Singh Shipra, Meena Amit K, Sharma Gautam, Deshpande Smita N
Department of Psychiatry, Postgraduate Institute of Medical Sciences, Rohtak, Haryana, India.
Department of Psychiatry, G.B. Pant Hospital, Delhi, India.
Ind Psychiatry J. 2021 Jul-Dec;30(2):305-309. doi: 10.4103/ipj.ipj_38_20. Epub 2021 Oct 28.
Depression is a highly prevalent condition and includes clusters of symptoms, namely, depressive cognition, anxiety, and visceral symptoms. Depressive symptoms often respond sub-optimally to pharmacotherapy. Adjunctive transcranial direct current stimulation (tDCS), a noninvasive brain stimulation modality, may improve depressive symptomatology.
The aim of this study was to study the effect of tDCS as an augmentation strategy in depression and its various symptom domains.
It is a prospective interventional study. Patients diagnosed with depressive disorder (based on International Classification of Disease- 10 criteria, diagnosed by treating psychiatrist), aged 18-70 years, who showed inadequate improvement on antidepressant selective serotonin reuptake inhibitors, were recruited after informed consent. Each participant was administered 20 sessions of tDCS over 2 weeks, each session of 20 min, with anode placement at left dorsolateral prefrontal cortex and cathode at right supraorbital region. Hamilton Rating Scale for Depression (HAM-D) was administered pre- and post-intervention to assess the change in symptoms.
Of a total of 35 participants, the mean score on HAM-D prior to and postintervention was 19.97 (standard deviation [SD] = 3.519) and 13.17 (SD = 3.365), respectively. The difference was statistically highly significant ( = 0.000) on paired -test. All symptom domains of HAM-D, identified using the Cole and Motivala model (Cole ., 2004), also showed significant reduction from pre-tDCS to post-tDCS scores ( = 0.000).
Positive effect of tDCS on depressive symptoms, its tolerability and safety profile, and affordability makes it an effective therapeutic strategy in augmenting antidepressants in patients with depression. However, longer period studies with larger sample size may yield more generalizable results.
抑郁症是一种高度普遍的病症，包括一系列症状，即抑郁认知、焦虑和躯体症状。抑郁症状对药物治疗的反应往往不太理想。辅助性经颅直流电刺激（tDCS）是一种非侵入性脑刺激方式，可能改善抑郁症状。
本研究旨在探讨tDCS作为抑郁症增效策略及其对各种症状领域的影响。
这是一项前瞻性干预研究。根据国际疾病分类第10版标准被诊断为抑郁症（由主治精神科医生诊断）、年龄在18至70岁之间且在抗抑郁选择性5-羟色胺再摄取抑制剂治疗下改善不足的患者，在获得知情同意后被招募。每位参与者在2周内接受20次tDCS治疗，每次治疗20分钟，阳极置于左侧背外侧前额叶皮层，阴极置于右侧眶上区域。在干预前后使用汉密尔顿抑郁量表（HAM-D）评估症状变化。
在总共35名参与者中，干预前和干预后HAM-D的平均得分分别为19.97（标准差[SD]=3.519）和13.17（SD=3.365）。配对t检验显示差异具有高度统计学意义（P=0.000）。使用科尔和莫蒂瓦拉模型（科尔等人，2004年）确定的HAM-D所有症状领域，从tDCS治疗前到治疗后的得分也显示出显著降低（P=0.000）。
tDCS对抑郁症状具有积极作用，其耐受性、安全性和可承受性使其成为抑郁症患者抗抑郁药物增效的有效治疗策略。然而，样本量更大、时间更长的研究可能会得出更具普遍性的结果。
