Effects of transcranial direct current stimulation on working memory and negative symptoms in schizophrenia: a phase II randomized sham-controlled trial.

Autor:	Gomes JS; Interdisciplinary Laboratory of Clinical Neurosciences, Federal University of Sao Paulo, Sao Paulo, Brazil.; Center for Neuromodulation Studies, Dep. of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil., Trevizol AP; Center for Neuromodulation Studies, Dep. of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil.; Reference Center for Alcohol, Tobacco and Other Drugs (CRATOD), Sao Paulo State Secretariat of Health, Sao Paulo, Brazil., Ducos DV; Interdisciplinary Laboratory of Clinical Neurosciences, Federal University of Sao Paulo, Sao Paulo, Brazil.; Center for Neuromodulation Studies, Dep. of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil., Gadelha A; Interdisciplinary Laboratory of Clinical Neurosciences, Federal University of Sao Paulo, Sao Paulo, Brazil.; Center for Neuromodulation Studies, Dep. of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil., Ortiz BB; Interdisciplinary Laboratory of Clinical Neurosciences, Federal University of Sao Paulo, Sao Paulo, Brazil., Fonseca AO; Interdisciplinary Laboratory of Clinical Neurosciences, Federal University of Sao Paulo, Sao Paulo, Brazil., Akiba HT; Interdisciplinary Laboratory of Clinical Neurosciences, Federal University of Sao Paulo, Sao Paulo, Brazil.; Center for Neuromodulation Studies, Dep. of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil., Azevedo CC; Interdisciplinary Laboratory of Clinical Neurosciences, Federal University of Sao Paulo, Sao Paulo, Brazil.; Center for Neuromodulation Studies, Dep. of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil., Guimaraes LSP; Epidemiology and Biostatistics Unity, Clinical Hospital of Porto Alegre, Federal University of Rio Grande do Sul, Rio Grande do Sul, Brazil., Shiozawa P; Department of Psychiatry, Santa Casa School of Medicine, Sao Paulo, Brazil., Cordeiro Q; Interdisciplinary Laboratory of Clinical Neurosciences, Federal University of Sao Paulo, Sao Paulo, Brazil.; Center for Neuromodulation Studies, Dep. of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil., Lacerda A; Interdisciplinary Laboratory of Clinical Neurosciences, Federal University of Sao Paulo, Sao Paulo, Brazil.; Center for Neuromodulation Studies, Dep. of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil.; Center for Research and Clinical Trials Sinapse-Bairral, Instituto Bairral de Psiquiatria, Itapira, Brazil., Dias AM; Interdisciplinary Laboratory of Clinical Neurosciences, Federal University of Sao Paulo, Sao Paulo, Brazil.; Center for Neuromodulation Studies, Dep. of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil.
Jazyk:	angličtina
Zdroj:	Schizophrenia research. Cognition [Schizophr Res Cogn] 2018 Feb 20; Vol. 12, pp. 20-28. Date of Electronic Publication: 2018 Feb 20 (Print Publication: 2018).
DOI:	10.1016/j.scog.2018.02.003
Abstrakt:	Background: The lack of efficacy of pharmacological treatments for cognitive and negative symptoms in schizophrenia highlights the need for new interventions. We investigated the effects of tDCS on working memory and negative symptoms in patients with schizophrenia. Method: Double-blinded, randomized, sham-controlled clinical trial, investigating the effects of 10 sessions of tDCS in schizophrenia subjects. Stimulation used 2 mA, for 20 min, with electrodes of 25 cm 2 wrapped in cotton material soaked in saline solution. Anode was positioned over the left DLPFC and the cathode in the contralateral area. Twenty-four participants were assessed at baseline, after intervention and in a three-months follow-up. The primary outcome was the working memory score from MATRICS and the secondary outcome the negative score from PANSS. Data were analyzed using generalized estimating equations. Results: We did not find group ∗ time interaction for the working memory ( p  = 0.720) score or any other cognitive variable ( p  > 0.05). We found a significant group ∗ time interaction for PANSS negative ( p  < 0.001, d = 0.23, CI.95 = -0.59-1.02), general ( p  = 0.011) and total scores ( p  < 0.001). Exploratory analysis of PANSS 5 factors suggests tDCS effect on PANSS negative ( p  = 0.012), cognitive ( p  = 0.016) and depression factors ( p  = 0.029). Conclusion: The results from this trial highlight the therapeutic effects of tDCS for treatment of persistent symptoms in schizophrenia, with reduction of negative symptoms. We were not able to confirm the superiority of active tDCS over sham to improve working memory performance. Larger sample size studies are needed to confirm these findings.
Databáze:	MEDLINE
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