Knotkova Helena, Rosedale Mary, Strauss Shiela M, Horne Jaclyn, Soto Eliezer, Cruciani Ricardo A, Malaspina Dolores, Malamud Daniel
Research Division, Department of Pain Medicine and Palliative Care, Institute for Non-Invasive Brain Stimulation, Beth Israel Medical Center New York, NY, USA.
Front Psychiatry. 2012 Jun 18;3:59. doi: 10.3389/fpsyt.2012.00059. eCollection 2012.
Transcranial direct current stimulation (tDCS) is a novel non-invasive neuromodulatory method that influences neuronal firing rates and excitability of neuronal circuits in the brain. tDCS has been shown to relieve Major Depressive Disorder (MDD) in the general population, suggesting its potential for other vulnerable populations with high MDD prevalence.
This study evaluated the feasibility, safety, acceptability, and clinical outcomes of a 2-week tDCS antidepressant treatment in HIV-MDD co-diagnosed patients, and the feasibility of collecting serum and saliva for analysis of immunity biomarkers.
Ten enrolled patients underwent baseline evaluation and started the tDCS treatment (Monday-Friday for 2 weeks) delivered with Phoresor II 850 PM for 20 min at 2 mA at each visit, using two saline-soaked sponge electrodes placed over the F3 position of EEG 10-20 system and the contralateral supraorbital region. Outcome measures were collected at baseline, after the last tDCS and 2 weeks later. A quantitative microarray (Ray Bio Tech Inc.) for TH1/TH2 cytokines was used for saliva and plasma analysis.
Analyzable outcome-data were obtained from eight subjects. Depression scores significantly decreased (p < 0.0005) after the treatment. No serious adverse events occurred. Several transient minor AEs and occasional changes of blood pressure and heart rate were noted. Mini-mental state examination scores remained unchanged or increased after the treatment. All subjects were highly satisfied with the protocol and treatment results and described the desire to find new treatments for HIV-MDD as motivating participation.
Findings support feasibility and clinical potential of tDCS for HIV-MDD patients, and justify larger-sample, sham-controlled trials.
经颅直流电刺激（tDCS）是一种新型的非侵入性神经调节方法，可影响大脑中神经元的放电频率和神经回路的兴奋性。tDCS已被证明可缓解普通人群中的重度抑郁症（MDD），这表明其对其他MDD患病率较高的易感人群具有潜在作用。
本研究评估了为期2周的tDCS抗抑郁治疗在HIV-MDD共诊断患者中的可行性、安全性、可接受性和临床结果，以及收集血清和唾液用于免疫生物标志物分析的可行性。
10名入组患者接受了基线评估，并开始tDCS治疗（周一至周五，为期2周），每次就诊时使用Phoresor II 850 PM以2 mA的电流进行20分钟的治疗，使用两个浸泡生理盐水的海绵电极分别置于EEG 10-20系统的F3位置和对侧眶上区域。在基线、最后一次tDCS治疗后以及2周后收集结果指标。使用用于TH1/TH2细胞因子的定量微阵列（Ray Bio Tech Inc.）对唾液和血浆进行分析。
从8名受试者中获得了可分析的结果数据。治疗后抑郁评分显著降低（p < 0.0005）。未发生严重不良事件。记录到一些短暂的轻微不良事件以及血压和心率的偶尔变化。治疗后简易精神状态检查评分保持不变或升高。所有受试者对方案和治疗结果高度满意，并表示希望找到针对HIV-MDD的新治疗方法是参与研究的动力。
研究结果支持tDCS对HIV-MDD患者的可行性和临床潜力，并为更大样本的假对照试验提供了依据。
