |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNESP |
Texto Completo: | http://dx.doi.org/10.1002/gps.5003 http://hdl.handle.net/11449/189670 |
Resumo: | Background: Pharmacological and conventional nonpharmacological treatments for behavioural and psychological symptoms of dementia (BPSD) have only modest efficacy. Furthermore, pharmacotherapy carries the risk of important side effects. Noninvasive brain stimulation (repetitive transcranial magnetic stimulation (TMS) or transcranial direct current stimulation (tDCS)) are valuable and safe for cognitive function in Alzheimer disease (AD). However, there have been few studies, and there is no consensus, regarding the use of these techniques to treat BPSD. Methods: We performed a systematic review of the literature and meta-analysis of studies reporting the effect of rTMS or tDCS on BPSD. Results: Seven articles were included: five randomized, controlled clinical trials and two open-label clinical trials. Five studies investigated the effects of rTMS and two the effects of tDCS. Both studies using tDCS reported no evidence of efficacy on BPSD, while two of the three RCTs using rTMS found statistically significant benefits. In an exploratory meta-analysis with four of the RCT studies, we did not find evidence of efficacy of noninvasive brain stimulation techniques, with an overall effect of −0.02 (95% CI = −0.90, 0.94; I2 = 85%). However, when we used only the data from the studies that applied rTMS, we found a positive effect on BPSD, with an overall effect of −0.58 (95% CI = −1.02, −0.14; I2 = 0%). With regards to the adverse effects reported, these were mild and not clinically relevant. Conclusions: Our results establish a tendency for efficacy of rTMS protocols on BPSD, while corroborating their safety and tolerability, suggesting the need for further research. |
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Noninvasive brain stimulation for behavioural and psychological symptoms of dementia: A systematic review and meta-analysisbehavioural and psychological symptoms of dementianeuropsychiatric symptoms of dementiatranscranial direct current stimulationtranscranial magnetic stimulationBackground: Pharmacological and conventional nonpharmacological treatments for behavioural and psychological symptoms of dementia (BPSD) have only modest efficacy. Furthermore, pharmacotherapy carries the risk of important side effects. Noninvasive brain stimulation (repetitive transcranial magnetic stimulation (TMS) or transcranial direct current stimulation (tDCS)) are valuable and safe for cognitive function in Alzheimer disease (AD). However, there have been few studies, and there is no consensus, regarding the use of these techniques to treat BPSD. Methods: We performed a systematic review of the literature and meta-analysis of studies reporting the effect of rTMS or tDCS on BPSD. Results: Seven articles were included: five randomized, controlled clinical trials and two open-label clinical trials. Five studies investigated the effects of rTMS and two the effects of tDCS. Both studies using tDCS reported no evidence of efficacy on BPSD, while two of the three RCTs using rTMS found statistically significant benefits. In an exploratory meta-analysis with four of the RCT studies, we did not find evidence of efficacy of noninvasive brain stimulation techniques, with an overall effect of −0.02 (95% CI = −0.90, 0.94; I2 = 85%). However, when we used only the data from the studies that applied rTMS, we found a positive effect on BPSD, with an overall effect of −0.58 (95% CI = −1.02, −0.14; I2 = 0%). With regards to the adverse effects reported, these were mild and not clinically relevant. Conclusions: Our results establish a tendency for efficacy of rTMS protocols on BPSD, while corroborating their safety and tolerability, suggesting the need for further research.Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Champalimaud Clinical Centre Champalimaud Centre for the UnknownDepartment of Psychiatry and Mental Health Hospital Beatriz ÂngeloLaboratorio de Neurociencias LIM27 Departamento e Instituto de Psiquiatria Hospital das Clinicas HCFMUSP Faculdade de Medicina Universidade de Sao PauloBiosciences Institute Universidade Estadual Paulista (UNESP)Dementia Study Group Institute of Molecular Medicine Faculdade de Medicina Universidade de LisboaPsychiatry and Psychology Departments Faculdade de Medicina Universidade de LisboaDepartment of Psychiatry and Mental Health Centro Hospitalar de Lisboa OcidentalNOVA School of Medicine Faculdade de Ciências Médicas Universidade Nova de LisboaChampalimaud Research Champalimaud Centre for the UnknownBiosciences Institute Universidade Estadual Paulista (UNESP)CNPq: 442795/2014-9CNPq: 466625/2014-6Champalimaud Centre for the UnknownHospital Beatriz ÂngeloUniversidade de São Paulo (USP)Universidade Estadual Paulista (Unesp)Universidade de LisboaCentro Hospitalar de Lisboa OcidentalUniversidade Nova de LisboaVacas, Sara M.Stella, Florindo [UNESP]Loureiro, Julia C.Simões do Couto, FredericoOliveira-Maia, Albino J.Forlenza, Orestes V.2019-10-06T16:48:22Z2019-10-06T16:48:22Z2019-01-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/conferenceObject1336-1345http://dx.doi.org/10.1002/gps.5003International Journal of Geriatric Psychiatry, v. 34, n. 9, p. 1336-1345, 2019.1099-11660885-6230http://hdl.handle.net/11449/18967010.1002/gps.50032-s2.0-85055165423Scopusreponame:Repositório Institucional da UNESPinstname:Universidade Estadual Paulista (UNESP)instacron:UNESPengInternational Journal of Geriatric Psychiatryinfo:eu-repo/semantics/openAccess2021-10-22T21:15:46Zoai:repositorio.unesp.br:11449/189670Repositório InstitucionalPUBhttp://repositorio.unesp.br/oai/requestopendoar:29462021-10-22T21:15:46Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)false |
dc.title.none.fl_str_mv |
Noninvasive brain stimulation for behavioural and psychological symptoms of dementia: A systematic review and meta-analysis |
title |
Noninvasive brain stimulation for behavioural and psychological symptoms of dementia: A systematic review and meta-analysis |
spellingShingle |
Noninvasive brain stimulation for behavioural and psychological symptoms of dementia: A systematic review and meta-analysis Vacas, Sara M. behavioural and psychological symptoms of dementia neuropsychiatric symptoms of dementia transcranial direct current stimulation transcranial magnetic stimulation |
title_short |
Noninvasive brain stimulation for behavioural and psychological symptoms of dementia: A systematic review and meta-analysis |
title_full |
Noninvasive brain stimulation for behavioural and psychological symptoms of dementia: A systematic review and meta-analysis |
title_fullStr |
Noninvasive brain stimulation for behavioural and psychological symptoms of dementia: A systematic review and meta-analysis |
title_full_unstemmed |
Noninvasive brain stimulation for behavioural and psychological symptoms of dementia: A systematic review and meta-analysis |
title_sort |
Noninvasive brain stimulation for behavioural and psychological symptoms of dementia: A systematic review and meta-analysis |
author |
Vacas, Sara M. |
author_facet |
Vacas, Sara M. Stella, Florindo [UNESP] Loureiro, Julia C. Simões do Couto, Frederico Oliveira-Maia, Albino J. Forlenza, Orestes V. |
author_role |
author |
author2 |
Stella, Florindo [UNESP] Loureiro, Julia C. Simões do Couto, Frederico Oliveira-Maia, Albino J. Forlenza, Orestes V. |
author2_role |
author author author author author |
dc.contributor.none.fl_str_mv |
Champalimaud Centre for the Unknown Hospital Beatriz Ângelo Universidade de São Paulo (USP) Universidade Estadual Paulista (Unesp) Universidade de Lisboa Centro Hospitalar de Lisboa Ocidental Universidade Nova de Lisboa |
dc.contributor.author.fl_str_mv |
Vacas, Sara M. Stella, Florindo [UNESP] Loureiro, Julia C. Simões do Couto, Frederico Oliveira-Maia, Albino J. Forlenza, Orestes V. |
dc.subject.por.fl_str_mv |
behavioural and psychological symptoms of dementia neuropsychiatric symptoms of dementia transcranial direct current stimulation transcranial magnetic stimulation |
topic |
behavioural and psychological symptoms of dementia neuropsychiatric symptoms of dementia transcranial direct current stimulation transcranial magnetic stimulation |
description |
Background: Pharmacological and conventional nonpharmacological treatments for behavioural and psychological symptoms of dementia (BPSD) have only modest efficacy. Furthermore, pharmacotherapy carries the risk of important side effects. Noninvasive brain stimulation (repetitive transcranial magnetic stimulation (TMS) or transcranial direct current stimulation (tDCS)) are valuable and safe for cognitive function in Alzheimer disease (AD). However, there have been few studies, and there is no consensus, regarding the use of these techniques to treat BPSD. Methods: We performed a systematic review of the literature and meta-analysis of studies reporting the effect of rTMS or tDCS on BPSD. Results: Seven articles were included: five randomized, controlled clinical trials and two open-label clinical trials. Five studies investigated the effects of rTMS and two the effects of tDCS. Both studies using tDCS reported no evidence of efficacy on BPSD, while two of the three RCTs using rTMS found statistically significant benefits. In an exploratory meta-analysis with four of the RCT studies, we did not find evidence of efficacy of noninvasive brain stimulation techniques, with an overall effect of −0.02 (95% CI = −0.90, 0.94; I2 = 85%). However, when we used only the data from the studies that applied rTMS, we found a positive effect on BPSD, with an overall effect of −0.58 (95% CI = −1.02, −0.14; I2 = 0%). With regards to the adverse effects reported, these were mild and not clinically relevant. Conclusions: Our results establish a tendency for efficacy of rTMS protocols on BPSD, while corroborating their safety and tolerability, suggesting the need for further research. |
publishDate |
2019 |
dc.date.none.fl_str_mv |
2019-10-06T16:48:22Z 2019-10-06T16:48:22Z 2019-01-01 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/conferenceObject |
format |
conferenceObject |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.1002/gps.5003 International Journal of Geriatric Psychiatry, v. 34, n. 9, p. 1336-1345, 2019. 1099-1166 0885-6230 http://hdl.handle.net/11449/189670 10.1002/gps.5003 2-s2.0-85055165423 |
url |
http://dx.doi.org/10.1002/gps.5003 http://hdl.handle.net/11449/189670 |
identifier_str_mv |
International Journal of Geriatric Psychiatry, v. 34, n. 9, p. 1336-1345, 2019. 1099-1166 0885-6230 10.1002/gps.5003 2-s2.0-85055165423 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
International Journal of Geriatric Psychiatry |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
1336-1345 |
dc.source.none.fl_str_mv |
Scopus reponame:Repositório Institucional da UNESP instname:Universidade Estadual Paulista (UNESP) instacron:UNESP |
instname_str |
Universidade Estadual Paulista (UNESP) |
instacron_str |
UNESP |
institution |
UNESP |
reponame_str |
Repositório Institucional da UNESP |
collection |
Repositório Institucional da UNESP |
repository.name.fl_str_mv |
Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP) |
repository.mail.fl_str_mv |
|
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1799965026838118400 |