Ningbo Kangning Hospital, Ningbo, Zhejiang, China.
Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, China; Co-innovation Center of Neuroregeneration, Nantong University, Nantong, Jiangsu, China.
Sleep Med. 2020 Jun;70:17-26. doi: 10.1016/j.sleep.2020.02.003. Epub 2020 Feb 20.
Although several strategies using transcranial direct current stimulation (tDCS) have been investigated to treat major depressive disorder (MDD), the efficacy of this treatment for patients with MDD who also have insomnia is unclear.
To observe the effects of tDCS on sleep quality and depressive symptoms in patients with MDD who have insomnia.
We conducted a randomized, double-blinded study involving adults with major depression and insomnia. We randomly assigned patients to either add tDCS or to sham tDCS to their regular treatment. After randomization, we treated a total of 90 patients at the Kangning Hospital, Ningbo, China. We allocated 47 patients to the tDCS group and 43 to the sham tDCS group. The tDCS treatment procedure included 20 sessions of 2-mA stimulation of the dorsolateral prefrontal cortex (DLPFC) for 30 min, which was followed by four weekly treatments. The anode and cathode electrodes were placed on the left and right DLPFC, respectively. We recorded the Self-rating Depression Scale (SDS), Self-rating Anxiety Scale (SAS), Pittsburgh Sleep Quality Inventory (PSQI), and Polysomnography (PSG) at Day 1 and Day 28.
Compared with the sham tDCS group, the active tDCS group showed improved total scores of SAS and SDS. PSQI total score and all PSQI sub-divisions, except for "sleep duration and sleep efficiency," significantly improved after treatment. We also observed that tDCS affected sleep architecture, by increasing total sleep time and improving sleep efficiency through PSG.
Our study demonstrated the effect of tDCS on sleep quality and depressive symptoms in patients with MDD and insomnia. These results suggested that tDCS stimulation not only improved symptoms of depression and anxiety but also had a positive effect on sleep quality in patients with MDD. For patients with depression and insomnia, tDCS stimulation could be a good supplement to drugs.
尽管已经研究了几种使用经颅直流电刺激（tDCS）的策略来治疗重度抑郁症（MDD），但对于同时患有失眠的 MDD 患者，这种治疗方法的疗效尚不清楚。
观察 tDCS 对伴有失眠的 MDD 患者睡眠质量和抑郁症状的影响。
我们进行了一项随机、双盲研究，纳入了患有重度抑郁症和失眠的成年人。我们将患者随机分配至 tDCS 组或假 tDCS 组，作为他们常规治疗的附加治疗。随机分组后，我们在中国宁波康宁医院共治疗了 90 名患者。我们将 47 名患者分配至 tDCS 组，43 名患者分配至假 tDCS 组。tDCS 治疗过程包括 20 次 2 mA 刺激外侧前额叶皮质（DLPFC），每次 30 分钟，随后进行四次每周治疗。阳极和阴极电极分别放置在左右 DLPFC 上。我们在第 1 天和第 28 天记录了自评抑郁量表（SDS）、自评焦虑量表（SAS）、匹兹堡睡眠质量指数（PSQI）和多导睡眠图（PSG）。
与假 tDCS 组相比，tDCS 组的 SAS 和 SDS 总分改善，PSQI 总分及除“睡眠时间和睡眠效率”以外的所有 PSQI 分项均改善。我们还观察到 tDCS 通过 PSG 增加总睡眠时间和提高睡眠效率来影响睡眠结构。
我们的研究表明，tDCS 对伴有失眠的 MDD 患者的睡眠质量和抑郁症状有影响。这些结果表明，tDCS 刺激不仅改善了抑郁和焦虑症状，而且对 MDD 患者的睡眠质量也有积极影响。对于患有抑郁症和失眠的患者，tDCS 刺激可能是药物治疗的良好补充。
