Yamada Yuji, Sueyoshi Kazuki, Yokoi Yuma, Inagawa Takuma, Hirabayashi Naotsugu, Oi Hideki, Shirama Aya, Sumiyoshi Tomiki
Department of Psychiatry, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan.
Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.
Front Psychiatry. 2022 Jun 20;13:862814. doi: 10.3389/fpsyt.2022.862814. eCollection 2022.
Patients with schizophrenia show impairments of social cognition, which cause poor real-world functional outcomes. Transcranial direct current stimulation (tDCS) delivered to frontal brain areas has been shown to partially alleviate disturbances of social cognition. In this study, we aimed to determine whether multisession tDCS targeting the superior temporal sulcus (STS), a brain region closely related to social cognition, would improve social cognitive performance in patients with schizophrenia.
This was an open-label, single-arm trial to investigate the benefits and safety of multisession tDCS over the left STS. Fifteen patients received tDCS (2 mA × 20 min) two times per day for 5 consecutive days. Anodal and cathodal electrodes were placed over the left STS and right supraorbital regions, respectively. Assessments with the Social Cognition Screening Questionnaire (SCSQ), the Hinting Task (HT), the Brief Assessment of Cognition in Schizophrenia (BACS), and the Positive and Negative Syndrome Scale (PANSS) were conducted at baseline and 1 month after the final stimulation.
Significant improvements were found on theory of mind, as measured using the SCSQ ( = 0.53) and the HT ( = 0.49). These changes on social cognition were not correlated with those of neurocognition, as measured using the BACS or psychotic symptoms, as measured using the PANSS. There were no adverse events of serious/moderate levels attributable to tDCS.
These results suggest that administration of multisession tDCS with anode stimulation targeting the left STS provides a novel strategy to improve functional outcomes in patients with schizophrenia.
The National Center of Neurology and Psychiatry Clinical Research Review Board (CRB3180006) approved this study.
This study was registered within the Japan Registry of Clinical Trials (jRCTs032180026).
精神分裂症患者存在社会认知障碍，这导致现实世界中的功能结局较差。经颅直流电刺激（tDCS）作用于额叶脑区已被证明可部分缓解社会认知障碍。在本研究中，我们旨在确定针对与社会认知密切相关的脑区颞上沟（STS）进行多疗程tDCS是否能改善精神分裂症患者的社会认知表现。
这是一项开放标签、单臂试验，旨在研究多疗程tDCS作用于左侧STS的益处和安全性。15名患者连续5天每天接受2次tDCS（2 mA×20分钟）。阳极和阴极电极分别置于左侧STS和右侧眶上区域。在基线和最后一次刺激后1个月，使用社会认知筛查问卷（SCSQ）、暗示任务（HT）、精神分裂症认知简短评估（BACS）和阳性与阴性症状量表（PANSS）进行评估。
使用SCSQ（=0.53）和HT（=0.49）测量发现，心理理论有显著改善。这些社会认知变化与使用BACS测量的神经认知变化或使用PANSS测量的精神病性症状变化无关。没有可归因于tDCS的严重/中度不良事件。
这些结果表明，采用阳极刺激靶向左侧STS的多疗程tDCS给药为改善精神分裂症患者的功能结局提供了一种新策略。
国家神经精神中心临床研究审查委员会（CRB3180006）批准了本研究。
本研究已在日本临床试验注册中心（jRCTs032180026）注册。
