Effects of online high-definition transcranial direct current stimulation over left dorsolateral prefrontal cortex on predominant negative symptoms and EEG functional connectivity in patients with schizophrenia: a randomized, double-blind, controlled trial.

IF 5 3区 医学 Q1 CLINICAL NEUROLOGY Psychiatry and Clinical Neurosciences Pub Date : 2024-09-24 DOI:10.1111/pcn.13745
Ta-Chuan Yeh, Yen-Yue Lin, Nian-Sheng Tzeng, Yu-Chen Kao, Yong-An Chung, Chuan-Chia Chang, Hsu-Wei Fang, Hsin-An Chang
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Abstract

Aims: Schizophrenia, a debilitating mental disorder, is characterized by persistent negative symptoms such as avolition and anhedonia. Currently, there are no effective treatments available for these symptoms. Thus, our study aims to assess the efficacy of online high-definition transcranial direct current stimulation (online HD-tDCS) in addressing the negative symptoms of schizophrenia, utilizing a double-blind, randomized, sham-controlled trial design.

Methods: Fifty-nine patients with schizophrenia were randomized to receive either active HD-tDCS or sham stimulation, targeting the left dorsolateral prefrontal cortex. Outcomes were measured by changes in the Positive and Negative Syndrome Scale Factor Score for Negative Symptom (PANSS-FSNS). Exact low-resolution electromagnetic tomography was used to assess the functional connectivity.

Results: All 59 participants, including 50.84% females with an average age of 43.36 years, completed the trial. In the intention-to-treat analysis, patients receiving active HD-tDCS showed greater improvement in PANSS-FSNS scores compared to those receiving the sham procedure. The differences were 2.34 (95% confidence interval [CI], 1.28-3.40), 4.28 (95% CI, 2.93-5.62), and 4.91 (95% CI, 3.29-6.52) after the intervention, as well as at 1-week and 1-month follow-ups, respectively. A tingling sensation on the scalp was more common in the active group (63.3%) compared to the sham group (10.3%). Additionally, HD-tDCS was associated with a decrease in delta-band connectivity within the default mode network.

Conclusions: High-definition transcranial direct current stimulation was effective and safe in ameliorating negative symptoms in patients with schizophrenia when combined with online functional targeting.

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在线高清经颅直流电刺激左侧背外侧前额叶皮层对精神分裂症患者主要阴性症状和脑电图功能连接的影响:随机、双盲、对照试验。
目的:精神分裂症是一种使人衰弱的精神疾病,其特征是持续的消极症状,如逃避和失神。目前,还没有针对这些症状的有效治疗方法。因此,我们的研究旨在采用双盲、随机、假对照试验设计,评估在线高清经颅直流电刺激(HD-tDCS)在治疗精神分裂症阴性症状方面的疗效:59名精神分裂症患者被随机分配接受主动HD-tDCS或假刺激,目标是左侧背外侧前额叶皮层。研究结果通过阳性和阴性症状量表因子评分(PANSS-FSNS)的变化进行测量。精确低分辨率电磁断层扫描用于评估功能连接:所有 59 名参与者均完成了试验,其中女性占 50.84%,平均年龄为 43.36 岁。在意向治疗分析中,与接受假手术的患者相比,接受主动 HD-tDCS 治疗的患者在 PANSS-FSNS 评分上有更大改善。干预后以及一周和一个月随访时的差异分别为 2.34(95% 置信区间 [CI],1.28-3.40)、4.28(95% CI,2.93-5.62)和 4.91(95% CI,3.29-6.52)。头皮刺痛感在积极干预组(63.3%)比假干预组(10.3%)更常见。此外,HD-tDCS还与默认模式网络中δ波段连接的减少有关:结论:高清经颅直流电刺激与在线功能靶向相结合,能有效、安全地改善精神分裂症患者的阴性症状。
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来源期刊
CiteScore
7.40
自引率
4.20%
发文量
181
审稿时长
6-12 weeks
期刊介绍: PCN (Psychiatry and Clinical Neurosciences) Publication Frequency: Published 12 online issues a year by JSPN Content Categories: Review Articles Regular Articles Letters to the Editor Peer Review Process: All manuscripts undergo peer review by anonymous reviewers, an Editorial Board Member, and the Editor Publication Criteria: Manuscripts are accepted based on quality, originality, and significance to the readership Authors must confirm that the manuscript has not been published or submitted elsewhere and has been approved by each author
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