Palavras-chave
Esquizofrenia
Nicotina
Transtorno Relacionado ao Uso de Substâncias
Como Citar
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Resumo
Objetivo: Verificar a eficácia da Estimulação Magnética Transcraniana (EMT) no tratamento do transtorno por uso de nicotina em pacientes esquizofrênicos. Métodos: O presente estudo é uma revisão sistemática que buscou verificar a eficácia da Estimulação Magnética Transcraniana (EMT) no tratamento do transtorno por uso de nicotina em pacientes esquizofrênicos. A revisão incluiu ensaios clínicos randomizados, disponíveis em inglês, das bases de dados PubMed, MEDLINE, ELSEVIER, SCOPUS e MedRxiv. Os estudos foram selecionados independentemente por dois revisores, com análise de qualidade e viés utilizando as escalas de Jadad e RoB2. Resultados: A revisão sistemática incluiu cinco ensaios clínicos que aplicaram sessões de EMT de alta frequência (10-20 Hz) no córtex pré-frontal dorsolateral de amostras pequenas. Os resultados foram variados, com alguns estudos observando redução no número de cigarros consumidos, enquanto outros não mostraram efeitos significativos. Considerações finais: A revisão concluiu que há uma significância clínica positiva para o uso de EMT para pacientes dependentes de nicotina, com diminuição da compulsão por nicotina. No entanto, ainda são necessários estudos com amostras maiores e novas abordagens terapêuticas.
Referências
MINISTÉRIO DA SAÚDE (BR). Gabinete do ministro. Portaria no 364, de 9 de abril de 2013. Brasília; 2013.
AMERICAN PSYCHIATRIC ASSOCIATION. Diagnostic and statistical manual of mental disorders: DSM-5-TR. 5th ed. Porto Alegre: Artmed; 2014. p. 87-123.
CARPENTER WT, et al. Espectro da esquizofrenia e outros transtornos psicóticos. In: American Psychiatric Association. Manual diagnóstico e estatístico de transtornos mentais: DSM-5-TR. 5. ed. Porto Alegre: Artmed; 2014. p. 87-123.
CATHER C, et al. Achieving smoking cessation in individuals with schizophrenia: special considerations. CNS Drugs. 2017;31(6):471-81.
COSTA MASG, et al. Esquizofrenia: perspectivas atuais acerca do diagnóstico, tratamento e evolução clínica da doença. Brazilian Journal of Health Review. 2023;6(1):61-71.
DASKALAKIS ZJ, et al. The effects of repetitive transcranial magnetic stimulation on cortical inhibition in healthy human subjects. Experiemtnal Brain Research. 2006;174(3):403-12.
DESALEGN D, ABDU Z, HAJURE M. Prevalence of tobacco dependence and associated factors among patients
with schizophrenia attending their treatments at southwest Ethiopia: hospital-based cross-sectional study. PLoS One. 2021;16(12):261154.
DICKERSON F, et al. Cigarette smoking by patients with serious mental illness, 1999–2016: an increasing disparity. Psychiatric Services. 2018;69(2):147-53.
DU X, et al. Combining neuroimaging and brain stimulation to test alternative causal pathways for nicotine addiction in schizophrenia. Brain Stimulation. 2024;17(2):324-32.
EVINS AE, HOEPPNER SS, SCHOENFELD DA, Hoeppner BB, Cather C, Pachas GN, et al. Maintenance pharmacotherapy normalizes the relapse curve in recently abstinent tobacco smokers with schizophrenia and bipolar disorder. Schizophrenia Research. 2017; 183:124-9.
HIGGINS JPT, et al. Chapter 8: assessing risk of bias in a randomized trial. Cochrane Handbook for Systematic Reviews of Interventions version 6.5. Cochrane Training; 2019.
HUANG W, et al. Effect of repetitive transcranial magnetic stimulation on cigarette smoking in patients with schizophrenia. Shanghai Archives of Psychiatry. 2016;28(6):309-17.
JADAD A.R., et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clinical Trials, v.17, n. 1, p. 1-12, 1996.
JOHNSTONE S, et al. Effects of acute smoking abstinence among people with schizophrenia: a systematic review and meta-analysis of laboratory studies. Schizophrenia Research. 2024;274:220-36.
KHEDR EM, et al. A. Dopamine levels after repetitive transcranial magnetic stimulation of motor cortex in patients with Parkinson’s disease: preliminary results. Movement Disorders. 2007;22(7):1046-50.
KIVIMIES K, et al. Opioid abuse and hospitalization rates in patients with schizophrenia. Nordic Journal of Psychiatry. 2015;70(2):128-32.
KOZAK K, et al. Effects of short-term, high-frequency repetitive transcranial magnetic stimulation to bilateral dorsolateral prefrontal cortex on smoking behavior and cognition in patients with schizophrenia and non-psychiatric controls. Schizophrenia Research. 2018;197:441-3.
KRISHNADAS R, et al. Nicotine dependence and illness severity in schizophrenia. Brazilian Journal of Psychiatry. 2012;201(4):306-12.
LEFAUCHEUR JP, et al. Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS). Clinical Neurophysiology. 2014;125:2150-2206.
LI Y, et al. Nicotine dependence in community-dwelling Chinese patients with schizophrenia. Gen Psychiatry. 2019;32(1):100014.
MCCUTCHEON RA, ET al. Schizophrenia: an overview. JAMA Psychiatry. 2020;77(2):201-10.
MOELLER SJ, et al. Deep rTMS of the insula and prefrontal cortex in smokers with schizophrenia: proof-of-concept study. Schizophrenia. 2022;8(1).
OZTURK H, VENUGOPAL S. Transcranial magnetic stimulation as a therapeutic option for neurologic diseases and psychiatric disorders: a systematic review. Cureus. 2022;14(8):e28259.
PAGE, M. J., et al. PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. The BMJ, v. 372, n. 160, 2021.
PAULY JR. Gender differences in tobacco smoking dynamics and the neuropharmacological actions of nicotine. Front Biosci. 2008;13(2):505-16.
PINHO S, ROCHA V, VIEIRA-COELHO MA. Effectiveness of multimodal interventions focused on smoking cessation in patients with schizophrenia: a systematic review. Schizophrenia Research. 2021;231:145-53.
PRIKRYL R, et al. Repetitive transcranial magnetic stimulation reduces cigarette consumption in schizophrenia patients. Prog Neuropsychopharmacol Biol Psychiatry. 2014;49:30-5.
QATAR FOUNDATION. Rayyan- Intelligent Systematic Review, 2022. Disponível em: < https://www.rayyan.ai/>. Acessado em: 17 mai. 2024.
REGNER MF, et al. The insula in nicotine use disorder: functional neuroimaging and implications for neuromodulation. Neuroscience Biobehavioral Review. 2019;103:414-24.
SHUANG LI, et al. Repetitive transcranial magnetic stimulation reshaped the dynamic reconfiguration of the executive and reward networks in individuals with tobacco use disorder. Journal of Affective Disorders. 2024;365:427-36.
SILVA AM, et al. Esquizofrenia: uma revisão bibliográfica. Revista UNILUS Ensino e Pesquisa. 2016;13(30).