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首页> 美国卫生研究院文献>Schizophrenia Bulletin >Prefrontal Transcranial Direct Current Stimulation for Treatment of Schizophrenia With Predominant Negative Symptoms: A Double-Blind Sham-Controlled Proof-of-Concept Study
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Prefrontal Transcranial Direct Current Stimulation for Treatment of Schizophrenia With Predominant Negative Symptoms: A Double-Blind Sham-Controlled Proof-of-Concept Study

机译：前额经颅直流电刺激治疗以阴性症状为主的精神分裂症：一项双盲假手术控制的概念验证研究

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Negative symptoms are highly relevant in the long-term course of schizophrenia and are an important target domain for the development of novel interventions. Recently, transcranial direct current stimulation (tDCS) of the prefrontal cortex has been investigated as a treatment option in schizophrenia. In this proof-of-concept study, 20 schizophrenia patients with predominantly negative symptoms were randomized to either 10 sessions of add-on active (2 mA, 20min) or sham tDCS (anode: left DLPFC/F3; cathode: right supraorbital/F4). Primary outcome measure was the change in the Scale for the Assessment of Negative Symptoms (SANS) sum score; secondary outcomes included reduction in Positive and Negative Syndrome Scale (PANSS) scores and improvement of depressive symptoms, cognitive processing speed, and executive functioning. Sixteen patients underwent 4 functional connectivity magnetic resonance imaging (fcMRI) scans (pre and post 1st and pre and post 10th tDCS) to investigate changes in resting state network connectivity after tDCS. Per-protocol analysis showed a significantly greater decrease in SANS score after active (−36.1%) than after sham tDCS (−0.7%). PANSS sum scores decreased significantly more with active (−23.4%) than with sham stimulation (−2.2%). Explorative analysis of fcMRI data indicated changes in subgenual cortex and dorsolateral prefrontal cortex (DLPFC) connectivity within frontal-thalamic-temporo-parietal networks. The results of this first proof-of-concept study indicate that prefrontal tDCS may be a promising intervention for treatment of schizophrenia with predominant negative symptoms. Large-scale randomized controlled studies are needed to further establish prefrontal tDCS as novel treatment for negative symptoms in schizophrenia.
机译：阴性症状在精神分裂症的长期病程中高度相关，并且是开发新型干预措施的重要目标领域。最近，前额叶皮层的经颅直流电刺激（tDCS）已作为精神分裂症的治疗选择进行了研究。在这项概念验证研究中，将20例主要表现为阴性症状的精神分裂症患者随机分为10个疗程的附加活动（2 mA，20分钟）或假tDCS（阳极：左DLPFC / F3；阴极：右眶上/ F4） ）。主要结局指标是阴性症状评估量表（SANS）总分的变化。次要结果包括阳性和阴性综合征量表（PANSS）得分的降低以及抑郁症状，认知加工速度和执行功能的改善。 16例患者接受了4次功能连接磁共振成像（fcMRI）扫描（第1个tDCS之前和之后以及第10个tDCS之前和之后），以研究tDCS之后静止状态网络连接的变化。根据协议分析，活动后的SANS得分下降幅度（-36.1％）比假tDCS之后的下降幅度更大（-0.7％）。主动（PAN）总分下降（-23.4％）比假刺激（-2.2％）大得多。 fcMRI数据的探索性分析表明，额-丘脑-颞-顶-顶叶网络内的亚皮层和背外侧前额叶皮层（DLPFC）连通性发生了变化。这项首次概念验证研究的结果表明，额前tDCS可能是治疗以阴性症状为主的精神分裂症的有前途的干预措施。需要进一步的大规模随机对照研究，以进一步建立前额叶tDCS，作为治疗精神分裂症阴性症状的新方法。

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