Department and Institute of Psychiatry, University of São Paulo, São Paulo, Brazil.
Expert Rev Med Devices. 2014 Jul;11(4):383-94. doi: 10.1586/17434440.2014.911082. Epub 2014 Apr 22.
Although recent clinical studies using transcranial direct current stimulation (tDCS) for schizophrenia showed encouraging results, several tDCS montages were employed and their current flow pattern has not been investigated. We performed a systematic review to identify clinical tDCS studies in schizophrenia. We then applied computer head modeling analysis for prediction of current flow. Out of 41 references, we identified 12 relevant studies. The most employed montage was anode and cathode over the left dorsolateral prefrontal and temporoparietal cortex, respectively. Computational model analysis predicted activation and under-activation under the anode and the cathode, respectively, occurring in areas respectively associated with negative and positive symptoms. We also identified tDCS-induced electrical currents in cortical areas between the electrodes (frontoparietal network) and, to a lesser extent, in deeper structures involved in schizophrenia pathophysiology. Mechanisms of tDCS effects in schizophrenia and the usefulness of computer modeling techniques for planning tDCS trials in schizophrenia are discussed.
虽然最近使用经颅直流电刺激（tDCS）治疗精神分裂症的临床研究取得了令人鼓舞的结果，但采用了几种 tDCS 模式，其电流流动模式尚未得到研究。我们进行了系统评价，以确定精神分裂症的临床 tDCS 研究。然后，我们应用计算机头部建模分析来预测电流流动。在 41 篇参考文献中，我们确定了 12 项相关研究。最常用的模式是阳极和阴极分别放置在左背外侧前额叶和颞顶叶皮层上。计算模型分析预测在阳极和阴极下分别会出现激活和失活，分别发生在与阴性和阳性症状相关的区域。我们还在电极之间的皮质区域（额顶网络）中发现了 tDCS 诱导的电流，在涉及精神分裂症病理生理学的更深层结构中则发现得较少。讨论了 tDCS 对精神分裂症的影响机制以及计算机建模技术在规划精神分裂症 tDCS 试验中的有用性。
