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

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dc.contributor.authorVacas, Sara M.
dc.contributor.authorStella, Florindo [UNESP]
dc.contributor.authorLoureiro, Julia C.
dc.contributor.authorSimões do Couto, Frederico
dc.contributor.authorOliveira-Maia, Albino J.
dc.contributor.authorForlenza, Orestes V.
dc.contributor.institutionChampalimaud Centre for the Unknown
dc.contributor.institutionHospital Beatriz Ângelo
dc.contributor.institutionUniversidade de São Paulo (USP)
dc.contributor.institutionUniversidade Estadual Paulista (Unesp)
dc.contributor.institutionUniversidade de Lisboa
dc.contributor.institutionCentro Hospitalar de Lisboa Ocidental
dc.contributor.institutionUniversidade Nova de Lisboa
dc.date.accessioned2019-10-06T16:48:22Z
dc.date.available2019-10-06T16:48:22Z
dc.date.issued2019-01-01
dc.description.abstractBackground: 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; I2 = 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; I2 = 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.en
dc.description.affiliationChampalimaud Clinical Centre Champalimaud Centre for the Unknown
dc.description.affiliationDepartment of Psychiatry and Mental Health Hospital Beatriz Ângelo
dc.description.affiliationLaboratorio de Neurociencias LIM27 Departamento e Instituto de Psiquiatria Hospital das Clinicas HCFMUSP Faculdade de Medicina Universidade de Sao Paulo
dc.description.affiliationBiosciences Institute Universidade Estadual Paulista (UNESP)
dc.description.affiliationDementia Study Group Institute of Molecular Medicine Faculdade de Medicina Universidade de Lisboa
dc.description.affiliationPsychiatry and Psychology Departments Faculdade de Medicina Universidade de Lisboa
dc.description.affiliationDepartment of Psychiatry and Mental Health Centro Hospitalar de Lisboa Ocidental
dc.description.affiliationNOVA School of Medicine Faculdade de Ciências Médicas Universidade Nova de Lisboa
dc.description.affiliationChampalimaud Research Champalimaud Centre for the Unknown
dc.description.affiliationUnespBiosciences Institute Universidade Estadual Paulista (UNESP)
dc.description.sponsorshipConselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
dc.description.sponsorshipIdCNPq: 442795/2014-9
dc.description.sponsorshipIdCNPq: 466625/2014-6
dc.format.extent1336-1345
dc.identifierhttp://dx.doi.org/10.1002/gps.5003
dc.identifier.citationInternational Journal of Geriatric Psychiatry, v. 34, n. 9, p. 1336-1345, 2019.
dc.identifier.doi10.1002/gps.5003
dc.identifier.issn1099-1166
dc.identifier.issn0885-6230
dc.identifier.scopus2-s2.0-85055165423
dc.identifier.urihttp://hdl.handle.net/11449/189670
dc.language.isoeng
dc.relation.ispartofInternational Journal of Geriatric Psychiatry
dc.rights.accessRightsAcesso aberto
dc.sourceScopus
dc.subjectbehavioural and psychological symptoms of dementia
dc.subjectneuropsychiatric symptoms of dementia
dc.subjecttranscranial direct current stimulation
dc.subjecttranscranial magnetic stimulation
dc.titleNoninvasive brain stimulation for behavioural and psychological symptoms of dementia: A systematic review and meta-analysisen
dc.typeTrabalho apresentado em evento
unesp.author.orcid0000-0001-6052-7312[2]

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Artigos - Neurologia, Psicologia e Psiquiatria - FMB