Centre of Psychiatry, Justus-Liebig University, Klinikstrasse 36, 35392, Giessen, Hessen, Germany.
Centre for Mind, Brain and Behaviour (CMBB), University of Marburg and Justus-Liebig University Giessen, Marburg, Germany.
Eur Arch Psychiatry Clin Neurosci. 2021 Feb;271(1):135-156. doi: 10.1007/s00406-020-01209-9. Epub 2020 Nov 19.
Transcranial alternating current stimulation (tACS) is a unique form of non-invasive brain stimulation. Sinusoidal alternating electric currents are delivered to the scalp to affect mostly cortical neurons. tACS is supposed to modulate brain function and, in turn, cognitive processes by entraining brain oscillations and inducing long-term synaptic plasticity. Therefore, tACS has been investigated in cognitive neuroscience, but only recently, it has been also introduced in psychiatric clinical trials. This review describes current concepts and first findings of applying tACS as a potential therapeutic tool in the field of psychiatry. The current understanding of its mechanisms of action is explained, bridging cellular neuronal activity and the brain network mechanism. Revisiting the relevance of altered brain oscillations found in six major psychiatric disorders, putative targets for the management of mental disorders using tACS are discussed. A systematic literature search on PubMed was conducted to report findings of the clinical studies applying tACS in patients with psychiatric conditions. In conclusion, the initial results may support the feasibility of tACS in clinical psychiatric populations without serious adverse events. Moreover, these results showed the ability of tACS to reset disturbed brain oscillations, and thus to improve behavioural outcomes. In addition to its potential therapeutic role, the reactivity of the brain circuits to tACS could serve as a possible tool to determine the diagnosis, classification or prognosis of psychiatric disorders. Future double-blind randomised controlled trials are necessary to answer currently unresolved questions. They may aim to detect response predictors and control for various confounding factors.
经颅交流电刺激（tACS）是一种独特的非侵入性脑刺激形式。正弦交流电被传递到头皮上，主要影响皮质神经元。tACS 被认为通过调制脑振荡和诱导长期突触可塑性来调节脑功能和认知过程。因此，tACS 在认知神经科学中得到了研究，但直到最近，它才被引入精神病学的临床试验中。本综述描述了将 tACS 作为一种潜在的治疗工具应用于精神病学领域的当前概念和初步发现。解释了其作用机制的当前理解，将细胞神经元活动和脑网络机制联系起来。回顾在六种主要精神障碍中发现的改变的脑振荡的相关性，讨论了使用 tACS 管理精神障碍的潜在目标。在 PubMed 上进行了系统的文献检索，以报告在精神病患者中应用 tACS 的临床研究结果。总之，初步结果可能支持 tACS 在没有严重不良事件的临床精神病人群中的可行性。此外，这些结果表明 tACS 能够重置紊乱的脑振荡，从而改善行为结果。除了其潜在的治疗作用外，大脑回路对 tACS 的反应可能作为确定精神障碍的诊断、分类或预后的一种可能工具。未来的双盲随机对照试验是必要的，以回答目前尚未解决的问题。它们可能旨在检测反应预测因子，并控制各种混杂因素。
