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经颅直流电刺激改善长期住院慢性精神分裂症患者的迟发性运动障碍。

Transcranial direct current stimulation improves tardive dyskinesia in long-term hospitalized patients with chronic schizophrenia.

机构信息

Yangzhou Wutaishan Hospital of Jiangsu Province, Teaching hospital of Yangzhou University, Yangzhou, China; Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China.

Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China.

出版信息

Clin Neurophysiol. 2024 Oct;166:20-30. doi: 10.1016/j.clinph.2024.07.006. Epub 2024 Jul 17.

Abstract

OBJECTIVE

This study aimed to evaluate the efficacy and safety of transcranial direct current stimulation (tDCS) in chronic schizophrenia patients with tardive dyskinesia (TD) who were long-term hospitalized.

METHODS

Sixty-four inpatients who met the DSM-IV diagnostic criteria for schizophrenia and TD were randomly assigned to either the active (N=35) or sham (N=29) group. Treatment was given 15 times, with each session lasting for 30 min, and an intensity of 2 mA. The anode was placed on the left dorsolateral prefrontal cortex and the cathode on the right supraorbital region. Primary outcome was measured by the changes in Abnormal Involuntary Movements Scale (AIMS) score. Secondary outcomes were measured using the Positive and Negative Syndrome Scale (PANSS) and the Scale for the Assessment of Negative Symptoms (SANS). Adverse effects of tDCS were assessed with an experimenter-administered open-ended questionnaire throughout the experiment.

RESULTS

Of the 64 patients, 52 (81.25%) completed the study. Compared to the sham group, patients in the active group exhibited a significant reduction in both the total AIMS score and the facial-oral subscore (P<0.05). An improvement of at least 30% in total AIMS scores was observed in the active group (14 patients, 50%) compared to the sham group (2 patients, 8.3%) after treatment (P<0.01). There were no between-group differences in the PANSS and SANS total scores. However, there was a significant difference between the two groups in the occurrence of the reported adverse effect of tingling sensation (P<0.05).

CONCLUSIONS

TDCS may be an effective and safe treatment for improving the facial-oral motor symptoms of TD in chronically hospitalized patients with schizophrenia.

SIGNIFICANCE

This study provides a novel perspective for the clinical treatment of patients with TD.

摘要

目的

本研究旨在评估经颅直流电刺激(tDCS)对长期住院的慢性精神分裂症迟发性运动障碍(TD)患者的疗效和安全性。

方法

64 名符合 DSM-IV 精神分裂症和 TD 诊断标准的住院患者被随机分为真刺激(n=35)或假刺激(n=29)组。治疗共进行 15 次,每次 30 分钟,强度为 2 mA。阳极置于左侧背外侧前额皮质,阴极置于右侧眶上区。主要结局指标为异常不自主运动量表(AIMS)评分的变化。次要结局指标采用阳性和阴性综合征量表(PANSS)和阴性症状评定量表(SANS)进行评估。在整个实验过程中,通过实验者进行的开放式问卷调查评估 tDCS 的不良反应。

结果

64 名患者中,52 名(81.25%)完成了研究。与假刺激组相比,真刺激组的 AIMS 总分和面部口腔子评分均显著降低(P<0.05)。治疗后,真刺激组的 AIMS 总分改善至少 30%(14 名患者,50%),而假刺激组仅 2 名患者(8.3%)(P<0.01)。两组间 PANSS 和 SANS 总分无差异。然而,两组在报告的刺痛感不良反应发生率上存在显著差异(P<0.05)。

结论

tDCS 可能是改善慢性住院精神分裂症患者 TD 的面部口腔运动症状的有效且安全的治疗方法。

意义

本研究为 TD 患者的临床治疗提供了新视角。

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