Stein Dirson João, Fernandes Medeiros Liciane, Caumo Wolnei, Torres Iraci Ls
Laboratório de Farmacologia da Dor e Neuromodulação, Investigações Pré-Clínicas, Centro de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil.
Programa de Pós-Graduação em Medicina: Ciências Médicas, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
Neuropsychiatr Dis Treat. 2020 Jan 14;16:161-169. doi: 10.2147/NDT.S195840. eCollection 2020.
Anxiety is one of the most prevalent and debilitating psychiatric conditions worldwide. Pharmaco- and psycho-therapies have been employed in the treatment of human anxiety to date. Yet, either alone or in combination, unsatisfactory patient outcomes are prevalent, resulting in a considerable number of people whose symptoms fail to respond to conventional therapies with symptoms remaining after intervention. The demand for new therapies has given birth to several noninvasive brain stimulation techniques. Transcranial direct current stimulation (tDCS) has arisen as a promising tool and has been proven to be safe and well tolerated for the treatment of many diseases, including chronic pain, depression, and anxiety. Here, reports of the use of tDCS in anxiety disorders in human patients were reviewed and summarized. A literature search was conducted in mid-2019, to identify clinical studies that evaluated the use of tDCS for the treatment of anxiety behavior. The PubMed, Web of Science, and Scielo and PsycInfo databases were explored using the following descriptors: "anxiety", "anxious behavior", "tDCS", and "transcranial direct current stimulation". Among the selected articles, considerable variability in the type of tDCS treatment applied in interventions was observed. Evidence shows that tDCS may be more effective when used in combination with drugs and cognitive behavioral therapies; however future large-scale clinical trials are recommended to better clarify the real effects of this intervention alone, or in combination with others.
焦虑是全球最普遍且使人衰弱的精神疾病之一。迄今为止，药物治疗和心理治疗已被用于治疗人类焦虑症。然而，无论是单独使用还是联合使用，患者治疗效果不理想的情况普遍存在，导致相当一部分人的症状对传统疗法没有反应，干预后症状依然存在。对新疗法的需求催生了几种非侵入性脑刺激技术。经颅直流电刺激（tDCS）已成为一种有前景的工具，并已被证明在治疗包括慢性疼痛、抑郁症和焦虑症在内的多种疾病时安全且耐受性良好。在此，对人类患者焦虑症中使用tDCS的报告进行了综述和总结。2019年年中进行了文献检索，以确定评估tDCS治疗焦虑行为的临床研究。使用以下描述词对PubMed、科学网、Scielo和PsycInfo数据库进行了检索：“焦虑”、“焦虑行为”、“tDCS”和“经颅直流电刺激”。在所选定的文章中，观察到干预中应用的tDCS治疗类型存在相当大的差异。有证据表明，tDCS与药物和认知行为疗法联合使用时可能更有效；然而，建议未来进行大规模临床试验，以更好地阐明这种干预单独使用或与其他方法联合使用的实际效果。
