| Texto completo | |
| Autor(es): Mostrar menos - |
Rosson, Stella
;
de Filippis, Renato
;
Croatto, Giovanni
;
Collantoni, Enrico
;
Pallottino, Simone
;
Guinart, Daniel
;
Brunoni, Andre R.
;
Dell'Osso, Bernardo
;
Pigato, Giorgio
;
Hyde, Joshua
;
Brandt, Valerie
;
Cortese, Samuele
;
Fiedorowicz, Jess G.
;
Petrides, Georgios
;
Correll, Christoph U.
;
Solmi, Marco
Número total de Autores: 16
|
| Tipo de documento: | Artigo Científico |
| Fonte: | NEUROSCIENCE AND BIOBEHAVIORAL REVIEWS; v. 139, p. 18-pg., 2022-06-27. |
| Resumo | |
Background: The degree of efficacy, safety, quality, and certainty of meta-analytic evidence of biological non-pharmacological treatments in mental disorders is unclear. Methods: We conducted an umbrella review (PubMed/Cochrane Library/PsycINFO-04-Jul-2021, PROSPERO/CRD42020158827) for meta-analyses of randomized controlled trials (RCTs) on deep brain stimulation (DBS), transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), electro-convulsive therapy (ECT), and others. Co-primary outcomes were standardized mean differences (SMD) of disease-specific symptoms, and acceptability (for all-cause discontinuation). Evidence was assessed with AMSTAR/AMSTAR-Content/GRADE. Results: We selected 102 meta-analyses. Effective interventions compared to sham were in depressive disorders: ECT (SMD=0.91/GRADE=moderate), TMS (SMD=0.51/GRADE=moderate), tDCS (SMD=0.46/GRADE=low), DBS (SMD=0.42/GRADE=very low), light therapy (SMD=0.41/GRADE=low); schizophrenia: ECT (SMD=0.88/GRADE=moderate), tDCS (SMD=0.45/GRADE=very low), TMS (prefrontal theta-burst, SMD=0.58/GRA-DE=low; left-temporoparietal, SMD=0.42/GRADE=low); substance use disorder: TMS (high frequency-dorsolateral-prefrontal-deep (SMD=1.16/GRADE=moderate), high frequency-left dorsolateral-prefrontal (SMD=0.77/GRADE=very low); OCD: DBS (SMD=0.89/GRADE=moderate), TMS (SMD=0.64/GRADE=very low); PTSD: TMS (SMD=0.46/GRADE=moderate); generalized anxiety disorder: TMS (SMD=0.68/GRA-DE=low); ADHD: tDCS (SMD=0.23/GRADE=moderate); autism: tDCS (SMD=0.97/GRADE=very low). No sig-nificant differences for acceptability emerged. Median AMSTAR/AMSTAR-Content was 8/2 (suggesting high -quality meta-analyses/low-quality RCTs), GRADE low. Discussion: Despite limited certainty, biological non-pharmacological interventions are effective and safe for numerous mental conditions. Results inform future research, and guidelines. Funding: None. (AU) | |
| Processo FAPESP: | 19/06009-6 - Terapias de neuromodulação não-implantáveis: uma perspectiva para o cérebro deprimido |
| Beneficiário: | Geraldo Busatto Filho |
| Modalidade de apoio: | Auxílio à Pesquisa - Temático |
| Processo FAPESP: | 18/10861-7 - Avaliação multimodal dos efeitos da estimulação transcraniana por corrente contínua e estimulação theta-burst no funcionamento do córtex pré-frontal: um estudo Fase-I bilateral, placebo-controlado, fatorial |
| Beneficiário: | Andre Russowsky Brunoni |
| Modalidade de apoio: | Auxílio à Pesquisa - Regular |