结合基于正念的减压疗法（MBSR）和经颅直流电刺激（tDCS）改善患有抑郁症或焦虑症的老年人的认知：一项试点随机临床试验的结果。
Enhancing Cognition in Older Persons with Depression or Anxiety with a Combination of Mindfulness-Based Stress Reduction (MBSR) and Transcranial Direct Current Stimulation (tDCS): Results of a Pilot Randomized Clinical Trial.
作者信息
Brooks Heather, Oughli Hanadi Ajam, Kamel Lojine, Subramanian Subha, Morgan Gwen, Blumberger Daniel M, Kloeckner Jeanne, Kumar Sanjeev, Mulsant Benoit H, Lenze Eric J, Rajji Tarek K
机构信息
Centre for Addiction and Mental Health and Department of Psychiatry, University of Toronto, Toronto, ON Canada.
Washington University School of Medicine, St. Louis, MO USA.
出版信息
Mindfulness (N Y). 2021;12(12):3047-3059. doi: 10.1007/s12671-021-01764-9. Epub 2021 Oct 5.
OBJECTIVES
Individuals with subjective memory complaints and symptoms of depression and/or anxiety are at high risk for further cognitive decline, and possible progression to dementia. Low-burden interventions to help slow or prevent cognitive decline in this high-risk group are needed. The objective of this study is to assess the feasibility of combining Mindfulness-Based Stress Reduction (MBSR) with transcranial direct current stimulation (tDCS) to increase putative benefits of MBSR for cognitive function and everyday mindfulness in depressed or anxious older adults with subjective cognitive decline.
METHODS
We conducted a two-site pilot double-blind randomized sham-controlled trial, combining active MBSR with either active or sham tDCS. The intervention included weekly in-class group sessions at the local university hospital and daily at-home practice. Anodal tDCS was applied for 30 min during MBSR meditative practice, both in-class and at-home.
RESULTS
Twenty-six individuals with subjective cognitive complaints and symptoms of depression and/or anxiety were randomized to active ( = 12) or sham tDCS ( = 14). The combination of MBSR and tDCS was safe and well tolerated, though at-home adherence and in-class attendance were variable. While they were not statistically significant, the largest effect sizes for active vs. sham tDCS were for everyday mindfulness ( = 0.6) and social functioning ( = 0.9) ( = 3.68, = 0.07 and = 3.9, = 0.06, respectively).
CONCLUSIONS
Our findings suggest that it is feasible and safe to combine tDCS with MBSR in older depressed and anxious adults, including during remote, at-home use. Furthermore, tDCS may enhance MBSR via transferring its meditative learning and practice into increases in everyday mindfulness. Future studies need to improve adherence to MBSR with tDCS.
TRIAL REGISTRATION
ClinicalTrials.gov (NCT03653351 and NCT03680664).
SUPPLEMENTARY INFORMATION
The online version contains supplementary material available at 10.1007/s12671-021-01764-9.
目的
有主观记忆问题以及抑郁和/或焦虑症状的个体，有进一步认知能力下降以及可能发展为痴呆症的高风险。需要低负担的干预措施来帮助减缓或预防这一高风险群体的认知能力下降。本研究的目的是评估将基于正念减压疗法（MBSR）与经颅直流电刺激（tDCS）相结合的可行性，以增强MBSR对有主观认知能力下降的抑郁或焦虑老年人认知功能和日常正念的假定益处。
方法
我们进行了一项双中心试点双盲随机假对照试验，将主动MBSR与主动或假tDCS相结合。干预措施包括在当地大学医院每周进行一次课堂小组课程以及每天的家庭练习。在课堂和家庭的MBSR冥想练习期间，阳极tDCS应用30分钟。
结果
26名有主观认知问题以及抑郁和/或焦虑症状的个体被随机分为主动tDCS组（n = 12）或假tDCS组（n = 14）。MBSR和tDCS的组合是安全且耐受性良好的，尽管家庭练习的依从性和课堂出勤率各不相同。虽然没有统计学意义，但主动tDCS与假tDCS相比，最大效应量出现在日常正念（Cohen's d = 0.6）和社交功能（Cohen's d = 0.9）方面（分别为F = 3.68，p = 0.07和F = 3.9，p = 0.06）。
结论
我们的研究结果表明，在抑郁和焦虑的老年人中，将tDCS与MBSR相结合是可行且安全的，包括在远程家庭使用期间。此外，tDCS可能通过将其冥想学习和练习转化为日常正念的增加来增强MBSR。未来的研究需要提高tDCS与MBSR结合的依从性。
试验注册
ClinicalTrials.gov（NCT03653351和NCT03680664）。
补充信息
在线版本包含可在10.1007/s12671-021-01764-9获取的补充材料。
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