Transcranial Direct Current Stimulation (tDCS) for Depression during Pregnancy: Results from an Open-Label Pilot Study.
Transcranial Direct Current Stimulation (tDCS) for Depression during Pregnancy: Results from an Open-Label Pilot Study.
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经颅直流电刺激治疗妊娠期抑郁症：一项开放式先导性研究的结果。
DOI：
10.3390/brainsci11070947
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发表时间：
2021-07-19
期刊：
影响因子：
3.3
通讯作者：
Palm U
中科院分区：
文献类型：
--
作者：
Kurzeck AK;Dechantsreiter E;Wilkening A;Kumpf U;Nenov-Matt T;Padberg F;Palm U
简介：抑郁症是怀孕期间最常见的疾病。可用的一线治疗选择有限，孕妇的抑郁症往往得不到治疗，对孕产妇和胎儿健康产生负面影响。目的：这项开放标签的初步研究的目的是扩展经颅直流电刺激（tDCS）作为产前抑郁症治疗的证据，并指出在这一人群中使用tDCS的选择。研究方法：6例妊娠期间（妊娠10周后）患有重度抑郁症的无药物女性患者被纳入本初步研究。患者在住院期间接受每日两次tDCS治疗（2 mA，30 min，阳极：F3，阴极：F4），持续10天（第1阶段），在可选门诊期间接受每日一次tDCS治疗，持续10天（第2阶段）。在基线、2周和4周后进行临床（HAMD-21，BDI）和神经心理学评分（连线测验A/B）以及产科检查。结果：6例右利手女性（23-43岁，12-33岁）。妊娠周）完成了第1阶段;另外4名患者加入了第2阶段。tDCS耐受性良好，未发生不良反应。临床评分显示平均基线HAMD-21从22.50 ± 7.56改善至第2周后的13.67 ± 3.93，第4周后改善至8.75 ± 4.99。平均基线BDI为26.00 ± 13.90，第2周后降至11.17 ± 5.46，第4周后降至9.25 ± 3.30。结论：HAMD-21和BDI在第1阶段后观察到统计学显著变化。1例患者在第1阶段达到HAMD缓解。虽然这项小规模研究缺乏假对照，但在这一关键人群中显示了临床改善和无不良事件。
Introduction: Depression is the most common morbidity during pregnancy. Available first-line therapy options are limited and depressive disorders in pregnant women are often untreated, leading to negative effects on maternal and fetal health. Objectives: The aim of this open-label pilot study is to extend evidence on the use of transcranial direct current stimulation (tDCS) as a treatment of antenatal depression and to point out options for the use of tDCS in this population. Methods: Six drug-free female patients with major depressive disorder during pregnancy (later than 10th gestational week) were included in this pilot study. Patients were treated with twice-daily tDCS (2 mA, 30 min, anode: F3, cathode: F4) over ten days during inpatient stay (Phase 1) and with once-daily tDCS over 10 days during an optional outpatient stay (Phase 2). Clinical (HAMD-21, BDI) and neuropsychological ratings (Trail Making Test A/B) were performed at baseline, after two and four weeks as well as an obstetric examination. Results: Six right-handed females (23–43 years, 12–33. gestational week) completed Phase 1; four patients additionally joined in Phase 2. tDCS was well tolerated and no adverse effects occurred. Clinical ratings showed an improvement of mean baseline HAMD-21 from 22.50 ± 7.56 to 13.67 ± 3.93 after week 2, and to 8.75 ± 4.99 after week 4. The mean baseline BDI was 26.00 ± 13.90 and declined to 11.17 ± 5.46 after week 2, and to 9.25 ± 3.30 after week 4. Conclusions: Statistically significant changes in HAMD-21 and BDI were observed after Phase 1. One patient achieved remission in terms of HAMD in Phase 1. Although this small-scale study lacks sham control, it shows clinical improvement and absence of adverse events in this critical population.
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