Repetitive Transcranial Magnetic Stimulation for Treatment of Autism Spectrum Disorder: A Systematic Review and Meta-Analysis.
Repetitive Transcranial Magnetic Stimulation for Treatment of Autism Spectrum Disorder: A Systematic Review and Meta-Analysis.
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DOI：
10.3389/fnint.2018.00027
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发表时间：
2018
影响因子：
3.5
通讯作者：
Oliveira-Maia AJ
中科院分区：
文献类型：
--
作者：
Barahona-Corrêa JB;Velosa A;Chainho A;Lopes R;Oliveira-Maia AJ
背景资料：自闭症谱系障碍（ASD）是一种神经发育障碍，表现为终身缺乏社交和互动，以及限制重复行为，兴趣和活动。虽然自闭症没有特定的药物或其他物理治疗方法，但近年来，重复经颅磁刺激（rTMS），一种用于非侵入性神经调节的技术，由于潜在的治疗价值而引起了人们的兴趣。在这里，我们报告了一个系统的文献综述和荟萃分析的结果，使用rTMS治疗ASD。研究方法：我们对PubMed、Web of Science、Science Direct、比勒费尔德学术搜索和教育资源信息交换中心进行了系统的文献检索。检索词反映了感兴趣的诊断和治疗方式。报告使用rTMS治疗核心ASD或ASD认知症状的研究符合条件。两名研究人员根据PRISMA指南独立进行文章选择和数据提取。ASD临床评分或认知能力的变化是主要结果。进行随机效应荟萃分析模型。结果如下：我们找到了23份合格的报告，包括4份病例报告，7项非对照临床试验和12项对照临床试验，比较了真实的TMS与等待列表对照（n = 6）或假治疗（n = 6）的效果。荟萃分析显示，对重复和刻板行为、社会行为和执行功能任务中的错误数量有显著但中等的影响，但对其他结果无影响。大多数研究存在中度至高度偏倚风险，主要是由于缺乏对治疗分配的受试者和评价者设盲。只有5项研究报告了这些增益的稳定性长达6个月，并描述了随着时间的推移而持续改善。结论：现有证据支持TMS可能有助于治疗ASD的某些方面。然而，这些证据必须谨慎对待，因为大多数研究没有充分控制安慰剂效应。此外，关于最有效的刺激参数、目标和时间表知之甚少。迫切需要进一步的随机、双盲、假对照试验，并有足够的随访期，以测试经颅磁刺激治疗这些疾病的疗效。现有的证据必须被视为初步的和不充分的，目前，以支持提供TMS治疗ASD。
Background: Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder manifesting as lifelong deficits in social communication and interaction, as well as restricted repetitive behaviors, interests and activities. While there are no specific pharmacological or other physical treatments for autism, in recent years repetitive Transcranial Magnetic Stimulation (rTMS), a technique for non-invasive neuromodulation, has attracted interest due to potential therapeutic value. Here we report the results of a systematic literature review and meta-analysis on the use of rTMS to treat ASD. Methods: We performed a systematic literature search on PubMed, Web of Science, Science Direct, Bielefeld Academic Search, and Educational Resources Information Clearinghouse. Search terms reflected diagnoses and treatment modalities of interest. Studies reporting use of rTMS to treat core ASD or cognitive symptoms in ASD were eligible. Two researchers performed article selection and data extraction independently, according to PRISMA guidelines. Changes in ASD clinical scores or in cognitive performance were the main outcomes. Random effects meta-analysis models were performed. Results: We found 23 eligible reports, comprising 4 case-reports, 7 non-controlled clinical trials, and 12 controlled clinical trials, comparing the effects of real TMS with waiting-list controls (n = 6) or sham-treatment (n = 6). Meta-analyses showed a significant, but moderate, effect on repetitive and stereotyped behaviors, social behavior, and number of errors in executive function tasks, but not other outcomes. Most studies had a moderate to high risk of bias, mostly due to lack of subject- and evaluator-blinding to treatment allocation. Only 5 studies reported stability of these gains for periods of up 6 months, with descriptions that improvements were sustained over time. Conclusions: Existing evidence supports that TMS could be useful to treat some dimensions of ASD. However, such evidence must be regarded with care, as most studies did not adequately control for placebo effects. Moreover, little is known regarding the most effective stimulation parameters, targets, and schedules. There is an urgent need for further randomized, double-blind, sham-controlled trials, with adequate follow-up periods, to test the efficacy of transcranial magnetic stimulation to treat these disorders. Available evidence must be regarded as preliminary and insufficient, at present, to support offering TMS to treat ASD.
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影响因子：
6.2
作者：
Kana, Rajesh K.;Maximo, Jose O.;Just, Marcel Adam
通讯作者：
Just, Marcel Adam
影响因子：
9.9
作者：
Casanova, MF;Buxhoeveden, DP;Roy, E
通讯作者：
Roy, E
影响因子：
2.6
作者：
Huettel, SA;McCarthy, G
通讯作者：
McCarthy, G
影响因子：
2.9
作者：
Casanova MF;Hensley MK;Sokhadze EM;El-Baz AS;Wang Y;Li X;Sears L
通讯作者：
Sears L
DOI：
10.1111/j.1460-9568.2011.07726.x
发表时间：
2011-07
期刊：
The European journal of neuroscience
影响因子：
--
作者：
Fecteau S;Agosta S;Oberman L;Pascual-Leone A
通讯作者：
Pascual-Leone A