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经颅直流电刺激治疗阿尔茨海默病抑郁:一项随机对照试验的研究方案

Transcranial direct current stimulation for depression in Alzheimer's disease: study protocol for a randomized controlled trial.

作者信息

Narita Zui, Yokoi Yuma

机构信息

Department of Psychiatry, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1, Ogawahigashi, Kodaira, Tokyo, Japan.

出版信息

Trials. 2017 Jun 19;18(1):285. doi: 10.1186/s13063-017-2019-z.

Abstract

BACKGROUND

Patients with Alzheimer's disease frequently elicit neuropsychiatric symptoms as well as cognitive deficits. Above all, depression is one of the most common neuropsychiatric symptoms in Alzheimer's disease but antidepressant drugs have not shown significant beneficial effects on it. Moreover, electroconvulsive therapy has not ensured its safety for potential severe adverse events although it does show beneficial clinical effect. Transcranial direct current stimulation can be the safe alternative of neuromodulation, which applies weak direct electrical current to the brain. Although transcranial direct current stimulation has plausible evidence for its effect on depression in young adult patients, no study has explored it in older subjects with depression in Alzheimer's disease. Therefore, we present a study protocol designed to evaluate the safety and clinical effect of transcranial direct current stimulation on depression in Alzheimer's disease in subjects aged over 65 years.

METHOD

This is a two-arm, parallel-design, randomized controlled trial, in which patients and assessors will be blinded. Subjects will be randomized to either an active or a sham transcranial direct current stimulation group. Participants in both groups will be evaluated at baseline, immediately, and 2 weeks after the intervention.

DISCUSSION

This study investigates the safety and effect of transcranial direct current stimulation that may bring a significant impact on both depression and cognition in patients with Alzheimer's disease, and may be useful to enhance their quality of life.

TRIAL REGISTRATION

ClinicalTrials.gov, NCT02351388 . Registered on 27 January 2015. Last updated on 30 May 2016.

摘要

背景

阿尔茨海默病患者常出现神经精神症状以及认知缺陷。其中,抑郁是阿尔茨海默病最常见的神经精神症状之一,但抗抑郁药物对其并未显示出显著的有益效果。此外,尽管电休克疗法确实显示出有益的临床效果,但其安全性因潜在的严重不良事件而未得到保障。经颅直流电刺激可作为一种安全的神经调节替代方法,它向大脑施加微弱的直流电。尽管经颅直流电刺激对年轻成年抑郁症患者的疗效有合理证据,但尚无研究在患有抑郁症的老年阿尔茨海默病患者中进行探索。因此,我们提出一项研究方案,旨在评估经颅直流电刺激对65岁以上阿尔茨海默病患者抑郁症的安全性和临床效果。

方法

这是一项双臂、平行设计、随机对照试验,患者和评估者将采用盲法。受试者将被随机分为经颅直流电刺激治疗组或假刺激组。两组参与者将在基线、干预后即刻和2周时进行评估。

讨论

本研究调查经颅直流电刺激的安全性和效果,其可能对阿尔茨海默病患者的抑郁和认知产生重大影响,并可能有助于提高他们的生活质量。

试验注册

ClinicalTrials.gov,NCT02351388。于2015年1月27日注册。最后更新于2016年5月30日。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f0f0/5477338/b7824c5d8153/13063_2017_2019_Fig1_HTML.jpg

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