Department of Head and Skin - Psychiatry and Medical Psychology, Ghent University Hospital, Ghent, Belgium; Ghent Experimental Psychiatry (GHEP) Lab, Ghent, Belgium.
Department of Head and Skin - Psychiatry and Medical Psychology, Ghent University Hospital, Ghent, Belgium; Ghent Experimental Psychiatry (GHEP) Lab, Ghent, Belgium; Department of Psychiatry, University Hospital UZBrussel, Brussels, Belgium; Eindhoven University of Technology, Department of Electrical Engineering, Eindhoven, the Netherlands.
Biol Psychol. 2021 Jan;158:107991. doi: 10.1016/j.biopsycho.2020.107991. Epub 2020 Nov 21.
Recent literature shows great heterogeneity in the reported efficacy of transcranial direct current stimulation (tDCS) as a stand-alone psychiatric treatment. Aiming to increase its efficacy, tDCS has been combined with psychological interventions. Our state-of-the-art overview of such combined treatment trials indicates, however, that these usually do not elicit synergistic clinical effects. We therefore explored more basic mechanisms related to the brain state-dependency of tDCS. Importantly, based on our overview, the efficacy of combined interventions may depend on whether individual patients present with endophenotypes that are implicated in the development and maintenance of psychopathology, such as prefrontal-mediated cognitive dysfunction. We discuss how future studies may contribute to the development of personally-tailored dual active treatments by adhering to the Research Domain Criteria (RDoC) framework. RDoC-based mechanistic research may reveal alternative neural circuits that should be functionally targeted by both tDCS and psychological interventions, with promising avenues for clinical psychological science and practice.
近期文献表明，经颅直流电刺激（tDCS）作为一种独立的精神科治疗方法，其疗效存在很大的异质性。为了提高其疗效，tDCS 已与心理干预相结合。然而，我们对这些联合治疗试验的最新综述表明，这些联合治疗通常不会产生协同的临床效果。因此，我们探索了与 tDCS 的大脑状态依赖性相关的更基本的机制。重要的是，基于我们的综述，联合干预的疗效可能取决于个体患者是否存在与精神病理学的发展和维持有关的表型，例如前额叶介导的认知功能障碍。我们讨论了未来的研究如何通过遵循研究领域标准（RDoC）框架，为个性化双激活治疗的发展做出贡献。基于 RDoC 的机制研究可能会揭示替代的神经回路，这些回路应该是 tDCS 和心理干预的功能靶点，为临床心理科学和实践提供了有前途的途径。
