【摘要】 目的系统评价重复经颅磁刺激(r TMS)对轻度认知功能损害(MCI)患者的疗效。方法计算机检索Pub Med、The Cochrane Library(2015年第10期)、EMbase、Psyc INF、EBSCO、CBM、CNKI、Wan Fang Data和VIP数据库,搜集有关r TMS治疗MCI患者的随机对照试验(RCT),检索时限均从建库至2015年10月。由2名评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用Rev Man 5.3软件进行Meta分析。结果共纳入5个RCT,180例患者。Meta分析结果显示,与对照组相比,r TMS治疗能够改善MCI患者的总体认知功能[SMD=2.53,95%CI(0.91,4.16),P=0.002],在单一认知域方面,改善MCI患者的情景记忆能力[MD=0.98,95%CI(0.24,1.72),P=0.01]与词语流畅性[MD=2.08,95%CI(0.46,3.69),P=0.01]。r TMS治疗的耐受性好,虽然较对照组更易发生不良反应[RD=0.09,95%CI(0.00,0.18),P=0.04],但不良反应主要为一过性头晕、头疼、头皮疼痛。结论r TMS对MCI患者的认知功能可能有改善作用。但受纳入研究数量及质量的限制,本研究结论还有赖于大样本、多中心、高质量的RCT进一步验证。更多还原

【Abstract】 Objective To systematically review the efficacy of repetitive transcranial magnetic stimulation(r TMS) on patients with mild cognitive impairment(MCI). Methods We searched databases including Pub Med, The Cochrane Library(Issue 10, 2015), EMbase, Psyc INF, EBSCO, CBM, CNKI, Wan Fang Data and VIP from inception to October 2015 to collect randomized controlled trials(RCTs) about r TMS for patients with MCI. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed by using Rev Man 5.3 software. Results A total of 5 RCTs involving 180 MCI patients were included. The results of meta-analysis showed that, compared with the control group, r TMS treatment could significantly improve the overall cognitive abilities of MCI patients(SMD=2.53, 95% CI 0.91 to 4.16, P=0.002), as well as the single-domain cognitive performances, including tests for episodic memory(MD=0.98, 95% CI 0.24 to 1.72, P=0.01) and verbal fluency(MD=2.08, 95% CI 0.46 to 3.69, P=0.01). r TMS was a well-tolerated therapy, with slightly more adverse events observed than the control group(RD=0.09, 95% CI 0.00 to 0.18, P=0.04), but cases were mainly transient headache, dizziness and scalp pain. Conclusion r TMS may benefit the cognitive abilities of MCI patients. Nevertheless, due to the limited quantity and quality of included studies, large-scale, multicenter, and high quality RCTs are required to verify the conclusion.更多还原