Background Previous functional magnetic resonance imaging studies indicated that acupuncture could activate the brain regions in patients with migraine. However, these studies showed inconsistent results. This activation likelihood estimation (ALE) meta-analysis aimed to investigate the consistent activated change of brain regions between pre- and post-acupuncture treatment in migraineurs. Methods We conducted a literature search in PubMed, Embase, Web of Science, the Cochrane Library, the China National Knowledge Infrastructure, the Chinese Science and Technology Periodical Database, the Wanfang Database, and the Chinese Biomedical Literature Database from their inception to 18 August, 2022, to obtain articles assessing the functional magnetic resonance imaging changes of acupuncture for migraine. Two investigators independently performed literature selection, data extraction, and quality assessment. The methodological quality was assessed with a modified version of the checklist. The reporting quality of interventions among included studies was evaluated by the Revised Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA). Our meta-analysis was conducted according to the GingerALE software. The Jackknife sensitivity analysis was used to assess the robustness of the results. Results 14 articles were finally included according to the eligible criteria. Regarding the immediate effect of acupuncture on migraine, the ALE meta-analysis demonstrated that the deactivation regions were mainly located in the superior frontal gyrus, and middle frontal gyrus (uncorrected P < 0.001). The ALE meta-analysis of the cumulative effect showed that the activation regions were the thalamus, superior frontal gyrus, posterior lobe of the cerebellum, insula, middle frontal gyrus, precentral gyrus, anterior cingulate, and the deactivation brain regions were located in the transverse temporal gyrus, postcentral gyrus, superior temporal gyrus, anterior cingulate, parahippocampal gyrus, inferior parietal lobule, and inferior occipital gyrus (uncorrected P < 0.001). Conclusion Acupuncture could activate multiple brain areas related with the regulation of pain conduction, processing, emotion, cognition, and other brain regions in patients with migraine. In the future, the combination of multiple imaging technologies could be a new approach to deeply investigate the central mechanism of acupuncture for migraine.

BackgroundDepression is generally accompanied by a disturbed conscious processing of emotion, which manifests as a negative bias to facial/voice emotion information and a decreased accuracy in emotion recognition tasks. Several studies have proved that abnormal brain activation was responsible for the deficit function of conscious emotion recognition in depression. However, the altered brain activation related to the conscious processing of emotion in depression was incongruent among studies. Therefore, we conducted an activation likelihood estimation (ALE) analysis to better understand the underlying neurophysiological mechanism of conscious processing of emotion in depression.MethodElectronic databases were searched using the search terms “depression,” “emotion recognition,” and “neuroimaging” from inceptions to April 10th, 2023. We retrieved trials which explored the neuro-responses of depressive patients to explicit emotion recognition tasks. Two investigators independently performed literature selection, data extraction, and risk of bias assessment. The spatial consistency of brain activation in conscious facial expressions recognition was calculated using ALE. The robustness of the results was examined by Jackknife sensitivity analysis.ResultsWe retrieved 11,365 articles in total, 28 of which were included. In the overall analysis, we found increased activity in the middle temporal gyrus, superior temporal gyrus, parahippocampal gyrus, and cuneus, and decreased activity in the superior temporal gyrus, inferior parietal lobule, insula, and superior frontal gyrus. In response to positive stimuli, depressive patients showed hyperactivity in the medial frontal gyrus, middle temporal gyrus, and insula (uncorrected p < 0.001). When receiving negative stimuli, a higher activation was found in the precentral gyrus, middle frontal gyrus, precuneus, and superior temporal gyrus (uncorrected p < 0.001).ConclusionAmong depressive patients, a broad spectrum of brain areas was involved in a deficit of conscious emotion processing. The activation of brain regions was different in response to positive or negative stimuli. Due to potential clinical heterogeneity, the findings should be treated with caution.Systematic review registrationhttps://inplasy.com/inplasy-2022-11-0057/, identifier: 2022110057.

BackgroundDepression is a mental health disorder characterized by affective, somatic, and cognitive symptoms. Attention bias modification (ABM) has been widely used to treat depression. However, the results seem inconsistent. We conducted a systematic review and meta-analysis to investigate the efficacy of ABM for depression and to explore the optimal protocol of ABM. MethodsSeven databases were systematically searched from their inceptions to 5 October 2022 to include randomized controlled trials (RCTs) of ABM for depression. Two independent reviewers selected the eligible articles, extracted data, and evaluated the risk of bias using version 2 of the Cochrane risk-of-bias tool (ROB 2.0) for randomized trials. The primary outcome was the evaluation of depressive symptoms using widely accepted and validated scales. The secondary outcomes included rumination and attentional control. Meta-analysis was conducted by using RevMan (version 5.4) and Stata (version 12.0). Subgroup analyses and meta-regressions were performed to identify the source of heterogeneity. The certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). ResultsA total of 19 trials involving 20 datasets (1,262 participants) were included. The overall risk of bias in one study was rated as low risk of bias, three studies were considered as high, and the remaining studies were some concerns. Compared with attention control training (ACT), ABM had a greater effect in the improvement of depression (SMD = -0.48, 95% CI -0.80 to -0.17, I-2 = 82%) and rumination (MD = -3.46, 95% CI -6.06 to -0.87, I-2 = 0%). No significant differences were observed in the attentional control outcome between ABM and ACT (MD = 3.07, 95% CI -0.52 to 6.65, I-2 = 0%). Subgroup analysis demonstrated that adults exhibited a greater decrease in depression scores than adolescents. ABM using the dot-probe task, training target stimulus presented by face, and training directions by left-right were associated with better antidepressant effects. ABM training delivered in the laboratory tended to yield a better effect than those conducted at home. Sensitivity analysis indicated that the results were robust. The certainty of the evidence for all outcomes was low or very low, and publication bias may exist. ConclusionDue to high heterogeneity and limited studies, not enough current evidence supported that ABM could be an effective intervention to relieve depressive symptoms. More rigorous RCTs are required to verify the benefits and to explore the optimal protocol of ABM training for depression.Systematic Review Registration: [PROSPERO], identifier [No. CRD42021279163].

Depression is generally accompanied by a disturbed conscious processing of emotion, which manifests as a negative bias to facial/voice emotion information and a decreased accuracy in emotion recognition tasks. Several studies have proved that abnormal brain activation was responsible for the deficit function of conscious emotion recognition in depression. However, the altered brain activation related to the conscious processing of emotion in depression was incongruent among studies. Therefore, we conducted an activation likelihood estimation (ALE) analysis to better understand the underlying neurophysiological mechanism of conscious processing of emotion in depression.Electronic databases were searched using the search terms "depression," "emotion recognition," and "neuroimaging" from inceptions to April 10th, 2023. We retrieved trials which explored the neuro-responses of depressive patients to explicit emotion recognition tasks. Two investigators independently performed literature selection, data extraction, and risk of bias assessment. The spatial consistency of brain activation in conscious facial expressions recognition was calculated using ALE. The robustness of the results was examined by Jackknife sensitivity analysis.We retrieved 11,365 articles in total, 28 of which were included. In the overall analysis, we found increased activity in the middle temporal gyrus, superior temporal gyrus, parahippocampal gyrus, and cuneus, and decreased activity in the superior temporal gyrus, inferior parietal lobule, insula, and superior frontal gyrus. In response to positive stimuli, depressive patients showed hyperactivity in the medial frontal gyrus, middle temporal gyrus, and insula (uncorrected p < 0.001). When receiving negative stimuli, a higher activation was found in the precentral gyrus, middle frontal gyrus, precuneus, and superior temporal gyrus (uncorrected p < 0.001).Among depressive patients, a broad spectrum of brain areas was involved in a deficit of conscious emotion processing. The activation of brain regions was different in response to positive or negative stimuli. Due to potential clinical heterogeneity, the findings should be treated with caution.https://inplasy.com/inplasy-2022-11-0057/, identifier: 2022110057.

Background Attention bias modification (ABM) , a newly emerging focus in emotion modification research, is a treatment to reduce individuals' attention bias toward negative stimuli to improve their abnormal cognition via repeated computer-based attention trainings toward neutral or positive stimuli. Recent studies about depression treated using ABM are increasing, but based on insufficient evidence with various efficacy assessment indicators. Objective To systematically assess the effect of ABM in patients with depression. Methods Databases including PubMed, The Cochrane Library, EMBase, CBM, CNKI, WanFang Data and VIP were searched from inception to December 31st, 2021 for randomized controlled trials (RCTs) regarding depressive patients treated by ABM (experimental group with computer-based ABM trainings) compared with placebo trainings under the same conditions (control group with no interventions or sham ABM trainings) . Primary outcome measures included Hamilton Rating Scale for Depression (HAMD/HRSD) , Beck Depression Inventory (BDI) and Center for Epidemiologic Studies Depression Scale (CES-D) . Secondary outcome measures included the State-Trait Anxiety Inventory (STAI-T) and Ruminative Responses Scale (RRS) . Two researchers independently performed literature enrollment, and extracted data, and evaluated the risk of bias using Risk of Bias 2 (RoB 2.0) tool. RevMan 5.4 and Stata 12.0 were used for Meta-analysis. Results Thirteen RCTs involving 968 patients were included, among which one had two trials. Risk of bias was low in seven RCTs, unclear in four, and high in two. Meta-analysis showed that the overall improvement of depression, anxiety and rumination in the experimental group was better than that in the control group (P<0.05) . Further analysis indicated that two groups had no significant differences in mean scores of BDI and HAMD within a follow-up period of less than two months (P>0.05) . When the follow-up time was prolonged to at least two months, the mean BDI score was still similar in both groups (P>0.05) . Conclusion ABM treatment could improve depressive, anxiety symptom and rumination in patients with depression, but its long-term effect needs to be studied further.

目的:已有相关Meta分析报道了抑郁患者存在显著的负性注视模式,但此模式影响的大小及不同类型刺激下注视指标的差异尚不清楚.为此,文章系统评价抑郁症患者在不同情绪任务刺激下眼动追踪的注视特征,为临床病情转归及预后评估提供参考依据.方法:计算机检索PubMed、The Cochrane Library、EMbase、Web of Science、CBM、中国知网、万方数据和维普数据库,纳入关于抑郁症患者眼动追踪的病例-对照研究,检索时限均为数据库建库至2021-09-05.由2名研究者独立筛选文献、提取资料,采用NOS量表评估纳入研究的文献质量,使用RevMan 5.4软件进行Meta分析.结果:共纳入12项病例-对照研究,包括病例组(抑郁症患者)231例,对照组307例.纳入研究的NOS评分均在5分以上,文献质量较高.Meta分析结果显示:①对于不同刺激类型,在注视时间上,与对照组相比,抑郁症患者在正性刺激下的注视时间显著减少(SMD正性=-1.00,95％CI:-1.88至-0.12,P=0.03),在负性刺激下的注视时间显著增加(SMD负性=0.77,95％CI:0.50-1.04,P<0.00001),在中性刺激下的注视时间则不存在显著性差异(SMD中性=-0.17,95％CI:-0.48-0.14,P=0.28);②在首视时间上,抑郁症患者与对照组差异均无显著性意义(SMD正性=0.18,95％CI:-0.25-0.61,P=0.42;SMD中性=-0.19,95％CI:-0.46-0.08,P=0.17;SMD负性=0.24,95％CI:-0.04-0.52,P=0.09);③在注视次数上,与对照组相比,抑郁症患者在正性和中性刺激下的注视次数显著减少(SMD正性=-3.65,95％CI:-4.59至-2.71,P<0.00001;SMD中性=-1.08,95％CI:-1.61至-0.56,P<0.0001),在负性刺激下的注视次数显著增加(SMD负性=1.32,95％CI:0.78-1.86,P<0.00001).结论:抑郁症与健康个体的注视模式存在显著性差异,其差异主要表现在注视时间和注视次数上,未来的研究可选取其他眼动指标作为观察变量,进一步探索抑郁症患者的注视模式特征.

目的 评价老年抗感染领域药物干预系统评价纳入的随机对照试验(randomized controlled trial,RCT)的方法学质量.方法 计算机检索PubMed、EMbase、CNKI、The Cochrane Library、WanFang Data、VIP和CBM数据库,搜集国内外老年抗感染领域的系统评价或Meta分析,检索时限均为建库至2020年2月17日.对纳入的系统评价/Meta分析中RCT的方法学质量进行分析.结果 共纳入8篇系统评价,包括19篇RCT,6 735例老年人.纳入RCT的样本量为23～2 538例,发表时间为1980～2020年.RCT关注疾病涉及老年人术后感染、泌尿道感染、艰难梭状芽胞杆菌感染等.纳入的RCT均不同程度存在方法学质量问题,其中选择性偏倚(随机序列生成)、选择性偏倚(分配隐藏)维度的低风险评价比例最低(47.4％、36.8％)且评价结果为不清楚的比例(42.1％、52.6％)最高.测量偏倚和实施偏倚维度的高风险评价比例最高,均为21.1％.结论 老年抗感染领域RCT质量有待进一步提升,今后应开展高质量的老年抗感染RCT,以更好地指导临床实践.