Efficacy and Safety of Transcranial Direct Current Stimulation as an Add-On Trial Treatment for Acute Bipolar Depression Patients With Suicidal Ideation

IF 4.8 1区医学 Q1 NEUROSCIENCES CNS Neuroscience & Therapeutics Pub Date : 2024-10-09 DOI:10.1111/cns.70077

Dandan Wang, Xiaonan Guo, Qi Huang, Zhong Wang, Jingkai Chen, Shaohua Hu

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Abstract

Aims

Bipolar depression poses an overwhelming suicide risk. We aimed to examine the efficacy and safety of transcranial direct current stimulation (tDCS) combined with quetiapine in bipolar patients as a suicidal intervention.

Methods

In a single-center, double-blind, treatment-naive bipolar depression patients with suicidal ideation were randomly assigned to quetiapine in combination with either active (n = 16) or sham (n = 15) tDCS over the left dorsolateral prefrontal cortex for three consecutive weeks. The 30-min, 2-mA tDCS was conducted twice a day on the weekday of the first week and then once a day on the weekdays of the two following weeks. Primary efficacy outcome measure was the change in the Beck Scale for Suicidal Ideation (BSSI). Secondary outcomes included changes on the 17-item Hamilton Depression Rating Scale (HDRS-17) and Montgomery-Asberg Depression Rating Scale (MADRS). Outcome was evaluated on Day 3 and weekend. Safety outcome was based on the reported adverse reactions.

Results

Active tDCS was superior to sham tDCS on the BSSI at Day 3 and tended to sustain every weekend during the treatment process, compared to baseline. However, no difference between active and sham in HDRS-17 and MADRS was found. Response and remission rate also supported the antisuicide effect of tDCS, with higher response and remission rate in BSSI, but no antidepressant effect, compared to sham, over time. Regarding safety, active tDCS was well tolerated and all the adverse reactions reported were mild and limited to transient scalp discomfort.

Conclusion

The tDCS was effective as an antisuicide treatment for acute bipolar depression patients with suicidal ideation, with minimal side effects reported.

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经颅直流电刺激作为对有自杀意念的急性双相抑郁症患者的附加试验治疗的有效性和安全性。

目的：双相抑郁症具有极大的自杀风险。我们旨在研究经颅直流电刺激（tDCS）联合喹硫平对双相抑郁症患者进行自杀干预的有效性和安全性：在一项单中心双盲研究中，有自杀意念的双相抑郁症患者被随机分配接受喹硫平联合左侧背外侧前额叶皮层活性（n = 16）或假性（n = 15）tDCS治疗，连续治疗三周。第一周的工作日每天进行两次，每次 30 分钟，每次 2 毫安，随后两周的工作日每天进行一次。主要疗效指标是贝克自杀意念量表（BSSI）的变化。次要结果包括 17 项汉密尔顿抑郁量表（HDRS-17）和蒙哥马利-阿斯伯格抑郁量表（MADRS）的变化。结果在第 3 天和周末进行评估。安全性结果基于报告的不良反应：结果：与基线相比，在第 3 天的 BSSI 上，活性 tDCS 优于假性 tDCS，并且在治疗过程中的每个周末，活性 tDCS 的疗效都趋于持续。然而，在 HDRS-17 和 MADRS 方面，活性和假性没有差异。反应和缓解率也支持 tDCS 的抗自杀效果，随着时间的推移，BSSI 的反应和缓解率更高，但与假体相比，没有抗抑郁效果。在安全性方面，主动tDCS的耐受性良好，所有不良反应都很轻微，仅限于短暂的头皮不适：tDCS对有自杀意念的急性双相抑郁症患者的抗自杀治疗有效，且副作用极小。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

CNS Neuroscience & Therapeutics 医学-神经科学

CiteScore

7.30

自引率

12.70%

发文量

240

审稿时长

2 months

期刊介绍： CNS Neuroscience & Therapeutics provides a medium for rapid publication of original clinical, experimental, and translational research papers, timely reviews and reports of novel findings of therapeutic relevance to the central nervous system, as well as papers related to clinical pharmacology, drug development and novel methodologies for drug evaluation. The journal focuses on neurological and psychiatric diseases such as stroke, Parkinson’s disease, Alzheimer’s disease, depression, schizophrenia, epilepsy, and drug abuse.