Biological markers in noninvasive brain stimulation trials in major depressive disorder: a systematic review.
Biological markers in noninvasive brain stimulation trials in major depressive disorder: a systematic review.
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DOI：
10.1097/yct.0b013e31828b34d8
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发表时间：
2014-03
期刊：
影响因子：
--
通讯作者：
Fregni F
中科院分区：
文献类型：
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作者：
Fidalgo TM;Morales-Quezada JL;Muzy GS;Chiavetta NM;Mendonca ME;Santana MV;Goncalves OF;Brunoni AR;Fregni F
经颅磁刺激（TMS）和经颅直流电刺激（tDCS）对重度抑郁症患者的治疗效果已显示出可喜的结果；然而，缺乏使用生物标记（BM）作为结果的机制研究。因此，我们的目的是回顾使用 BM 治疗抑郁症的非侵入性脑刺激试验。我们的系统评价使用了以下数据库：MEDLINE、Web of Science、Cochrane 和 SCIELO。我们检查了 2012 年 11 月之前发表的文章，这些文章使用 TMS 和 tDCS 作为抑郁症的干预措施，并以 BM 作为结果衡量标准。搜索仅限于用英语撰写的人类研究。在 1234 篇潜在文章中，有 52 篇论文被纳入。仅发现使用 TMS 的研究。 BM 包括免疫和内分泌血清标志物、神经影像技术和电生理结果。在 12 篇文章 (21.4%) 中，终点 BM 测量与临床结果没有显着相关。所有研究在主要临床评级量表中均取得了显着结果。 BM 结果被用作反应的预测因子，以了解 TMS 的机制，并作为安全性的替代指标。 fMRI、SPECT、PET、MRS、皮质兴奋性和 BDNF 始终显示出阳性结果。 BDNF 是患者反应可能性的最佳预测指标。这些初步结果是有希望的；然而，所有调查 BM 的研究规模都很小，使用的样本异质，并且没有考虑年龄、性别或家族史等混杂因素。根据我们的发现，我们建议进一步研究以验证 MDD 非侵入性脑刺激试验中的 BM。
The therapeutic effects of Transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) in patients with major depression have shown promising results; however, there is a lack of mechanistic studies using biological markers (BM) as an outcome. Therefore, our aim was to review non-invasive brain stimulation trials in depression using BM. The following databases were used for our systematic review: MEDLINE, Web of Science, Cochrane, and SCIELO. We examined articles published before November 2012 that used TMS and tDCS as an intervention for depression and had BM as an outcome measure. The search was limited to human studies written in English. Of 1234 potential articles, 52 papers were included. Only studies using TMS were found. BM included immune and endocrine serum markers, neuroimaging techniques and electrophysiological outcomes. In 12 articles (21.4%) endpoint BM measurements were not significantly associated with clinical outcomes. All studies reached significant results in the main clinical rating scales. BM outcomes were used as predictors of response, to understand mechanisms of TMS, and as a surrogate of safety. fMRI, SPECT, PET, MRS, cortical excitability and BDNF consistently showed positive results. BDNF was the best predictor of patients’ likeliness to respond. These initial results are promising; however, all studies investigating BM are small, used heterogeneous samples, and did not take into account confounders such as age, gender or family history. Based on our findings we recommend further studies to validate BM in non-invasive brain stimulation trials in MDD.