Pathak Harsh, Sreeraj Vanteemar S, Venkatasubramanian Ganesan
InSTAR Program and WISER Neuromodulation Program, Schizophrenia Clinic, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India.
Clin Psychopharmacol Neurosci. 2023 Nov 30;21(4):634-649. doi: 10.9758/cpn.22.1042. Epub 2023 May 22.
Transcranial alternating current stimulation (tACS) may modulate neuronal oscillations by applying sinusoidal alternating current, thereby alleviating associated symptoms in schizophrenia. Considering its possible utility in schizophrenia, we reviewed the literature for tACS protocols administered in schizophrenia and their findings. A scoping review was conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guideline in databases and clinical trial registers. The search resulted in 59 publications. After excluding review articles unrelated to tACS, trials without published results or not involving patients with schizophrenia, 14 studies were included. Among the included studies/case reports only 5 were randomized controlled therapeutic trials. The studies investigated the utility of tACS for clinical and neurobiological outcomes. All studies reported good tolerability with only transient mild side effects. It was administered mostly during the working memory task (such as computerized n-back task, dual back task, and computerized digit symbol substitution task) for schizophrenia patients with cognitive deficits and during resting state while targeting positive symptoms. A possible reduction in hallucinations and delusions using alpha tACS, and improvement in negative and cognitive deficits with theta and gamma tACS were reported. Nevertheless, one of the randomized controlled trials targeting hallucinations was negative and rigorous large-sample studies are lacking for other domains. The current evidence for tACS in schizophrenia is preliminary though promising. In future, more sham controlled randomized trials assessing the effect of tACS on various domains are needed to substantiate these early findings.
经颅交流电刺激（tACS）可通过施加正弦交流电来调节神经元振荡，从而缓解精神分裂症的相关症状。考虑到其在精神分裂症中的潜在效用，我们检索了关于精神分裂症中应用tACS方案及其研究结果的文献。按照系统评价和Meta分析的首选报告项目（PRISMA）指南，在数据库和临床试验注册库中进行了一项范围综述。检索结果为59篇出版物。在排除与tACS无关的综述文章、未发表结果或未涉及精神分裂症患者的试验后，纳入了14项研究。在所纳入的研究/病例报告中，只有5项是随机对照治疗试验。这些研究调查了tACS对临床和神经生物学结果的效用。所有研究均报告耐受性良好，仅有短暂的轻度副作用。对于有认知缺陷的精神分裂症患者，tACS大多在工作记忆任务（如计算机化n-back任务、双背任务和计算机化数字符号替换任务）期间施用，而在针对阳性症状时则在静息状态下施用。据报告，使用α tACS可能会减少幻觉和妄想，使用θ和γ tACS可改善阴性症状和认知缺陷。然而，一项针对幻觉的随机对照试验结果为阴性，且在其他领域缺乏严格的大样本研究。目前tACS在精神分裂症中的证据虽有前景但尚属初步。未来，需要更多评估tACS对各个领域影响的假对照随机试验来证实这些早期发现。
