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神经认知功能作为重度抑郁症前额叶经颅直流电刺激的结果及预测指标:来自DepressionDC试验的分析

Neurocognitive function as outcome and predictor for prefrontal transcranial direct current stimulation in major depressive disorder: an analysis from the DepressionDC trial.

作者信息

Soldini Aldo, Vogelmann Ulrike, Aust Sabine, Goerigk Stephan, Plewnia Christian, Fallgatter Andreas, Normann Claus, Frase Lukas, Zwanzger Peter, Kammer Thomas, Schönfeldt-Lecuona Carlos, Vural Gizem, Bajbouj Malek, Padberg Frank, Burkhardt Gerrit

机构信息

Department of Psychiatry and Psychotherapy, LMU University Hospital, Munich, Germany.

International Max Planck Research School for Translational Psychiatry, Munich, Germany.

出版信息

Eur Arch Psychiatry Clin Neurosci. 2024 Feb 26. doi: 10.1007/s00406-024-01759-2.

Abstract

Transcranial direct current stimulation (tDCS) of the prefrontal cortex might beneficially influence neurocognitive dysfunctions associated with major depressive disorder (MDD). However, previous studies of neurocognitive effects of tDCS have been inconclusive. In the current study, we analyzed longitudinal, neurocognitive data from 101 participants of a randomized controlled multicenter trial (DepressionDC), investigating the efficacy of bifrontal tDCS (2 mA, 30 min/d, for 6 weeks) in patients with MDD and insufficient response to selective serotonin reuptake inhibitors (SSRI). We assessed whether active tDCS compared to sham tDCS elicited beneficial effects across the domains of memory span, working memory, selective attention, sustained attention, executive process, and processing speed, assessed with a validated, digital test battery. Additionally, we explored whether baseline cognitive performance, as a proxy of fronto-parietal-network functioning, predicts the antidepressant effects of active tDCS versus sham tDCS. We found no statistically significant group differences in the change of neurocognitive performance between active and sham tDCS. Furthermore, baseline cognitive performance did not predict the clinical response to tDCS. Our findings indicate no advantage in neurocognition due to active tDCS in MDD. Additional research is required to systematically investigate the effects of tDCS protocols on neurocognitive performance in patients with MDD.

摘要

经颅直流电刺激(tDCS)前额叶皮层可能对与重度抑郁症(MDD)相关的神经认知功能障碍产生有益影响。然而,先前关于tDCS神经认知效应的研究尚无定论。在本研究中,我们分析了一项随机对照多中心试验(DepressionDC)中101名参与者的纵向神经认知数据,该试验旨在研究双额叶tDCS(2毫安,每天30分钟,持续6周)对MDD患者且对选择性5-羟色胺再摄取抑制剂(SSRI)反应不足的疗效。我们使用经过验证的数字测试组合评估了与假刺激相比,主动tDCS在记忆广度、工作记忆、选择性注意、持续注意、执行过程和处理速度等领域是否产生有益效果。此外,我们还探讨了作为额顶叶网络功能指标的基线认知表现是否能预测主动tDCS与假刺激相比的抗抑郁效果。我们发现主动tDCS与假刺激在神经认知表现变化方面无统计学显著组间差异。此外,基线认知表现不能预测对tDCS的临床反应。我们的研究结果表明,主动tDCS对MDD患者的神经认知无优势。需要进一步研究以系统调查tDCS方案对MDD患者神经认知表现的影响。

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