Minichino Amedeo, Bersani Francesco Saverio, Spagnoli Francesco, Corrado Alessandra, De Michele Francesco, Calò Wanda Katharina, Primavera Martina, Yang Baoran, Bernabei Laura, Macrì Francesco, Vergnani Lucilla, Biondi Massimo, Delle Chiaie Roberto
Department of Neurology and Psychiatry, Sapienza University of Rome, Viale dell'Università 30, 00185 Rome, Italy.
Behav Neurol. 2014;2014:876521. doi: 10.1155/2014/876521. Epub 2014 Dec 7.
Sleep problems are common in bipolar disorder (BD) and may persist during the euthymic phase of the disease. The aim of the study was to improve sleep quality of euthymic BD patients through the administration of prefronto-cerebellar transcranial direct current stimulation (tDCS).
25 euthymic outpatients with a diagnosis of BD Type I or II have been enrolled in the study. tDCS montage was as follows: cathode on the right cerebellar cortex and anode over the left dorsolateral prefrontal cortex (DLPFC); the intensity of stimulation was set at 2 mA and delivered for 20 min/die for 3 consecutive weeks. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality at baseline and after the tDCS treatment.
PSQI total score and all PSQI subdomains, with the exception of "sleep medication," significantly improved after treatment.
This is the first study where a positive effect of tDCS on the quality of sleep in euthymic BD patients has been reported. As both prefrontal cortex and cerebellum may play a role in regulating sleep processes, concomitant cathodal (inhibitory) stimulation of cerebellum and anodal (excitatory) stimulation of DLPFC may have the potential to modulate prefrontal-thalamic-cerebellar circuits leading to improvements of sleep quality.
睡眠问题在双相情感障碍（BD）中很常见，并且可能在疾病的心境正常期持续存在。本研究的目的是通过给予前额叶 - 小脑经颅直流电刺激（tDCS）来改善心境正常的BD患者的睡眠质量。
25名诊断为I型或II型BD的心境正常的门诊患者被纳入本研究。tDCS的电极放置如下：阴极置于右侧小脑皮质，阳极置于左侧背外侧前额叶皮质（DLPFC）；刺激强度设定为2毫安，每天持续20分钟，连续3周。匹兹堡睡眠质量指数（PSQI）用于在基线和tDCS治疗后评估睡眠质量。
治疗后，PSQI总分及除“睡眠药物”外的所有PSQI子域均有显著改善。
这是第一项报道tDCS对心境正常的BD患者睡眠质量有积极影响的研究。由于前额叶皮质和小脑可能都在调节睡眠过程中发挥作用，因此同时对小脑进行阴极（抑制性）刺激和对DLPFC进行阳极（兴奋性）刺激可能有潜力调节前额叶 - 丘脑 - 小脑回路，从而改善睡眠质量。
