PMID- 30246461
OWN - NLM
STAT- MEDLINE
DCOM- 20200313
LR  - 20200313
IS  - 1099-1166 (Electronic)
IS  - 0885-6230 (Linking)
VI  - 34
IP  - 9
DP  - 2019 Sep
TI  - Noninvasive brain stimulation for behavioural and psychological symptoms of 
      dementia: A systematic review and meta-analysis.
PG  - 1336-1345
LID - 10.1002/gps.5003 [doi]
AB  - BACKGROUND: 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; I(2)  = 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; I(2)  = 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.
CI  - (c) 2018 John Wiley & Sons, Ltd.
FAU - Vacas, Sara M
AU  - Vacas SM
AD  - Champalimaud Clinical Centre, Champalimaud Centre for the Unknown, Lisbon, 
      Portugal.
AD  - Department of Psychiatry and Mental Health, Hospital Beatriz Angelo, Loures, 
      Portugal.
FAU - Stella, Florindo
AU  - Stella F
AUID- ORCID: 0000-0001-6052-7312
AD  - Laboratorio de Neurociencias LIM27, Departamento e Instituto de Psiquiatria, 
      Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, 
      Sao Paulo, SP, Brazil.
AD  - Biosciences Institute, Universidade Estadual Paulista (UNESP), Sao Paulo, SP, 
      Brazil.
FAU - Loureiro, Julia C
AU  - Loureiro JC
AD  - Laboratorio de Neurociencias LIM27, Departamento e Instituto de Psiquiatria, 
      Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, 
      Sao Paulo, SP, Brazil.
FAU - Simoes do Couto, Frederico
AU  - Simoes do Couto F
AD  - Dementia Study Group, Institute of Molecular Medicine, Faculdade de Medicina, 
      Universidade de Lisboa, Lisbon, Portugal.
AD  - Psychiatry and Psychology Departments, Faculdade de Medicina, Universidade de 
      Lisboa, Lisbon, Portugal.
FAU - Oliveira-Maia, Albino J
AU  - Oliveira-Maia AJ
AD  - Champalimaud Clinical Centre, Champalimaud Centre for the Unknown, Lisbon, 
      Portugal.
AD  - Department of Psychiatry and Mental Health, Centro Hospitalar de Lisboa 
      Ocidental, Lisbon, Portugal.
AD  - NOVA School of Medicine, Faculdade de Ciencias Medicas, Universidade Nova de 
      Lisboa, Lisbon, Portugal.
AD  - Champalimaud Research, Champalimaud Centre for the Unknown, Lisbon, Portugal.
FAU - Forlenza, Orestes V
AU  - Forlenza OV
AD  - Laboratorio de Neurociencias LIM27, Departamento e Instituto de Psiquiatria, 
      Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, 
      Sao Paulo, SP, Brazil.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Systematic Review
DEP - 20181017
PL  - England
TA  - Int J Geriatr Psychiatry
JT  - International journal of geriatric psychiatry
JID - 8710629
SB  - IM
MH  - Alzheimer Disease/*psychology
MH  - Brain/physiology
MH  - Cognition/physiology
MH  - Humans
MH  - Mental Disorders/psychology/*therapy
MH  - Pain Management/methods
MH  - Transcranial Direct Current Stimulation/*methods
MH  - Transcranial Magnetic Stimulation/*methods
OTO - NOTNLM
OT  - behavioural and psychological symptoms of dementia
OT  - neuropsychiatric symptoms of dementia
OT  - transcranial direct current stimulation
OT  - transcranial magnetic stimulation
EDAT- 2018/09/25 06:00
MHDA- 2020/03/14 06:00
CRDT- 2018/09/25 06:00
PHST- 2017/12/20 00:00 [received]
PHST- 2018/07/30 00:00 [accepted]
PHST- 2018/09/25 06:00 [pubmed]
PHST- 2020/03/14 06:00 [medline]
PHST- 2018/09/25 06:00 [entrez]
AID - 10.1002/gps.5003 [doi]
PST - ppublish
SO  - Int J Geriatr Psychiatry. 2019 Sep;34(9):1336-1345. doi: 10.1002/gps.5003. Epub 
      2018 Oct 17.