Transcranial direct current stimulation for the outpatient treatment of poor-responder depressed patients
Transcranial direct current stimulation for the outpatient treatment of poor-responder depressed patients
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经颅直流电刺激对不良反应抑郁症患者的门诊治疗
DOI：
10.1016/j.eurpsy.2011.02.008
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发表时间：
2012-10-01
影响因子：
7.8
通讯作者：
Altamura, A. C.
中科院分区：
文献类型：
--
作者：
Dell'Osso, B.;Zanoni, S.;Altamura, A. C.
经颅直流电刺激 (tDCS) 是一种选择性、无痛脑刺激技术，可以对特定皮质区域进行电刺激。 TDCS 最近已被用作重度抑郁症和难治性抑郁症 (TRD) 的研究性干预措施，并取得了令人鼓舞的结果。本研究旨在探讨 tDCS 对药物治疗反应不佳的重度抑郁症患者的疗效和耐受性。在一项盲评试验中，23 名被诊断为重度抑郁症或双相情感障碍的抑郁症患者接受了为期 5 天的增强 tDCS 治疗，每天两次。使用 HAM-D 和 MADRS 总分的重复测量方差分析来分析抑郁症状的过程。还进行了基于 HAM-D 响应的定性分析。两项分析均在三个时间点进行：T0（基线）、T1（终点 tDCS）和 T2（随访第一周结束）。所有患者均完成了试验，没有出现相关副作用。研究期间观察到，4 名患者 (17.4%) 在 T1 时和 7 名患者 (30.4%) 在 T2 时 HAM-D 和 MADRS 总分显着降低 (P= 50%)，3 名患者 (13.0%) 在 T1 时和 4 名受试者 (17.4%) 在 T2 时获得缓解（终点 HAM-D < 8）。目前的研究结果支持 tDCS 在 TRD 患者急性治疗中的有效性和良好的耐受性，临床获益不断进展并延长至随访第一周。需要进一步进行更长随访的假对照试验来证实目前的结果。 (C) 2011 Elsevier Masson SAS。版权所有。
Transcranial direct current stimulation (tDCS) is a selective, painless, brain stimulation technique that allows the electric stimulation of specific cortical regions. TDCS has been recently used as investigational intervention for major depression and treatment resistant depression (TRD) with encouraging results. The present study was aimed to investigate the efficacy and tolerability of tDCS in major depressives with poor response to pharmacological treatment. Twenty-three depressed patients, with a diagnosis of major depressive disorder or bipolar disorder, were treated with augmentative tDCS for 5 days, two sessions per day in a blind-rater trial. The course of depressive symptoms was analyzed using repeated measures ANOVA for HAM-D and MADRS total scores. A qualitative analysis on the basis of the HAM-D response was performed as well. Both analyses were conducted at three time-points: T0 (baseline), T1 (endpoint tDCS) and T2 (end of the first week of follow-up). All patients completed the trial without relevant side-effects. A significant reduction of HAM-D and MADRS total scores was observed during the study (P= 50%) was obtained by four patients (17.4%) at T1 and by seven patients (30.4%) at T2 and remission (endpoint HAM-D < 8) by three patients (13.0%) at T1 and by four subjects (17.4%) at T2. Present findings support the efficacy and good tolerability of tDCS in the acute treatment of patients with TRD with clinical benefit being progressive and extended to the first week of follow-up. Further sham-controlled trials with longer follow-up are needed to confirm present results. (C) 2011 Elsevier Masson SAS. All rights reserved.