Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
Department of Psychology, University of Münster, Münster, Germany.
Eur Arch Psychiatry Clin Neurosci. 2021 Feb;271(1):101-110. doi: 10.1007/s00406-020-01127-w. Epub 2020 Apr 11.
Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation intervention investigated for the treatment of depression. Clinical results have been heterogeneous, partly due to the variability of electric field (EF) strength in the brain owing to interindividual differences in head anatomy. Therefore, we investigated whether EF strength was correlated with behavioral changes in 16 depressed patients using simulated electric fields in real patient data from a controlled clinical trial. We hypothesized that EF strength in the dorsolateral prefrontal cortex (DLPFC) and anterior cingulate cortex (ACC), brain regions implicated in depression pathophysiology, would be associated with changes in depression, mood and anxiety scores. SimNIBS were used to simulate individual electric fields based on the MRI structural T1-weighted brain scans of depressed subjects. Linear regression models showed, at the end of the acute treatment phase, that simulated EF strength was inversely associated with negative affect in the bilateral ACC (left: β = - 160.463, CI [- 291.541, - 29.385], p = 0.021; right: β = - 189.194, CI [- 289.479, - 88.910], p = 0.001) and DLPFC (left: β = - 93.210, CI [- 154.960, - 31.461], p = 0.006; right: β = - 82.564, CI [- 142.867, - 22.262], p = 0.011) and with depression scores in the left ACC (β = - 156.91, CI [- 298.51, - 15.30], p = 0.033). No association between positive affect or anxiety scores, and simulated EF strength in the investigated brain regions was found. To conclude, our findings show preliminary evidence that EF strength simulations might be associated with further behavioral changes in depressed patients, unveiling a potential mechanism of action for tDCS. Further studies should investigate whether individualization of EF strength in key brain regions impact clinical response.
经颅直流电刺激（tDCS）是一种非侵入性脑刺激干预措施，用于治疗抑郁症。临床结果存在异质性，部分原因是由于个体头部解剖结构的差异导致大脑中的电场（EF）强度发生变化。因此，我们使用来自对照临床试验的真实患者数据中的模拟电场，研究了 16 名抑郁症患者的 EF 强度是否与行为变化相关。我们假设，在与抑郁症病理生理学有关的脑区背外侧前额叶皮层（DLPFC）和前扣带皮层（ACC）中的 EF 强度与抑郁、情绪和焦虑评分的变化相关。SimNIBS 用于根据抑郁患者的 MRI 结构 T1 加权脑扫描来模拟个体电场。线性回归模型显示，在急性治疗阶段结束时，双侧 ACC（左侧：β= -160.463，CI [-291.541，-29.385]，p=0.021；右侧：β= -189.194，CI [-289.479，-88.910]，p=0.001）和 DLPFC（左侧：β= -93.210，CI [-154.960，-31.461]，p=0.006；右侧：β= -82.564，CI [-142.867，-22.262]，p=0.011）中的模拟 EF 强度与负面情绪呈负相关，并且与左 ACC 中的抑郁评分呈负相关（β= -156.91，CI [-298.51，-15.30]，p=0.033）。在研究的脑区中，未发现积极情绪或焦虑评分与模拟 EF 强度之间存在关联。总之，我们的研究结果初步表明，EF 强度模拟可能与抑郁患者的进一步行为变化相关，揭示了 tDCS 的潜在作用机制。进一步的研究应调查关键脑区中的 EF 强度个体化是否会影响临床反应。
