Department of Psychiatry, Busan Paik Hospital, Inje University, Busan, Republic of Korea.
Department of Psychiatry, Busan Paik Hospital, Inje University, Busan, Republic of Korea.
Schizophr Res. 2018 Jul;197:378-385. doi: 10.1016/j.schres.2017.12.009.
Cognitive impairment is a common symptom of schizophrenia that has significant effects on quality of life and the activities of daily living. The present study examined the ability of transcranial direct current stimulation (tDCS) to improve cognitive function and clinical symptoms in patients with schizophrenia.
Fifty-six patients with schizophrenia were randomized to real-tDCS and sham-tDCS groups. The participants were stable for a period of 3months before study enrollment. Each group received 30min of active 2-mA tDCS or sham stimulation over the left dorsolateral prefrontal cortex (anode F3, cathode F4) once per day for 10 consecutive weekdays. The Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery (MCCB) and Wisconsin Card Sorting Test (WCST) were used to evaluate cognitive function, and the Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression-Schizophrenia scale (CGI-SCH), and Calgary Depression Scale for Schizophrenia (CDSS) were used to evaluate symptoms at baseline, after 10 sessions, and at 3-month follow-up.
There was a significant time×group interaction, indicating that MCCB working memory (P=0.008) and overall scores (P=0.031) improved over time in the real-tDCS group compared to the sham-tDCS group. There was also a significant time×group interaction for depressive symptoms as evaluated by the CGI-SCH, which decreased over time in the real-tDCS group (P=0.041). tDCS treatment combined with antipsychotic medication was generally well-tolerated and safe.
Adjunct tDCS treatment is safe and effective for improving cognitive status in patients with schizophrenia.
认知障碍是精神分裂症的常见症状,对生活质量和日常生活活动有重大影响。本研究考察了经颅直流电刺激(tDCS)改善精神分裂症患者认知功能和临床症状的能力。
56 名精神分裂症患者被随机分为真 tDCS 组和假 tDCS 组。参与者在研究入组前稳定了 3 个月。每组每天接受 30 分钟的左背外侧前额叶皮层(阳极 F3,阴极 F4)2mA 真刺激或假刺激,连续 10 天。采用测量和治疗改善精神分裂症认知共识认知电池(MCCB)和威斯康星卡片分类测验(WCST)评估认知功能,阳性和阴性综合征量表(PANSS)、临床总体印象-精神分裂症量表(CGI-SCH)和卡尔加里精神分裂症抑郁量表(CDSS)评估症状基线、10 次治疗后和 3 个月随访。
存在时间×组的交互作用,表明与假 tDCS 组相比,真 tDCS 组的 MCCB 工作记忆(P=0.008)和总评分(P=0.031)随时间改善。CGI-SCH 评估的抑郁症状也存在显著的时间×组交互作用,真 tDCS 组随时间下降(P=0.041)。tDCS 治疗联合抗精神病药物通常耐受良好且安全。
辅助 tDCS 治疗对改善精神分裂症患者的认知状态是安全有效的。