Li Zhe, Zhao Xueli, Feng Lingfang, Zhao Yu, Pan Wen, Liu Ying, Yin Ming, Yue Yan, Fang Xiaojia, Liu Guorui, Gao Shigeng, Zhang Xiaobin, Huang Norden Eh, Du Xiangdong, Chen Rui
Sleep Center, The Second Affiliated Hospital of Soochow University, Suzhou, China.
Sleep Center, Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China.
Front Psychiatry. 2022 May 18;13:851908. doi: 10.3389/fpsyt.2022.851908. eCollection 2022.
The purpose of this study was to determine the effects of daytime transcranial direct current stimulation (tDCS) on sleep electroencephalogram (EEG) in patients with depression.
The study was a double-blinded, randomized, controlled clinical trial. A total of 37 patients diagnosed with a major depression were recruited; 19 patients (13 females and 6 males mean age 44.79 ± 15.25 years) received tDCS active stimulation and 18 patients (9 females and 9 males; mean age 43.61 ± 11.89 years) received sham stimulation. Ten sessions of daytime tDCS were administered with the anode over F3 and the cathode over F4. Each session delivered a 2 mA current for 30 min per 10 working days. Hamilton-24 and Montgomery scales were used to assess the severity of depression, and polysomnography (PSG) was used to assess sleep structure and EEG complexity. Eight intrinsic mode functions (IMFs) were computed from each EEG signal in a channel. The sample entropy of the cumulative sum of the IMFs were computed to acquire high-dimensional multi-scale complexity information of EEG signals.
The complexity of Rapid Eye Movement (REM) EEG signals significantly decreased intrinsic multi-scale entropy (iMSE) (1.732 ± 0.057 vs. 1.605 ± 0.046, = 0.0004 in the case of the C4 channel, IMF 1:4 and scale 7) after tDCS active stimulation. The complexity of the REM EEG signals significantly increased iMSE (1.464 ± 0.101 vs. 1.611 ± 0.085, = 0.001 for C4 channel, IMF 1:4 and scale 7) after tDCS sham stimulation. There was no significant difference in the Hamilton-24 ( = 0.988), Montgomery scale score ( = 0.726), and sleep structure (N1% = 0.383; N2% = 0.716; N3% = 0.772) between the two groups after treatment.
Daytime tDCS changed the complexity of sleep in the REM stage, and presented as decreased intrinsic multi-scale entropy, while no changes in sleep structure occurred. This finding indicated that daytime tDCS may be an effective method to improve sleep quality in depressed patients. Trial registration This trial has been registered at the ClinicalTrials.gov (protocol ID: TCHIRB-10409114, in progress).
本研究旨在确定白天经颅直流电刺激（tDCS）对抑郁症患者睡眠脑电图（EEG）的影响。
该研究为双盲、随机、对照临床试验。共招募了37名被诊断为重度抑郁症的患者；19名患者（13名女性和6名男性，平均年龄44.79±15.25岁）接受tDCS主动刺激，18名患者（9名女性和9名男性；平均年龄43.61±11.89岁）接受假刺激。在白天进行10次tDCS治疗，阳极置于F3，阴极置于F4。每10个工作日的每个疗程施加2 mA电流，持续30分钟。使用汉密尔顿-24量表和蒙哥马利量表评估抑郁严重程度，并使用多导睡眠图（PSG）评估睡眠结构和EEG复杂性。从每个通道的EEG信号中计算出8个本征模函数（IMF）。计算IMF累积和的样本熵，以获取EEG信号的高维多尺度复杂性信息。
tDCS主动刺激后，快速眼动（REM）期EEG信号的复杂性显著降低了本征多尺度熵（iMSE）（C4通道、IMF 1:4和尺度7的情况下，1.732±0.057对1.605±0.046， = 0.0004）。tDCS假刺激后，REM期EEG信号的复杂性显著增加了iMSE（C4通道、IMF 1:4和尺度7的情况下，1.464±0.101对1.611±0.085， = 0.001）。治疗后两组在汉密尔顿-24量表（ = 0.988）、蒙哥马利量表评分（ = 0.726）和睡眠结构（N1% = 0.383；N2% = 0.716；N3% = 0.772）方面无显著差异。
白天tDCS改变了REM期睡眠的复杂性，表现为本征多尺度熵降低，而睡眠结构无变化。这一发现表明白天tDCS可能是改善抑郁症患者睡眠质量的有效方法。试验注册 该试验已在ClinicalTrials.gov注册（协议编号：TCHIRB-10409114，进行中）。
