Transcranial direct current stimulation in severe, drug-resistant major depression
Transcranial direct current stimulation in severe, drug-resistant major depression
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DOI：
10.1016/j.jad.2009.02.015
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发表时间：
2009-11-01
影响因子：
6.6
通讯作者：
Priori, A.
中科院分区：
文献类型：
--
作者：
Ferrucci, R.;Bortolomasi, M.;Priori, A.
背景：尽管抗抑郁药物是严重抑郁症的首选治疗方法，但许多患者并没有通过药物治疗得到改善。本研究旨在评估经颅直流电刺激（tDCS）对严重耐药抑郁症患者的效果。方法：纳入 14 例住院患者，年龄 37-68 岁，患有符合 DSM-IV.TR 标准的严重抑郁症，耐药，自杀风险高，并转诊接受 ECT。使用贝克抑郁量表（BDI）、汉密尔顿抑郁量表（HDRS）和视觉模拟量表（VAS）评估情绪。我们还进行了认知任务来评估认知对记忆和注意力可能产生的影响。每天两次通过背外侧前额皮质 (DLPC) 进行 tDCS（2 mA，20 分钟，阳极左，阴极右）。 结果：治疗五天后，尽管认知表现保持不变，BDI 和 HDRS 评分改善了 30% 以上（BDI p = 0.001；HDRS p = 0.017）。治疗结束后四（T2）周，情绪持续改善，甚至有所改善。通过 VAS 评估的悲伤感和情绪在 tDCS 后得到改善（悲伤 p = 0.007：情绪 p = 0.036）。 结论：我们得出的结论是，额叶 tDCS 是一种简单、有前途的技术，在临床实践中可以考虑作为住院的严重耐药重度抑郁症患者的辅助治疗。 (C) 2009 Elsevier B.V. 保留所有权利。
Background: Though antidepressant drugs are the treatment of choice for severe major depression, a number of patients do not improve with pharmacologic treatment. This study aimed to assess the effects of transcranial direct current Stimulation (tDCS) in patients with severe, drug-resistant depression.Methods: Fourteen hospitalized patients aged 37-68, with severe major depressive disorder according to DSM-IV.TR criteria, drug resistant, with high risk of suicide and referred for ECT were included. Mood was evaluated using the Beck Depression Inventory (BDI), the Hamilton Depression Rating Scale (HDRS) and the Visual Analogue Scale (VAS). We also administered cognitive tasks to evaluate the possible cognitive effects on memory and attention. tDCS was delivered over the dorsolateral prefrontal cortex (DLPC) (2 mA, 20 min, anode left, cathode right) twice a day.Results: After five days of treatment although cognitive performances remained unchanged, the BDI and HDRS scores improved more than 30% (BDI p = 0.001; HDRS p = 0.017). The mood improvement persisted and even increased at four (T2) weeks after treatment ended. The feeling of sadness and mood as evaluated by VAS improved after tDCS (Sadness p = 0.007: Mood p = 0.036).Conclusions: We conclude that frontal tDCS is a simple, promising technique that can be considered in clinical practice as adjuvant treatment for hospitalized patients with severe, drug-resistant major depression. (C) 2009 Elsevier B.V. All rights reserved.