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https://observatorio.fm.usp.br/handle/OPI/48271
Title: | Brain stimulation and other biological non-pharmacological interventions in mental disorders: An umbrella review |
Authors: | ROSSON, Stella; FILIPPIS, Renato de; 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 |
Citation: | NEUROSCIENCE AND BIOBEHAVIORAL REVIEWS, v.139, article ID 104743, 18p, 2022 |
Abstract: | 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. |
Appears in Collections: | Artigos e Materiais de Revistas Científicas - FM/MCM Artigos e Materiais de Revistas Científicas - LIM/27 Artigos e Materiais de Revistas Científicas - ODS/03 |
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