Affiliated Psychological Hospital of Anhui Medical University, Anhui Mental Health Center, Hefei Fourth People's Hospital, Hefei, Anhui, 230026, China; National Clinical Research Center for Mental Disorders-Anhui Branch, Hefei, Anhui, 230026, China; Anhui Clinical Research Center for Mental Disorders, Anhui, 230026, China.
Affiliated Psychological Hospital of Anhui Medical University, Anhui Mental Health Center, Hefei Fourth People's Hospital, Hefei, Anhui, 230026, China; National Clinical Research Center for Mental Disorders-Anhui Branch, Hefei, Anhui, 230026, China; Anhui Clinical Research Center for Mental Disorders, Anhui, 230026, China; Anhui Provincial Key Laboratory of Philosophy and Social Sciences for Intelligent Intervention of Adolescent Mental Health and Crisis, Anhui, 230061, China.
J Psychiatr Res. 2024 Jul;175:227-234. doi: 10.1016/j.jpsychires.2024.05.015. Epub 2024 May 3.
Transcranial alternating current stimulation (tACS) is a potential therapeutic psychiatric tool that has been shown to modulate clinical symptoms and brain function by inducing brain oscillations. However, direct evidence on the effects of gamma-tACS (γ-tACS) on Bipolar I Disorder (BD-I) is limited. In the present study we used functional near-infrared spectroscopy to explore prefrontal hemodynamic changes in BD-I patients receiving combined γ-tACS intervention in addition to pharmacological treatment.
Only 39 male patients with BD-I in the acute manic phase were included, and they were randomly divided into an intervention group (n = 18) and a control group (n = 21). The intervention group received γ-tACS treatment on a weekday for a total of 10 sessions in the right prefrontal cortex and left prefrontal cortex. All participants were pretested (baseline) and posttested (2 weeks after) with questionnaires to assess clinical symptoms and cognitive abilities, and with functional near infrared spectroscopy (fNIRS) to assess spontaneous cortical hemodynamic activities.
Compared to the control group, the intervention group had greater increases in Montreal Cognitive Assessment (MoCA) scores, and greater decreases in Bech-Rafaelsen Mania Rating Scale (BRMS) scores. In the intervention group, functional connectivity (FC) was significantly greater in the left hemisphere. γ-tACS treatment resulted in a left hemispheric lateralization effect of resting state FC in BD-I patients, increasing the hemodynamic activity of the patient's left prefrontal cortex.
γ-tACS can improve cognitive impairment and mood symptoms with BD-I patients in an acute manic episode by enhancing FC in the patients' left prefrontal cortex.
经颅交流电刺激（tACS）是一种有潜力的精神科治疗工具，通过诱导脑振荡已被证明可以调节临床症状和大脑功能。然而，关于γ-tACS（γ-tACS）对双相 I 型障碍（BD-I）影响的直接证据有限。在本研究中，我们使用功能近红外光谱（fNIRS）来探索接受联合γ-tACS 干预加药物治疗的 BD-I 患者前额叶的血液动力学变化。
仅纳入 39 名处于急性躁狂期的男性 BD-I 患者，并将其随机分为干预组（n=18）和对照组（n=21）。干预组在右前额叶和左前额叶接受 γ-tACS 治疗，每周 5 天，共 10 个疗程。所有参与者在基线和 2 周后（治疗后）均进行问卷评估以评估临床症状和认知能力，同时进行功能近红外光谱（fNIRS）以评估自发性皮质血液动力学活动。
与对照组相比，干预组蒙特利尔认知评估（MoCA）评分增加，Bech-Rafaelsen 躁狂评定量表（BRMS）评分降低。干预组左侧功能连接（FC）明显增加。γ-tACS 治疗导致 BD-I 患者静息状态 FC 的左侧半球偏侧化效应，增加了患者左前额叶的血液动力学活动。
γ-tACS 通过增强患者左前额叶的 FC，可改善急性躁狂发作的 BD-I 患者的认知障碍和情绪症状。
