比较阳极、阴极和假经颅直流电刺激对阿片类药物成瘾患者脑源性神经营养因子及心理症状的疗效。
Comparing the Efficacy of Anodal, Cathodal, and Sham Transcranial Direct Current Stimulation on Brain-Derived Neurotrophic Factor and Psychological Symptoms in Opioid-Addicted Patients.
作者信息
Eskandari Zakaria, Dadashi Mohsen, Mostafavi Hossin, Armani Kia Alireza, Pirzeh Reza
机构信息
Department of Clinical Psychology, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran.
Department of Clinical Psychology, Faculty of Medicine, Social Determinants of Health Research Center, Zanjan University of Medical Sciences, Zanjan, Iran.
出版信息
Basic Clin Neurosci. 2019 Nov-Dec;10(6):641-650. doi: 10.32598/BCN.10.6.1710.1. Epub 2019 Nov 1.
INTRODUCTION
Today, addiction to opioids is a serious problem all over the world. Unfortunately, the consumption of these drugs and the number of addicted people have drastically increased. This research aimed at comparing the efficacy of anodal, cathodal, and sham transcranial Direct Current Stimulation (tDCS) on the Brain-Derived Neurotrophic Factor (BDNF) and psychological symptoms in opioid-addicted patients.
METHODS
Thirty opioid-addicted patients were selected based on the Diagnostic and Statistical Manual of Mental Disorders, the Fifth Edition, through the convenience sampling method. They were then randomly assigned to 3 groups (10 in each group). The subjects were evaluated before and after tDCS by their serum level of BDNF, desires for drug questionnaire, and depression anxiety stress scale. The data were analyzed by the Kolmogorov-Smirnov test, one-way analysis of variance, as well as the Bonferroni test.
RESULTS
Stimulating the Dorsolateral Prefrontal Cortex (DLPFC) led to a significant change in increasing the level of BDNF (P=0.031) and reducing the degree of depression (P=0.018), anxiety (P=0.001), stress (P=0.012), and decreased the level of craving (P=0.001) in opioid-addicted patients. There was no significant difference between active stimulation groups (anodal left/cathodal right and anodal right/cathodal left). The stimulation of the right DLPFC (group B) significantly increased BDNF in comparison with the sham group (sham tDCS) and decreased anxiety and craving. Nonetheless, no change was observed in depression and stress. The stimulation of the left DLPFC (group A) significantly reduced depression, anxiety, stress, and craving compared with the sham group, while there was no change in BDNF.
CONCLUSION
In addition to the conventional treatments of opioid-addicted patients, tDCS is an effective complementary treatment.
引言
如今，阿片类药物成瘾在全球都是一个严重问题。不幸的是，这些药物的消费量以及成瘾人数都急剧增加。本研究旨在比较阳极、阴极和假经颅直流电刺激（tDCS）对阿片类药物成瘾患者脑源性神经营养因子（BDNF）及心理症状的疗效。
方法
根据《精神疾病诊断与统计手册》第五版，通过便利抽样法选取30例阿片类药物成瘾患者。然后将他们随机分为3组（每组10人）。在tDCS前后，通过检测患者血清BDNF水平、药物渴望问卷及抑郁焦虑压力量表对受试者进行评估。数据采用柯尔莫哥洛夫 - 斯米尔诺夫检验、单因素方差分析以及邦费罗尼检验进行分析。
结果
刺激背外侧前额叶皮质（DLPFC）可使阿片类药物成瘾患者的BDNF水平显著升高（P = 0.031），抑郁程度（P = 0.018）、焦虑程度（P = 0.001）、压力程度（P = 0.012）显著降低，药物渴望程度降低（P = 0.001）。主动刺激组（阳极左/阴极右和阳极右/阴极左）之间无显著差异。与假刺激组（假tDCS）相比，右侧DLPFC刺激（B组）显著增加了BDNF，并降低了焦虑和药物渴望。然而，抑郁和压力方面未观察到变化。与假刺激组相比，左侧DLPFC刺激（A组）显著降低了抑郁、焦虑、压力和药物渴望，而BDNF无变化。
结论
除了对阿片类药物成瘾患者的常规治疗外，tDCS是一种有效的辅助治疗方法。
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