Mervis Joshua E, Capizzi Riley J, Boroda Elias, MacDonald Angus W
Department of Psychology, University of Minnesota Minneapolis, MN, USA.
Department of Neuroscience, University of Minnesota Minneapolis, MN, USA.
Front Hum Neurosci. 2017 Feb 2;11:44. doi: 10.3389/fnhum.2017.00044. eCollection 2017.
Cognitive deficits are a core and disabling feature of psychotic disorders, specifically schizophrenia. Current treatments for impaired cognition in schizophrenia remain insufficient. Recent research suggests transcranial direct current stimulation (tDCS) targeting the dorsolateral prefrontal cortex can potentiate cognitive improvements in healthy individuals and those with psychiatric conditions, such as schizophrenia. However, this burgeoning literature has not been quantitatively evaluated. Through a literature search and quantitative review, we identified 194 papers on tDCS, psychosis, and cognition. Selection criteria included pre/post design and sham control to achieve specific sham-adjusted effect sizes. The 6 retained studies all address schizophrenia populations and include single and repeated stimulation, as well as within and between subject designs. Small positive effects were found for anodal stimulation on behavioral measures of attention and working memory, with tentative findings for cognitive ability and memory. Cathodal stimulation yielded a small positive effect on behaviorally measured cognitive ability. Neurophysiological measures of attention showed a small to medium down-modulation effect for anodal stimulation. Implications of these findings and guidelines for future research are discussed. As revealed by this report, due to the paucity of data available, much remains unknown regarding the clinical efficacy of tDCS in schizophrenia.
认知缺陷是精神障碍尤其是精神分裂症的核心致残特征。目前针对精神分裂症认知功能受损的治疗方法仍显不足。近期研究表明，针对背外侧前额叶皮层的经颅直流电刺激（tDCS）可增强健康个体以及患有精神疾病（如精神分裂症）者的认知改善。然而，这一新兴文献尚未得到定量评估。通过文献检索和定量综述，我们确定了194篇关于tDCS、精神病和认知的论文。选择标准包括前后设计和假刺激对照，以得出特定的经假刺激调整后的效应大小。保留的6项研究均针对精神分裂症患者群体，包括单次和重复刺激，以及受试者内和受试者间设计。阳极刺激对注意力和工作记忆的行为测量有小的积极影响，对认知能力和记忆有初步发现。阴极刺激对行为测量的认知能力有小的积极影响。注意力的神经生理学测量显示阳极刺激有小到中等程度的下调效应。讨论了这些发现的意义以及未来研究的指导方针。正如本报告所揭示的，由于可用数据匮乏，关于tDCS在精神分裂症中的临床疗效仍有许多未知之处。
