San-Juan Daniel, Mas Raúl Nathanael May, Gutiérrez Cuauhtémoc, Morales Jorge, Díaz Ana, Quiñones Gerardo, Galindo Axel Kevin, Baigts Luis Armando, Ximenez-Camilli Cecilia, Anschel David
Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Epilepsy Clinic - Mexico City - Mexico City - Mexico.
Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Neurology Department - Mexico City - Mexico City - Mexico.
Sleep Sci. 2022 Jan-Mar;15(Spec 1):89-96. doi: 10.5935/1984-0063.20220007.
Medical residents must sustain acute sleep deprivation, which can lead to nonfatal and fatal consequences in hospitals due to cognitive decline. Anodal transcranial direct current stimulation (a-tDCS) is a safe noninvasive neuromodulation technique that can induce depolarization of neurons. Previous studies in pilots have shown benefits against fatigue increasing wakefulness and cognitive performance. However, the effects of a-tDCS on cognition in acute sleep deprived healthcare workers remains unknown.
To evaluate cognitive changes in sleep deprived medical residents after one session of a-tDCS.
Open clinical test-re-test study including 13 medical residents with acute sleep deprivation. Subjects received 1 session of bifrontal a-tDCS (2mAx20min), anodal over the left dorsolateral prefrontal region. Pre-and-post treatment subjects were tested with Beck anxiety inventory, Beck depression and HVLT tests, Rey´s and Taylor´s figures, Trail Making A/B, Stroop, Aleatory Digit retention test (WAIS), Digits and symbols and MoCA tests. Post-intervention was added the Executive functions and Frontal Lobes Neuropsychological Battery (BANFE2) test and changing the Taylor figure for Reyfigure.
Twelve medical residents were analyzed; 8 men and 4 women, 29.5 (+/-2.2) years mean age. All had a mean of 21.6 (+/-1.3) hours of sleep deprivation. There were no serious adverse events. We found statistically significant difference in Rey´s/Taylor´s figures (p=0.002), Trail Making Test (p=0.005), WAIS IV symbols (p=0.003), Word Stroop (p=0.021). BANFE-2 showed that the main affected area was the orbito-medial prefrontal region.
a-tDCS appears safe and improves working memory, attention, response time and distractors elimination in acute sleep deprived medical residents.
住院医生必须忍受急性睡眠剥夺，这可能因认知能力下降而在医院导致非致命和致命后果。阳极经颅直流电刺激（a-tDCS）是一种安全的非侵入性神经调节技术，可诱导神经元去极化。先前针对飞行员的研究表明，该技术有助于对抗疲劳，提高清醒度和认知表现。然而，a-tDCS对急性睡眠剥夺的医护人员认知的影响仍不清楚。
评估单次a-tDCS治疗后睡眠剥夺住院医生的认知变化。
开放性临床重测研究，纳入13名急性睡眠剥夺的住院医生。受试者接受1次双额叶a-tDCS治疗（2毫安×20分钟），阳极置于左侧背外侧前额叶区域。治疗前后，受试者接受贝克焦虑量表、贝克抑郁量表和霍普金斯词语学习测验、雷氏和泰勒图形测验、连线测验A/B、斯特鲁普测验、随机数字记忆测验（韦氏成人智力量表）、数字和符号测验以及蒙特利尔认知评估量表测试。干预后增加执行功能和额叶神经心理成套测验（BANFE2）测试，并将泰勒图形测验改为雷氏图形测验。
分析了12名住院医生；8名男性和4名女性，平均年龄29.5（±2.2）岁。所有人平均睡眠剥夺21.6（±1.3）小时。未发生严重不良事件。我们发现，雷氏/泰勒图形测验（p = 0.002）、连线测验（p = 0.005）、韦氏成人智力量表第四版符号测验（p = 0.003）、词语斯特鲁普测验（p = 0.021）有统计学显著差异。BANFE-2显示，主要受影响区域是眶内侧前额叶区域。
a-tDCS似乎安全，可改善急性睡眠剥夺住院医生的工作记忆、注意力、反应时间和干扰项排除能力。
