Transcranial direct current stimulation for the treatment of generalized anxiety disorder: A randomized clinical trial
Transcranial direct current stimulation for the treatment of generalized anxiety disorder: A randomized clinical trial
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DOI：
10.1016/j.jad.2019.08.020
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发表时间：
2019-12-01
影响因子：
6.6
通讯作者：
Pegado, Rodrigo
中科院分区：
文献类型：
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作者：
de Lima, Ana Lucia;Azevedo Braga, Francisco Moises;Pegado, Rodrigo
背景：广泛性焦虑症(GAD)是一种常见疾病，目前的治疗方法仅有中等疗效。无创脑刺激技术可能为治疗广泛性AD提供一种新的方法。经颅直流电刺激治疗抑郁症已显示出良好的疗效和耐受性，但尚未有针对广泛性抑郁症的研究。因此，我们研究了tdcs对GAD患者的影响。方法：我们对30例GAD患者进行了试点、双盲、随机、假对照试验。TDCS5次(2 mA，20min，左侧前额叶背外侧的阳极，右侧眶上皮质的阴极)。焦虑是主要结果，采用汉密尔顿焦虑量表和贝克焦虑量表进行测量。通过LIPP成人应激症状清单、积极和消极情绪量表和贝克抑郁问卷(BDI)获得次要结果。在基线、干预第5天和1周随访时对数据进行检查。结果：30名患者完成了研究。在焦虑、压力情绪症状、情感或抑郁方面没有显著改善。刺激左侧DLPFC可以显著改善GAD患者的躯体应激症状。限制：额外的tDCS治疗可能会导致更大的tDCs效应。结论：虽然GAD患者的躯体应激症状有所改善，但5次阳极刺激并不能改善GAD患者的主要结局。应使用不同的参数在更大的患者样本中探索tDCs在GAD中的作用。
Background: Generalized anxiety disorder (GAD) is a common condition with current treatments being only moderately effective. Non-invasive brain stimulation techniques might provide a novel approach for treating GAD. Transcranial direct current stimulation (tDCS) has shown promising efficacy and tolerability for major depression but has not been investigated for GAD yet. Thus, we investigated the effects of tDCS on patients with GAD.Methods: We conducted a pilot, double-blind, randomized, sham-controlled trial on 30 GAD patients. Five sessions of tDCS (2 mA, 20 min, anode over the left dorsolateral prefrontal cortex and cathode over the right supraorbital cortex) were performed. Anxiety was the primary outcome and it was measured by the Hamilton Anxiety Rating Scale and the Beck Anxiety Inventory. Secondary outcomes were accessed by the Lipp Inventory of Stress Symptoms for Adults, Positive and Negative Affect Schedule, and the Beck Depression Inventory (BDI). Data were examined at baseline, after the 5th day of intervention, and at 1-week follow-up.Results: Thirty patients finished the study. There were no significant improvements in anxiety, mood symptoms of stress, affectivity or depression. Anodal stimulation of the left DLPFC showed significant improvements in physical symptoms of stress in GAD patients.Limitations: Additional tDCS sessions could have resulted in larger tDCS effects.Conclusion: Five sessions of anodal tDCS over the DLPFC did not improve the main outcomes for GAD patients, although physical symptoms of stress were improved. The role of tDCS in GAD should be explored in larger patient samples using different parameters.