Department of Psychiatry, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany,
Department of Psychiatry, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.
Neuropsychobiology. 2020;79(6):372-383. doi: 10.1159/000501227. Epub 2019 Jul 24.
Transcranial direct current stimulation (tDCS) is a neuromodulation technique, which noninvasively alters cortical excitability via weak polarizing currents between two electrodes placed on the scalp. Since it is comparably easy to handle, cheap to use and relatively well tolerated, tDCS has gained increasing interest in recent years. Based on well-known behavioral effects, a number of clinical studies have been performed in populations including patients with major depressive disorder followed by schizophrenia and substance use disorders, in sum with heterogeneous results with respect to efficacy. Nevertheless, the potential of tDCS must not be underestimated since it could be further improved by systematically investigating the various stimulation parameters to eventually increase clinical efficacy. The present article briefly explains the underlying physiology of tDCS, summarizes typical stimulation protocols and then reviews clinical efficacy for various psychiatric disorders as well as prevalent adverse effects. Future developments include combined and more complex interactions of tDCS with pharmacological or psychotherapeutic interventions. In particular, using computational models to individualize stimulation protocols, considering state dependency and applying closed-loop technologies will pave the way for tDCS-based personalized interventions as well as the development of home treatment settings promoting the role of tDCS as an effective treatment option for patients with mental health problems.
经颅直流电刺激（tDCS）是一种神经调节技术，通过放置在头皮上的两个电极之间施加弱极化电流来非侵入性地改变皮质兴奋性。由于 tDCS 易于操作、使用成本低且耐受性相对较好，近年来越来越受到关注。基于众所周知的行为效应，已经在包括重度抑郁症、精神分裂症和物质使用障碍患者在内的人群中进行了多项临床研究，但在疗效方面存在异质性结果。尽管如此，也不能低估 tDCS 的潜力，因为通过系统地研究各种刺激参数，可以进一步提高其临床疗效。本文简要解释了 tDCS 的潜在生理学机制，总结了典型的刺激方案，然后回顾了各种精神障碍的临床疗效以及常见的不良反应。未来的发展包括 tDCS 与药物或心理治疗干预的联合和更复杂的相互作用。特别是，使用计算模型来个性化刺激方案，考虑状态依赖性并应用闭环技术将为基于 tDCS 的个性化干预以及促进 tDCS 作为精神健康问题患者有效治疗选择的家庭治疗环境的发展铺平道路。
