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(Referência obtida automaticamente do Web of Science, por meio da informação sobre o financiamento pela FAPESP e o número do processo correspondente, incluída na publicação pelos autores.)

Noninvasive brain stimulation for behavioural and psychological symptoms of dementia: A systematic review and meta-analysis

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Autor(es):
Vacas, Sara M. [1, 2] ; Stella, Florindo [3, 4] ; Loureiro, Julia C. [3] ; do Couto, Frederico Simoes [5, 6, 7] ; Oliveira-Maia, Albino J. [1, 8, 9, 10] ; Forlenza, Orestes V. [3]
Número total de Autores: 6
Afiliação do(s) autor(es):
[1] Champalimaud Ctr Unknown, Champalimaud Clin Ctr, Lisbon - Portugal
[2] Hosp Beatriz Angelo, Dept Psychiat & Mental Hlth, Loures - Portugal
[3] Univ Sao Paulo, Fac Med, Hosp Clin HCFMUSP, Lab Neurociencias LIM27, Dept & Inst Psiquiatria, Rua Dr Ovidio Pires de Campos 785, 1st Floor, BR-05403010 Sao Paulo, SP - Brazil
[4] Univ Estadual Paulista, Biosci Inst, Sao Paulo, SP - Brazil
[5] Univ Lisbon, Inst Mol Med, Dementia Study Grp, Fac Med, Lisbon - Portugal
[6] Univ Lisbon, Dept Psychiat, Fac Med, Lisbon - Portugal
[7] Univ Lisbon, Dept Psychol, Fac Med, Lisbon - Portugal
[8] Ctr Hosp Lisboa Ocidental, Dept Psychiat & Mental Hlth, Lisbon - Portugal
[9] Univ Nova Lisboa, Fac Ciencias Med, NOVA Sch Med, Lisbon - Portugal
[10] Champalimaud Ctr Unknown, Champalimaud Res, Lisbon - Portugal
Número total de Afiliações: 10
Tipo de documento: Artigo de Revisão
Fonte: INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY; v. 34, n. 9, SI, p. 1336-1344, SEP 2019.
Citações Web of Science: 0
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; I-2 = 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; I-2 = 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. (AU)

Processo FAPESP: 09/52825-8 - Neurobiologia da doença de Alzheimer: marcadores de risco, prognóstico e resposta terapêutica
Beneficiário:Wagner Farid Gattaz
Linha de fomento: Auxílio à Pesquisa - Temático
Processo FAPESP: 16/01302-9 - Identificação das vias direta e indireta da inibição da glicogênio sintase kinase 3B pelo lítio em cultura de neurônios
Beneficiário:Vanessa de Jesus Rodrigues de Paula
Linha de fomento: Bolsas no Brasil - Pós-Doutorado
Processo FAPESP: 14/14211-6 - Comprimento telomérico no sistema nervoso central de um modelo de Doença de Alzheimer tratado com lítio
Beneficiário:Giancarlo de Mattos Cardillo
Linha de fomento: Bolsas no Brasil - Mestrado