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评估高清经颅直流电刺激治疗强迫症的有效性:一项随机、双盲、对照试验的结果。

Assessing the effectiveness of high-definition transcranial direct current stimulation for treating obsessive-compulsive disorder: Results from a randomized, double-blind, controlled trial.

机构信息

Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China.

Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China; TUM-Neuroimaging Center (TUM-NIC), Technical University of Munich, Munich, Germany.

出版信息

Compr Psychiatry. 2024 Nov;135:152520. doi: 10.1016/j.comppsych.2024.152520. Epub 2024 Jul 23.

Abstract

OBJECTIVE

Characterized by its disabling nature, obsessive compulsive disorder (OCD) affects individuals profoundly, with nearly 40% of patients showing resistance to initial treatment methods. Despite being safe and easily accessible, transcranial direct current stimulation (tDCS) lacks extensive substantiation supporting its efficacy in treating OCD. The objective of this study was to evaluate how cathodal high-definition transcranial direct current stimulation (HD-tDCS) applied to the right orbitofrontal cortex affected patients with OCD in terms of efficacy.

METHOD

47 patients with OCD were enrolled. They were randomly allocated to active or sham stimulation groups, and underwent HD-tDCS stimulation treatment for 2 weeks. The central electrode located in the right orbitofrontal cortex region was cathodic. The severity of the patients' obsessive-compulsive symptoms, depression and anxiety were assessed before and after treatment.

RESULT

Out of the total, 44 patients concluded the treatment, comprising 23 participants from the active stimulation group and 21 from the sham stimulation group. Notably, substantial reductions in symptoms related to OCD, depression, and anxiety were exhibited in both groups. With a response rate of 26.1% in the active stimulation group and 23.8% in the sham stimulation group, there was no significant difference in efficacy observed. Furthermore, the reduction in depression and anxiety symptoms at the conclusion of the treatment was not notably superior in the active stimulation group.

CONCLUSION

This study provided evidence for the acceptability and safety of HD-tDCS. Nevertheless, the study did not reveal notable clinical effectiveness of tDCS in addressing moderate to severe OCD in comparison to the sham stimulation group.

摘要

目的

强迫症(OCD)具有致残性,对患者影响深远,近 40%的患者对初始治疗方法有耐药性。尽管经颅直流电刺激(tDCS)安全且易于获得,但缺乏广泛的证据支持其治疗 OCD 的疗效。本研究旨在评估右侧眶额皮层的阴极高分辨率经颅直流电刺激(HD-tDCS)对 OCD 患者的疗效。

方法

共纳入 47 例 OCD 患者,随机分为主动刺激组和假刺激组,接受 2 周的 HD-tDCS 刺激治疗。中央电极位于右侧眶额皮层区域为阴极。治疗前后评估患者的强迫症状、抑郁和焦虑严重程度。

结果

共有 44 例患者完成了治疗,其中主动刺激组 23 例,假刺激组 21 例。两组患者 OCD、抑郁和焦虑相关症状均显著减轻。主动刺激组有效率为 26.1%,假刺激组为 23.8%,两组疗效无显著差异。此外,治疗结束时,主动刺激组在降低抑郁和焦虑症状方面也没有明显优势。

结论

本研究为 HD-tDCS 的可接受性和安全性提供了证据。然而,与假刺激组相比,tDCS 对中重度 OCD 的临床疗效并不显著。

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