Non-invasive brain stimulation for treating catatonia: a systematic review

Hongqi Xiao; Yajing Meng; Shiyu Liu; Yuan Cao; Huan Sun; Gaoju Deng; Mei Wang; Yaozong Zheng; Changjian Qiu

doi:10.3389/fpsyt.2023.1135583

Non-invasive brain stimulation for treating catatonia: a systematic review

Front Psychiatry. 2023 May 16:14:1135583. doi: 10.3389/fpsyt.2023.1135583. eCollection 2023.

Authors

Hongqi Xiao^#^{1

2}, Yajing Meng^#^{1

2}, Shiyu Liu^{1

2}, Yuan Cao^{1

2

3

4}, Huan Sun^{1

2}, Gaoju Deng^{1

2}, Mei Wang^{1

2}, Yaozong Zheng^{1

2}, Changjian Qiu^{1

2}

Affiliations

¹ Mental Health Center, West China Hospital of Sichuan University, Chengdu, China.
² Sichuan Clinical Medical Research Center for Mental Disorders, Chengdu, China.
³ Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
⁴ Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China.

^# Contributed equally.

Abstract

Background: Non-invasive brain stimulation (NIBS) techniques offer new therapeutic options for modifying pathological neuroplasticity and have been proven to be beneficial in the treatment of neuropsychiatric disorders.

Objective: This study aimed to investigate the role of NIBS in treating catatonia.

Materials and methods: We conducted a systematic search to identify meta-analyses or systematic reviews on electroconvulsive therapy (ECT) and studies on the effects of repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) on patients with catatonia from the PubMed, Web of Science, Embase, China National Knowledge Internet, Wanfang, and China Science and Technology Journal databases from inception until 31 July 2022. The methodological quality of the included studies was assessed with the AMSTAR2 or Joanna Briggs Institute Critical Appraisal tools. Paired t-tests and Wilcoxon signed-rank tests were used to compare changes in catatonia symptom scores after rTMS or tDCS.

Results: A total of 13 systematic reviews and one meta-analysis on ECT, two systematic reviews and 12 case reports on rTMS, and seven studies of 14 cases applying tDCS were identified. Systematic reviews of ECT consistently described improvement in catatonia symptoms across catatonia types and patient age groups. After treatment with rTMS (t = 4.489, p = 0.006) and tDCS (z = -3.065, p = 0.002), patients exhibited significant improvement.

Conclusion: ECT, rTMS, and tDCS were effective in treating catatonia. Early intervention with NIBS techniques may help improve catatonia symptoms in patients with schizophrenia. It may be advantageous to use rTMS or tDCS to maintain this improvement. NIBS techniques may thus represent a promising treatment for catatonia, but additional high-quality randomized controlled trials are needed.

Keywords: catatonia; electroconvulsive therapy; non-invasive brain stimulation; repetitive transcranial magnetic stimulation; transcranial direct current stimulation.

Publication types

Systematic Review

Grants and funding

This study was supported by the 1·3·5 Project for Disciplines of Excellence–Clinical Research Incubation Project, West China Hospital, Sichuan University (grant no. ZYJC21083), the Department of Science and Technology of Sichuan Province (grant no. 2022YFS0345), and the 1·3·5 Project for Disciplines of Excellence–Clinical Research Incubation Project, West China Hospital, Sichuan University (grant no. 2022HXFH029). No funding source played a role in the study design; the collection, analysis, and interpretation of the data; the writing of the report; or the decision to submit the manuscript for publication.