Ferrucci R, Bortolomasi M, Vergari M, Tadini L, Salvoro B, Giacopuzzi M, Barbieri S, Priori A
Centro Clinico per le Neuronanotecnologie e la Neurostimolazione, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Milan, Italy.
J Affect Disord. 2009 Nov;118(1-3):215-9. doi: 10.1016/j.jad.2009.02.015. Epub 2009 Mar 16.
Though antidepressant drugs are the treatment of choice for severe major depression, a number of patients do not improve with pharmacologic treatment. This study aimed to assess the effects of transcranial direct current stimulation (tDCS) in patients with severe, drug-resistant depression.
Fourteen hospitalized patients aged 37-68, with severe major depressive disorder according to DSM-IV.TR criteria, drug resistant, with high risk of suicide and referred for ECT were included. Mood was evaluated using the Beck Depression Inventory (BDI), the Hamilton Depression Rating Scale (HDRS) and the Visual Analogue Scale (VAS). We also administered cognitive tasks to evaluate the possible cognitive effects on memory and attention. tDCS was delivered over the dorsolateral prefrontal cortex (DLPC) (2 mA, 20 min, anode left, cathode right) twice a day.
After five days of treatment although cognitive performances remained unchanged, the BDI and HDRS scores improved more than 30% (BDI p=0.001; HDRS p=0.017). The mood improvement persisted and even increased at four (T2) weeks after treatment ended. The feeling of sadness and mood as evaluated by VAS improved after tDCS (Sadness p=0.007; Mood p=0.036).
We conclude that frontal tDCS is a simple, promising technique that can be considered in clinical practice as adjuvant treatment for hospitalized patients with severe, drug-resistant major depression.
尽管抗抑郁药物是重度重度抑郁症的首选治疗方法，但仍有许多患者药物治疗效果不佳。本研究旨在评估经颅直流电刺激（tDCS）对重度耐药抑郁症患者的疗效。
纳入14例年龄在37 - 68岁之间的住院患者，这些患者符合DSM-IV.TR标准的重度重度抑郁症，耐药，有高自杀风险且被转诊接受ECT治疗。使用贝克抑郁量表（BDI）、汉密尔顿抑郁评定量表（HDRS）和视觉模拟量表（VAS）评估情绪。我们还进行了认知任务，以评估对记忆和注意力可能的认知影响。tDCS通过背外侧前额叶皮质（DLPC）（2 mA，20分钟，阳极在左，阴极在右）每天进行两次。
治疗五天后，尽管认知表现保持不变，但BDI和HDRS评分改善超过30%（BDI p = 0.001；HDRS p = 0.017）。情绪改善持续存在，甚至在治疗结束四周（T2）时有所增加。tDCS后，VAS评估的悲伤感和情绪得到改善（悲伤p = 0.007；情绪p = 0.036）。
我们得出结论，额叶tDCS是一种简单且有前景的技术，可以在临床实践中作为重度耐药重度抑郁症住院患者的辅助治疗方法。
