scholarly journals Can pharmacological, psychological and non-invasive brain stimulation interventions prevent depression after stroke? A cochrane review summary with commentary

2021 ◽  
pp. 1-3
Author(s):  
Irene Ferrario ◽  
Stefano Negrini
Keyword(s):  
Usual Care ◽  
Brain Stimulation ◽  
Depressive Disorders ◽  
Cochrane Review ◽  
Psychological Therapy ◽  
Current Evidence ◽  
Pharmacological Intervention ◽  
Pharmacological Interventions ◽  
Non Invasive ◽  
Outcome Information

BACKGROUND: Depression is very common in patients after a stroke and it can impact recovery. OBJECTIVE: The Cochrane Review aimed to determine whether psychological therapy, pharmacological interventions, non-invasive brain stimulation, or their combination can prevent depression after stroke. METHODS: The population addressed were patients who suffered from a stroke and had no previous diagnosis of depressive disorders. Studies comparing pharmacological intervention to placebo, psychological therapy to usual care, and non-invasive brain stimulation to sham stimulation or usual care were included. RESULTS: Outcome information was available for nine pharmacological and two psychological trials, showing favorable treatment effects. CONCLUSIONS: The available evidence suggests that pharmacological interventions and psychological therapy may prevent depression and improve mood after stroke. Although, the current evidence is of very low quality resulting in serious uncertainties about the estimates of effect observed.

scholarly journals Does non-invasive vagus nerve stimulation affect heart rate variability? A living and interactive Bayesian meta-analysis

2021 ◽  
Author(s):  
Vinzent Wolf ◽  
Anne Kühnel ◽  
Vanessa Teckentrup ◽  
Julian Koenig ◽  
Nils B. Kroemer
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Vagus Nerve ◽  
Brain Stimulation ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Meta Analysis ◽  
Current Evidence ◽  
Beneficial Effects ◽  
Non Invasive

AbstractNon-invasive brain stimulation techniques, such as transcutaneous auricular vagus nerve stimulation (taVNS), have considerable potential for clinical use. Beneficial effects of taVNS have been demonstrated on symptoms in patients with mental or neurological disorders as well as transdiagnostic dimensions, including mood and motivation. However, since taVNS research is still an emerging field, the underlying neurophysiological processes are not yet fully understood, and the replicability of findings on biomarkers of taVNS effects has been questioned. Here, we perform a living Bayesian random effects meta-analysis to synthesize the current evidence concerning the effects of taVNS on heart rate variability (HRV), a candidate biomarker that has, so far, received most attention in the field. To keep the synthesis of evidence transparent and up to date as new studies are being published, we developed a Shiny web app that regularly incorporates new results and enables users to modify study selection criteria to evaluate the robustness of the inference across potential confounds. Our analysis focuses on 17 single-blind studies comparing taVNS versus sham in healthy participants. These newly synthesized results provide strong evidence for the null hypothesis (g = 0.011, CIshortest = [−0.103, 0.125], BF01 = 25.587), indicating that acute taVNS does not alter HRV compared to sham. To conclude, based on a synthesis of the available evidence to date, there is no support for the hypothesis that HRV is a robust biomarker for acute taVNS. By increasing transparency and timeliness, we believe that the concept of living meta-analyses can lead to transformational benefits in emerging fields such as non-invasive brain stimulation.

tDCS dans le traitement de la dépression : un exemple de recherche clinique translationnelle

2014 ◽  
Vol 29 (S3) ◽  
pp. 668-668
Author(s):  
E. Haffen
Keyword(s):  
Animal Models ◽  
Direct Current ◽  
Brain Stimulation ◽  
Depressive Disorders ◽  
Cortical Excitability ◽  
Biological Psychiatry ◽  
Clinical Effects ◽  
Cognitive Effects ◽  
Non Invasive ◽  
Technological Advances

Since the discovery of psychopharmacological treatments in the early 1950s, followed by the development of second-generation antidepressants, biological psychiatry has not achieved much progress. Recent technological advances in the field of non-invasive brain stimulation open new perspectives in the treatment of depressive disorders (MDD). Amongst them, transcranial direct current stimulation (tDCS) modulates cortical excitability and induces long-lasting effects. Here, we aimed at evaluating whether tDCS has potential to be developed as an innovative treatment in psychiatry. We conducted several studies in humans and animal models, exploring clinical and cognitive effects, especially in MDD. Our findings indicated beneficial clinical effects of tDCS. The data published to date are promising and supports the use of tDCS as a treatment for MDD. However, its place regarding other treatments still has to be determined before becoming a routine clinical treatment.

scholarly journals Pharmacological interventions for sex offenders: A poor evidence base to guide practice

2017 ◽  
Vol 23 (6) ◽  
pp. 361-365
Author(s):  
Keith Rix
Keyword(s):  
Sex Offenders ◽  
Sexual Offending ◽  
Cochrane Review ◽  
Significant Proportion ◽  
Evidence Base ◽  
New Drugs ◽  
Pharmacological Intervention ◽  
Pharmacological Interventions ◽  
Limited Support ◽  
High Level

SummaryAlthough a significant proportion of prisoners and patients in secure hospitals are sex offenders and victim surveys reveal a high level of hidden sexual victimisation, the authors of this Cochrane review found only very limited support for pharmacological intervention with sex offenders. Given the nature and extent of the problem of sexual offending and the promise shown by new drugs, there is a need for clinical scientists, lawyers and ethicists to rise to the challenge of ascertaining the effectiveness and safety of drugs which are being used to treat sex offenders, some involuntarily, without the evidence base to justify confidence as to their effectiveness and safety.

Cardiovascular Risk in Rheumatoid Arthritis and Mechanistic Links: From Pathophysiology to Treatment

2020 ◽  
Vol 18 (5) ◽  
pp. 431-446 ◽  
Author(s):  
George E. Fragoulis ◽  
Ismini Panayotidis ◽  
Elena Nikiphorou
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Current Evidence ◽  
Pharmacological Intervention ◽  
Cvd Risk ◽  
The Past ◽  
Increased Risk ◽  
Cv Disease ◽  
Obesity Hypertension ◽  
Inflammatory Burden

Rheumatoid arthritis (RA) is an autoimmune inflammatory arthritis. Inflammation, however, can spread beyond the joints to involve other organs. During the past few years, it has been well recognized that RA associates with increased risk for cardiovascular (CV) disease (CVD) compared with the general population. This seems to be due not only to the increased occurrence in RA of classical CVD risk factors and comorbidities like smoking, obesity, hypertension, diabetes, metabolic syndrome, and others but also to the inflammatory burden that RA itself carries. This is not unexpected given the strong links between inflammation and atherosclerosis and CVD. It has been shown that inflammatory cytokines which are present in abundance in RA play a significant role in every step of plaque formation and rupture. Most of the therapeutic regimes used in RA treatment seem to offer significant benefits to that end. However, more studies are needed to clarify the effect of these drugs on various parameters, including the lipid profile. Of note, although pharmacological intervention significantly helps reduce the inflammatory burden and therefore the CVD risk, control of the so-called classical risk factors is equally important. Herein, we review the current evidence for the underlying pathogenic mechanisms linking inflammation with CVD in the context of RA and reflect on the possible impact of treatments used in RA.

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