Effects of bilateral, bipolar-nonbalanced, frontal transcranial Direct Current Stimulation (tDCS) on negative symptoms and neurocognition in a sample of patients living with schizophrenia: Results of a randomized double-blind sham-controlled trial.

Autor: Lisoni J; Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy. Electronic address: jacopo.lisoni@gmail.com., Baldacci G; Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy., Nibbio G; Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy., Zucchetti A; Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy., Butti Lemmi Gigli E; Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy., Savorelli A; Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy., Facchi M; Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy., Miotto P; Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy., Deste G; Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy; Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy., Barlati S; Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy; Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy., Vita A; Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy; Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
Jazyk: angličtina
Zdroj: Journal of psychiatric research [J Psychiatr Res] 2022 Nov; Vol. 155, pp. 430-442. Date of Electronic Publication: 2022 Sep 21.
DOI: 10.1016/j.jpsychires.2022.09.011
Abstrakt: Negative symptoms (NS), conceived as Avolition-Apathy (AA) and Expressive Deficit (EXP) domains, and neurocognitive impairments represent unmet therapeutic needs for patients with schizophrenia. The present study investigated if bilateral bipolar-nonbalanced frontal transcranial Direct Current Stimulation (tDCS) could improve these psychopathological dimensions. This randomized, double-blind, sham-controlled study (active-tDCS versus sham-tDCS, both, n = 25) included 50 outpatients diagnosed with schizophrenia clinically stabilized. Patients received 20-min 2 mA active-tDCS or sham-tDCS (anode: left Dorsolateral Prefrontal Cortex; cathode: right orbitofrontal region). Primary outcomes included: PANSS-Negative subscale, Negative Factor (Neg-PANSS), AA and EXP domains; neurocognitive performance at Brief Assessment of Cognition in Schizophrenia. Secondary outcomes included: PANSS subscales and total score, Disorganized/Concrete (DiscC-PANSS) and Positive Factors, Clinical Global Impression (CGI) scores, clinical insight at Scale to Assess Unawareness of Mental Disorder (SUMD). Analysis of covariance (ANCOVA) was performed evaluating between-group changes over time. Significant improvements following active-tDCS were observed for all NS measures (all, p < 0.001; d > 0.8) and for working memory (p = 0.025, d = 0.31). Greater variations following to active treatment emerged also for PANSS-General Psychopathology subscale (p < 0.001; d = 0.54), PANSS total score (p < 0.001; d = 0.69), CGI indexes (all, p < 0.001; d > 0.6), DiscC-PANSS (p < 0.001; d = 0.80) and SUMD-general Unawareness index (p = 0.005; d = 0.15) but not for positive symptoms and others insight measures. Good safety/tolerability profiles were found. Bilateral bipolar-nonbalanced frontal-tDCS is a non-pharmacological approach in schizophrenia effectively improving NS, particularly the AA and EXP domains, probably acting by modulating dysfunctional cortical-subcortical networks. Preliminary results also suggest working memory improvements following tDCS. Further studies are needed to confirm the neurobiological basis of these results.
Competing Interests: Declaration of competing interest The authors declare no conflict of interest in the present study.
(Copyright © 2022 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: