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| 脑电信号在焦虑障碍疗效预测与治疗机制中的应用 |
| The application of electroencephalography in the prediction of efficacy and therapeutic mechanism of anxiety disorders |
| 投稿时间：2023-11-02 修订日期：2024-06-13 |
| DOI： |
| 中文关键词: 焦虑障碍 脑电图 疗效 预测 |
| 英文关键词:anxiety disorder electroencephalogram efficacy prediction |
| 基金项目:科技创新2030-“脑科学与类脑研究”重大项目（2021ZD0202004） |
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| 中文摘要: |
| 焦虑障碍具有高患病率和高复发率，SSRIs类药物治疗和认知行为治疗（CBT）是焦虑障碍的一线治疗手段。然而，部分焦虑障碍患者对一线治疗手段无应答，且治疗有效的神经生物学机制尚不明确，临床缺乏客观的疗效预测指标。既往研究显示焦虑障碍治疗前后的脑电信号发生变化，且基线的脑电信号与治疗反应相关，提示其可能具有疗效预测的价值。本文对脑电图预测焦虑障碍疗效以及治疗机制的相关研究进行了系统综述，为焦虑障碍的个性化治疗决策提供电生理证据支持。本研究检索了5个数据库（PubMed、Embase、Web of Science、中国知网、万方）中基于脑电图疗效预测焦虑障碍以及治疗相关电生理改变的观察性研究。检索时间2011年3月截止至2023年3月。共检索到1528篇文献，最终纳入15篇文献。预测研究结果显示，治疗前对负性情绪面孔刺激的高反应，如LPP波幅增高可能预示更大的可能在SSRIs、CBT治疗中获益。纵向研究结果显示，ERN、P1波幅在CBT治疗前后无显著改变，说明CBT治疗可能未通过改善注意偏向以及行为监控控制焦虑症状。有限的临床证据提示,基线期负性情绪刺激下的情绪感知相关的脑电指标，如LPP成分有望成为焦虑障碍疗效预测的电生理标志物。但相关研究结果有待通过更多大样本、高质量的前瞻性研究进行验证。 |
| 英文摘要: |
| Anxiety disorders are the most common mental diseases with high prevalence and recurrence rate. Selective Serotonin Reuptake Inhibitors (SSRIs) and cognitive behavioral therapy (CBT) are the two first-line treatments for anxiety disorders. However, many patients failed to response to the first-line treatments, and the neurobiological mechanisms underlying the therapeutic effects and independent predictors of treatment response are unknown. Previous studies reported some EEG changes after treatment for anxiety disorders, and baseline EEG were correlated with treatment response, suggesting the predictive role of EEG in the treatment of anxiety disorders. To provide electrophysiological evidence for individual treatment decision of anxiety disorders by systematically reviewing the studies on predictors and neural mechanisms for the successful treatment of anxiety, five electronic databases (PubMed, Embase, Web of Science databases, China National Knowledge Infrastructure [CNKI], and Wanfang Database [WF]) were searched up to March 2023. The search yielded 1528 records, and only 15 literatures were finally included. Results of prediction studies suggested an increased LPP at baseline may be associated with greater reduction in anxiety symptoms during SSRIs or CBT. Longitudinal study results showed that ERN and P1 amplitude did not change significantly pre-to-post-CBT, suggesting that CBT may not reduce anxiety symptoms through improving attention bias and behavioral monitoring. Limited evidence suggested that EEG components associated with emotional processing might be predictors of treatment outcomes for anxiety disorders. High level of response to emotional stimuli at baseline may predict greater clinical benefit to patients with anxiety disorders. Due to the small sample size and the considerable heterogeneity in methodological approaches, no reliable conclusions can be drawn at present and more prospective studies with large samples are needed. |
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