Agarwal Sri Mahavir, Shivakumar Venkataram, Bose Anushree, Subramaniam Aditi, Nawani Hema, Chhabra Harleen, Kalmady Sunil V, Narayanaswamy Janardhanan C, Venkatasubramanian Ganesan
The Schizophrenia Clinic, Department of Psychiatry and Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bangalore, India.
Clin Psychopharmacol Neurosci. 2013 Dec;11(3):118-25. doi: 10.9758/cpn.2013.11.3.118. Epub 2013 Dec 24.
Transcranial direct current stimulation (tDCS) is an upcoming treatment modality for patients with schizophrenia. A series of recent observations have demonstrated improvement in clinical status of schizophrenia patients with tDCS. This review summarizes the research work that has examined the effects of tDCS in schizophrenia patients with respect to symptom amelioration, cognitive enhancement and neuroplasticity evaluation. tDCS is emerging as a safe, rapid and effective treatment for various aspects of schizophrenia symptoms ranging from auditory hallucinations-for which the effect is most marked, to negative symptoms and cognitive symptoms as well. An interesting line of investigation involves using tDCS for altering and examining neuroplasticity in patients and healthy subjects and is likely to lead to new insights into the neurological aberrations and pathophysiology of schizophrenia. The mechanistic aspects of the technique are discussed in brief. Future work should focus on establishing the clinical efficacy of this novel technique and on evaluating this modality as an adjunct to cognitive enhancement protocols. Understanding the mechanism of action of tDCS as well as the determinants and neurobiological correlates of clinical response to tDCS remains an important goal, which will help us expand the clinical applications of tDCS for the treatment of patients with schizophrenia.
经颅直流电刺激(tDCS)是一种即将应用于精神分裂症患者的治疗方式。最近的一系列观察表明,经颅直流电刺激可改善精神分裂症患者的临床状况。本综述总结了关于经颅直流电刺激对精神分裂症患者症状改善、认知增强和神经可塑性评估影响的研究工作。经颅直流电刺激正在成为一种安全、快速且有效的治疗方法,可用于治疗精神分裂症的各种症状,从效果最为显著的幻听,到阴性症状和认知症状。一个有趣的研究方向是利用经颅直流电刺激来改变和检测患者及健康受试者的神经可塑性,这可能会为精神分裂症的神经异常和病理生理学带来新的见解。本文简要讨论了该技术的作用机制。未来的工作应侧重于确立这种新技术的临床疗效,并将这种治疗方式作为认知增强方案的辅助手段进行评估。了解经颅直流电刺激的作用机制以及临床反应的决定因素和神经生物学相关性仍然是一个重要目标,这将有助于我们扩大经颅直流电刺激在精神分裂症患者治疗中的临床应用。