Department of Psychiatry and Psychotherapy, RG Stress, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, J5, 68159, Mannheim, Germany.
Sci Rep. 2023 Apr 6;13(1):5619. doi: 10.1038/s41598-023-32531-6.
The main objective of this study was to evaluate the effect of left anodal transcranial direct current stimulation (tDCS) on hypothalamic-pituitary-adrenal axis (HPAA) activity in individuals with depression. We conducted a 3-week, randomized, triple-blind pilot trial with 47 participants (dropout rate: 14.89%) randomly assigned to either the tDCS or control group (sham stimulation). Salivary cortisol was used as an HPAA activity marker since cortisol is the effector hormone of the HPAA. The primary outcome was the effect of tDCS on the diurnal cortisol pattern (DCP and area under the curve with respect to ground -AUCg-). Secondary outcomes included tDCS effects on cortisol awakening response (CAR) and cortisol decline (CD), as well as the variation of cortisol concentrations between the initiation of tDCS and 2 weeks later. Intention-to-treat and per-protocol analyses were conducted. Our primary outcome showed an absent effect of tDCS on DCP and AUCg. Additionally, tDCS had an absent effect on CAR, CD, and cortisol concentration variation before-after stimulation. Our pilot study suggests that anodal tDCS showed an absent effect on HPAA activity in individuals with depression. More studies are needed to confirm these findings.
本研究的主要目的是评估左侧阳极经颅直流电刺激（tDCS）对抑郁症患者下丘脑-垂体-肾上腺轴（HPAA）活性的影响。我们进行了为期 3 周的随机、三盲、平行对照试验，共纳入 47 名参与者（失访率：14.89%），随机分配至 tDCS 组或对照组（假刺激）。唾液皮质醇被用作 HPAA 活性的标志物，因为皮质醇是 HPAA 的效应激素。主要结局是 tDCS 对昼夜皮质醇模式（DCP 和基线校正后的 AUCg）的影响。次要结局包括 tDCS 对皮质醇觉醒反应（CAR）和皮质醇下降（CD）的影响，以及 tDCS 开始前后皮质醇浓度的变化。进行了意向治疗和方案分析。我们的主要结局显示 tDCS 对 DCP 和 AUCg 没有影响。此外，tDCS 对 CAR、CD 和刺激前后皮质醇浓度变化也没有影响。我们的初步研究表明，阳极 tDCS 对抑郁症患者的 HPAA 活性没有影响。需要更多的研究来证实这些发现。
