Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Department of Psychiatry, Tri-Service General Hospital Songshan Branch, National Defense Medical Center, Taipei, Taiwan.
Prog Neuropsychopharmacol Biol Psychiatry. 2020 Jan 10;96:109715. doi: 10.1016/j.pnpbp.2019.109715. Epub 2019 Jul 27.
No studies have examined the efficacy of bi-anodal transcranial direct current stimulation (tDCS) over bilateral dorsolateral prefrontal cortex (DLPFC) coupled with bilateral extracephalic references in treating negative symptoms of non-acute schizophrenia patients. This study aimed to investigate the therapeutic effects of the new approach of tDCS on negative symptoms, other schizophrenia symptoms, cognitive deficits and psychosocial functioning in a double-blind, randomized, sham-controlled trial. Patients with non-acute schizophrenia (N = 60) in randomized order received sham treatment or bilaterally provided tDCS (2 mA, twice-daily sessions for five consecutive days) with the anode over the DLPFC and the reference (cathode) over the ipsilateral forearm. The negative symptoms as measured by a dimensional approach of Positive and Negative Syndrome Scale (PANSS) were rapidly reduced by bimodal tDCS relative to sham stimulation (F = 24.86, Cohen's d = 0.661, p = 6.11 × 10). The beneficial effect on negative symptoms lasted for up to 3 months. The authors also observed improvement with tDCS of psychosocial functioning as measured by the global score of Personal and Social Performance scale (PSP) and psychopathological symptoms especially for disorganization and cognitive symptoms as measured by the PANSS. No effects were observed on other schizophrenia symptom dimensions and the performance on a series of neurocognitive tests. Our results show promise for bi-anodal tDCS over bilateral DLPFC using bilateral extracephalic references in treating negative symptoms and other selected manifestations of schizophrenia. Further studies with electrophysiological or imaging evaluation help unravel the exact mechanism of action of this novel stimulation parameter of tDCS in schizophrenia patients. (ClinicalTrials.gov ID:NCT03701100).
尚无研究探讨双-阳极经颅直流电刺激(tDCS)作用于双侧背外侧前额叶皮层(DLPFC)联合双侧颅外参考电极对非急性期精神分裂症患者阴性症状的疗效。本研究旨在通过双盲、随机、假刺激对照试验,探究 tDCS 新方法对阴性症状、其他精神分裂症症状、认知缺陷和社会心理功能的治疗效果。将 60 例非急性期精神分裂症患者随机分为假刺激组或双模式 tDCS 组,双模式 tDCS 组采用 2 mA 电流,每天两次,连续 5 天,阳极置于 DLPFC,阴极置于同侧前臂。阳性和阴性综合征量表(PANSS)维度评分显示,双模态 tDCS 可快速减轻阴性症状(F=24.86,Cohen's d=0.661,p=6.11×10)。这种对阴性症状的有益影响持续长达 3 个月。作者还观察到 tDCS 可改善社会心理功能,个人和社会表现量表(PSP)的总体评分升高,PANSS 中精神病理症状,特别是紊乱和认知症状也有所改善。tDCS 对其他精神分裂症症状维度和一系列神经认知测试的表现没有影响。本研究结果表明,双-阳极 tDCS 作用于双侧 DLPFC 联合双侧颅外参考电极可能对治疗精神分裂症的阴性症状和其他特定症状有效。进一步的电生理学或影像学评估研究有助于阐明 tDCS 这种新型刺激参数治疗精神分裂症患者的确切作用机制。(ClinicalTrials.gov 注册号:NCT03701100)。
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