Prefrontal Transcranial Direct Current Stimulation for Treatment of Schizophrenia With Predominant Negative Symptoms: A Double-Blind, Sham-Controlled Proof-of-Concept Study
| Autor: | Thomas Meindl, Peter Falkai, Frank Padberg, Alkomiet Hasan, Ulrich Palm, Nina Sarubin, Ina Unger, Filipa Kaymakanova, Birgit Ertl-Wagner, M. Kupka, Janusch Blautzik, Daniel Keeser |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Prefrontal Cortex Audiology Transcranial Direct Current Stimulation Young Adult 03 medical and health sciences 0302 clinical medicine Double-Blind Method Outcome Assessment Health Care Connectome Humans Medicine Deep transcranial magnetic stimulation Prefrontal cortex Scale for the Assessment of Negative Symptoms Positive and Negative Syndrome Scale Resting state fMRI Transcranial direct-current stimulation business.industry Regular Article Middle Aged medicine.disease Magnetic Resonance Imaging 030227 psychiatry Dorsolateral prefrontal cortex Psychiatry and Mental health medicine.anatomical_structure Schizophrenia Female Nerve Net business 030217 neurology & neurosurgery Clinical psychology |
| Zdroj: | Schizophrenia Bulletin. 42:1253-1261 |
| ISSN: | 1745-1701 0586-7614 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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