한빛사논문
- 조회174
경희대학교
Jiseung Kang1,2,3,17, Hyeri Lee4,5,17, Seungyeong Yu1, Myeongcheol Lee4,5, Hyeon Jin Kim4,5, Rosie Kwon4,5, Sunyoung Kim6, Guillaume Fond7, Laurent Boyer7, Masoud Rahmati7,8,9, Ai Koyanagi10, Lee Smith11, Christa J. Nehs2,3, Min Seo Kim12, Guillermo F. López Sánchez13, Elena Dragioti14,15, Tae Kim1 and Dong Keon Yon4,5,16
1Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology, Gwangju, South Korea.
2Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA.
3Department of Anesthesia, Harvard Medical School, Boston, MA, USA.
4Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea.
5Department of Regulatory Science, Kyung Hee University, Seoul, South Korea.
6Department of Family Medicine, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea.
7Assistance Publique-Hopitaux de Marseille, Research Centre on Health Services and Quality of Life, Aix Marseille University, Marseille, France.
8Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khoramabad, Iran.
9Department of Physical Education and Sport Sciences, Faculty of Literature and Humanities, Vali-E-Asr University of Rafsanjan, Rafsanjan, Iran.
10Research and Development Unit, Parc Sanitari Sant Joan de Deu, Barcelona, Spain.
11Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK.
12Cardiovascular Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, MA, USA.
13Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, Murcia, Spain.
14Pain and Rehabilitation Centre, and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
15Research Laboratory Psychology of Patients, Families, and Health Professionals, Department of Nursing, School of Health Sciences, University of Ioannina, Ioannina, Greece.
16Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea.
17These authors contributed equally: Jiseung Kang, Hyeri Lee.
Corresponding authors
Correspondence to Tae Kim or Dong Keon Yon.
Abstract
Transcranial direct current stimulation (tDCS), which delivers a direct current to the brain, emerged as a non-invasive potential therapeutic in treating a range of neurological and neuropsychiatric disorders. However, a comprehensive quantitative evidence synthesis on the effects of tDCS on a broad range of mental illnesses is lacking. Here, we systematically assess the certainty of the effects and safety of tDCS on several health outcomes using an umbrella review of randomized controlled trials (RCTs). The methodological quality of each included original meta-analysis was assessed by the A Measurement Tool for Assessing Systematic Reviews 2 (AMSTAR2), and the certainty of the evidence for each effect was evaluated with Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). We followed an a priori protocol (PROSPERO CRD42023458700). We identified 15 meta-analyses of RCTs (AMSTAR 2; high 3, moderate 3, and low 9) that included 282 original articles, covering 22 unique health endpoints across 22 countries and six continents. From meta-analyses of RCTs supported by very low to high certainty of evidence, it was found that tDCS improved symptoms related to post-stroke, including post-stroke depression scale score (equivalent standardized mean difference [eSMD], 1.61 [95% confidence level, 0.72–2.50]; GRADE=moderate), activities of daily living independence (7.04 [3.41–10.67]; GRADE=high), motor recovery of upper and lower extremity (upper extremity: 0.15 [0.06–0.24], GRADE=high; lower extremity: 0.10 [0.03–0.16], GRADE=high), swallowing performance (GRADE=low), and spasticity (GRADE=moderate). In addition, tDCS had treatment effects on symptoms of several neurological and neuropsychiatric disorders, including obsessive-compulsive disorder (0.81 [0.44–1.18]; GRADE=high), pain in fibromyalgia (GRADE=low), disease of consciousness (GRADE=low), insight score (GRADE=moderate) and working memory (0.34 [0.01-0.67]; GRADE=high) in schizophrenia, migraine-related pain (−1.52 [−2.91 to −0.13]; GRADE=high), attention-deficit/hyperactivity disorder (reduction in overall symptom severity: 0.24 [0.04–0.45], GRADE=low; reduction in inattention: 0.56 [0.02–1.11], GRADE=low; reduction in impulsivity: 0.28 [0.04–0.51], GRADE=low), depression (GRADE=low), cerebellar ataxia (GRADE=low), and pain (GRADE=very low). Importantly, tDCS induced an increased number of reported cases of treatment-emergent mania or hypomania (0.88 [0.62–1.13]; GRADE=moderate). We found varied levels of evidence for the effects of tDCS with multiple neurological and neuropsychiatric conditions, from very low to high certainty of evidence. tDCS was effective for people with stroke, obsessive-compulsive disorder, fibromyalgia, disease of consciousness, schizophrenia, migraine, attention-deficit/hyperactivity disorder, depression, cerebellar ataxia, and pain. Therefore, these findings suggest the benefit of tDCS for several neurological and neuropsychiatric disorders; however, further studies are needed to understand the underlying mechanism and optimize its therapeutic potential.
논문정보
- Research article
- 2024년 05월 (BRIC 등록일 2024-05-31)
- 국내(교신)+국외 연구진
- 바이오·의료융합 > 다학제 융합/복합
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