Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, PO Box 59, London, SE5 8AF, UK.
Department of Psychology, School of Social Science, University of Westminster, London, W1W 6UW, UK.
Eur Child Adolesc Psychiatry. 2024 Sep;33(9):3003-3023. doi: 10.1007/s00787-023-02157-0. Epub 2023 Feb 11.
Transcranial direct current stimulation (tDCS) has demonstrated benefits in adults with various psychiatric disorders, but its clinical utility in children and young people (CYP) remains unclear. This PRISMA systematic review used published and ongoing studies to examine the effects of tDCS on disorder-specific symptoms, mood and neurocognition in CYP with psychiatric disorders. We searched Medline via PubMed, Embase, PsychINFO via OVID, and Clinicaltrials.gov up to December 2022. Eligible studies involved multiple session (i.e., treatment) tDCS in CYP (≤ 25 years old) with psychiatric disorders. Two independent raters assessed the eligibility of studies and extracted data using a custom-built form. Of 33 eligible studies (participant N = 517), the majority (n = 27) reported an improvement in at least one outcome measure of disorder-specific symptoms. Few studies (n = 13) examined tDCS effects on mood and/or neurocognition, but findings were mainly positive. Overall, tDCS was well tolerated with minimal side effects. Of 11 eligible ongoing studies, many are sham-controlled RCTs (n = 9) with better blinding techniques and a larger estimated participant enrolment (M = 79.7; range 15-172) than published studies. Although encouraging, the evidence to date is insufficient to firmly conclude that tDCS can improve clinical symptoms, mood, or cognition in CYP with psychiatric disorders. Ongoing studies appear of improved methodological quality; however, future studies should broaden outcome measures to more comprehensively assess the effects of tDCS and develop dosage guidance (i.e., treatment regimens).
经颅直流电刺激(tDCS)已被证明对各种精神障碍的成年人有好处,但它在儿童和青少年(CYP)中的临床应用尚不清楚。本 PRISMA 系统评价使用已发表和正在进行的研究,检查 tDCS 对患有精神障碍的 CYP 中特定障碍症状、情绪和神经认知的影响。我们通过 PubMed 搜索了 Medline、通过 OVID 搜索了 Embase、通过 OVID 搜索了 PsychINFO,以及截止到 2022 年 12 月的 Clinicaltrials.gov。符合条件的研究包括对患有精神障碍的 CYP(≤ 25 岁)进行多次疗程(即治疗)tDCS。两名独立的评估员使用定制的表格评估研究的资格并提取数据。在 33 项符合条件的研究中(参与者 N = 517),大多数(n = 27)报告了至少一种特定障碍症状的测量结果有所改善。少数研究(n = 13)检查了 tDCS 对情绪和/或神经认知的影响,但结果主要是积极的。总体而言,tDCS 的耐受性良好,副作用极小。在 11 项符合条件的正在进行的研究中,许多是假对照 RCT(n = 9),具有更好的盲法技术和更大的估计参与者招募人数(M = 79.7;范围 15-172)比已发表的研究。尽管令人鼓舞,但迄今为止的证据还不足以确定 tDCS 可以改善患有精神障碍的 CYP 的临床症状、情绪或认知。正在进行的研究似乎具有更高的方法学质量;然而,未来的研究应该扩大结果测量范围,更全面地评估 tDCS 的效果,并制定剂量指南(即治疗方案)。