A meta-analysis of cortical inhibition and excitability using transcranial magnetic stimulation in psychiatric disorders
A meta-analysis of cortical inhibition and excitability using transcranial magnetic stimulation in psychiatric disorders
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DOI：
10.1016/j.clinph.2013.01.014
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发表时间：
2013-07-01
影响因子：
4.7
通讯作者：
Daskalakis, Zafiris J.
中科院分区：
文献类型：
--
作者：
Radhu, Natasha;de Jesus, Danilo R.;Daskalakis, Zafiris J.
目的：评价经颅磁刺激(TMS)对强迫症(OCD)、重度抑郁障碍(MDD)和精神分裂症(SCZ)患者的抑制和兴奋作用。方法：采用短间期皮质抑制(SICI)、皮层静止期(CSP)、静息运动阈值、皮层内易化和运动诱发电位波幅。结果：强迫症患者SICI降低(g=0.572，95%可信区间[0.179，0.966]，p=0.004)，皮质内促进作用增强(g=0.446，95%可信区间[0.042，0.849]，p=0.030)，CSP降低(g=-0.466，95%可信区间[-0.881，-0.052]，p=0.027)。对于MDD，SICI降低(g=0.641，95%可信区间[0.384，0.898]，p=0.000)和CSP缩短(g=-1.232，95%可信区间[-1.530，-0.933]，p=0.000)具有显著的效应大小。结论：抑制缺陷在强迫症、中枢性痴呆、强迫症中普遍存在，皮层内易化作用的增强是强迫症所特有的。意义：提供一个可用于开发诊断程序的明确平台。(C)2013年国际临床神经生理学联合会。爱思唯尔爱尔兰有限公司出版。版权所有。
Objective: To evaluate transcranial magnetic stimulation (TMS) measures of inhibition and excitation in obsessive-compulsive disorder (OCD), major depressive disorder (MDD) and schizophrenia (SCZ).Methods: Paradigms included: short-interval cortical inhibition (SICI), cortical silent period (CSP), resting motor threshold, intracortical facilitation, and motor evoked potential amplitude. A literature search was performed using PubMed, Ovid Medline, Embase Psychiatry and PsycINFO 1990 through April 2012.Results: A significant Hedge's g was found for decreased SICI (g = 0.572, 95% confidence interval [0.179, 0.966], p = 0.004), enhanced intracortical facilitation (g = 0.446, 95% confidence interval [0.042, 0.849], p = 0.030) and decreased CSP (g = -0.466, 95% confidence interval [-0.881, -0.052], p = 0.027) within the OCD population. For MDD, significant effect sizes were demonstrated for decreased SICI (g = 0.641, 95% confidence interval [0.384, 0.898], p = 0.000) and shortened CSP (g = -1.232, 95% confidence interval [-1.530, -0.933], p = 0.000). In SCZ, a significant Hedge's g was shown for decreased SICI (g = 0.476, 95% confidence interval [0.331, 0.620], p = 0.000).Conclusion: Inhibitory deficits are a ubiquitous finding across OCD, MDD, SCZ and enhancement of intracortical facilitation is specific to OCD. Significance: Provides a clear platform from which diagnostic procedures can be developed. (C) 2013 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.