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经颅直流电刺激(tDCS)可降低认知训练对老年人增龄研究(ACT)中老年人的抑郁和状态焦虑症状。

tDCS reduces depression and state anxiety symptoms in older adults from the augmenting cognitive training in older adults study (ACT).

机构信息

Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA; Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA.

Department of Psychiatry, Neuroscience and Physiological Sciences Graduate Interdisciplinary Programs, and BIO5 Institute, University of Arizona and Arizona Alzheimer's Disease Consortium, Tucson, AZ, USA; Brain Imaging, Behavior and Aging Laboratory, Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA.

出版信息

Brain Stimul. 2024 Mar-Apr;17(2):283-311. doi: 10.1016/j.brs.2024.02.021. Epub 2024 Mar 2.

Abstract

BACKGROUND

Pharmacological interventions for depression and anxiety in older adults often have significant side effects, presenting the need for more tolerable alternatives. Transcranial direct current stimulation (tDCS) is a promising non-pharmacological intervention for depression in clinical populations. However, its effects on depression and anxiety symptoms, particularly in older adults from the general public, are understudied.

OBJECTIVE

We conducted a secondary analysis of the Augmenting Cognitive Training in Older Adults (ACT) trial to assess tDCS efficacy in reducing psychological symptoms in older adults. We hypothesized that active stimulation would yield greater reductions in depression and state anxiety compared to sham post-intervention and at the one-year follow-up. We also explored tDCS effects in subgroups characterized by baseline symptom severity.

METHODS

A sample of 378 older adults recruited from the community completed a 12-week tDCS intervention with cognitive or education training. Electrodes were placed at F3/F4, and participants received active or sham tDCS during training sessions. We assessed the association between tDCS group and changes in depression, state anxiety, and trait anxiety from baseline to post-intervention and one-year controlling for covariates.

RESULTS

The active tDCS group demonstrated greater reductions in depression and state anxiety compared to sham post-intervention, particularly in individuals with mild depression and moderate/severe state anxiety at baseline. Furthermore, the active tDCS group with moderate/severe state anxiety maintained greater symptom reductions at one-year.

CONCLUSIONS

tDCS effectively reduced depression and state anxiety symptoms in a large sample of older adults. These findings highlight the importance of considering symptom severity when identifying those who may benefit most from this intervention.

摘要

背景

在老年人中,治疗抑郁和焦虑的药物干预往往有显著的副作用,因此需要寻找更耐受的替代方法。经颅直流电刺激(tDCS)是一种有前途的非药物干预方法,可用于治疗临床人群的抑郁。然而,其在抑郁和焦虑症状方面的效果,特别是在一般人群中的老年人中,研究较少。

目的

我们对增龄认知训练中的经颅直流电刺激(ACT)试验进行了二次分析,以评估 tDCS 对降低老年人心理症状的疗效。我们假设,与假刺激相比,在干预后和一年随访时,积极刺激会更大程度地降低抑郁和状态焦虑。我们还探讨了根据基线症状严重程度对 tDCS 效果的影响。

方法

从社区招募的 378 名老年人完成了为期 12 周的 tDCS 干预,包括认知或教育训练。电极放置在 F3/F4 上,参与者在训练期间接受积极或假 tDCS。我们评估了 tDCS 组与从基线到干预后和一年随访时的抑郁、状态焦虑和特质焦虑变化之间的关联,控制了协变量。

结果

与假刺激相比,积极 tDCS 组在干预后即刻显示出更大的抑郁和状态焦虑降低,特别是在基线时有轻度抑郁和中度/重度状态焦虑的个体中。此外,基线时有中度/重度状态焦虑的积极 tDCS 组在一年时保持了更大的症状减轻。

结论

tDCS 有效地降低了老年人中抑郁和状态焦虑的症状。这些发现强调了在确定最有可能从这种干预中受益的人群时,考虑症状严重程度的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e527/11110843/1b4948e5113f/nihms-1991135-f0001.jpg

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