Kumar Pattath Narayanan Suresh, Krishnan Arun Gopala, Suresh Rohith, Andrade Chittaranjan
Department of Psychiatry, KMCT Medical College, Kozhikode, Kerala, India.
Department of Medicine, Government Medical College, Ernamkulam, Kerala, India.
Indian J Psychiatry. 2020 Sep-Oct;62(5):572-576. doi: 10.4103/psychiatry.IndianJPsychiatry_182_19. Epub 2020 Oct 10.
Transcranial direct current stimulation (tDCS) has demonstrated efficacy against antipsychotic-refractory auditory verbal hallucinations (AVH) in schizophrenia. The duration of persistence of benefit is not well characterized.
Thirty-one adults with schizophrenia and medication-refractory AVH were treated with 2-3 mA tDCS in 30 min sessions, twice a day, 6 days a week, for 2-4 weeks. The anode was sited over F3 and the cathode midway between T3 and P3 in the 10-20 EEG system. Patients were assessed until a 4-month study endpoint using two auditory hallucination rating scales and the Positive and Negative Syndrome Scale (PANSS-N).
Auditory hallucinations were moderately reduced by tDCS with 25%-29% improvement evident by the end of the 2 week and another 10% improvement between week 2 and 4 months. There was no loss of benefit at the end of the 4-month study. There was also a small (11%) but statistically significant improvement in PANSS-N scores.
Although this study is limited by the nonblind, uncontrolled design, the results suggest that tDCS, as delivered, holds promise for treating refractory AVH in schizophrenia; the benefits persist beyond the short term.
经颅直流电刺激(tDCS)已被证明对治疗精神分裂症中对抗精神病药物难治的幻听有效。益处持续的时间尚未得到很好的描述。
31名患有精神分裂症且对药物难治的幻听患者接受2 - 3毫安的tDCS治疗,每次30分钟,每天两次,每周6天,持续2 - 4周。在10 - 20脑电图系统中,阳极置于F3上方,阴极置于T3和P3之间的中点。使用两种幻听评定量表和阳性与阴性症状量表(PANSS - N)对患者进行评估,直至4个月研究终点。
tDCS使幻听程度适度降低,在2周结束时改善明显,改善率为25% - 29%,在第2周和4个月之间又有10%的改善。在4个月研究结束时益处没有消失。PANSS - N评分也有小幅(11%)但具有统计学意义的改善。
尽管本研究受非盲法、非对照设计的限制,但结果表明,所采用的tDCS有望治疗精神分裂症中的难治性幻听;益处持续时间超过短期。