Transcranial Direct Current Stimulation in Psychiatry: What Psychiatrists Need to Know.
Transcranial Direct Current Stimulation in Psychiatry: What Psychiatrists Need to Know.
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精神病学中的经颅直流电刺激：精神病学家需要了解什么。
DOI：
10.1176/appi.focus.20180029
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发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Philip,NoahStephen
中科院分区：
文献类型：
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作者：
Zandvakili,Amin;Berlow,YosefAlfred;Carpenter,LindaLeigh;Philip,NoahStephen
经颅直流电刺激（tDCS）正在成为一种潜在的治疗许多神经精神疾病的方法。数据似乎表明，在大脑额叶或前额叶区域应用tDCS可能减轻重度抑郁症的症状，但结果好坏参半。早期的研究显示了希望，但最近的工作未能复制早期的结果。是否使用tDCS的决定进一步受到复杂监管环境的影响；没有tDCS装置被美国食品和药物管理局批准用于临床。尽管在严格的试验中尚未证明其有效性，但较旧的系统已经获得了治疗情绪、焦虑和失眠的监管批准。此外，随着无创脑刺激领域的发展，各种副作用和禁忌症越来越被认识到。在过去的几年里，tDCS的研究和消费者使用已经超过了教育，因此对临床医生和受训人员如何理解tDCS提供的指导很少。因此，本文的重点综述包括精神科临床医生和培训生最需要了解的tDCS项目，包括基本的电和神经生理学原理，对重度抑郁症疗效数据的简要回顾，以及如何管理使用tDCS的患者的建议指南。
Transcranial direct current stimulation (tDCS) is emerging as a potential treatment for a host of neuropsychiatric disorders. Data appear to indicate that tDCS applied over frontal or prefrontal brain regions may reduce symptoms of major depression, yet results have been mixed. Early studies showed promise, but recent work failed to replicate earlier results. The decision whether to use tDCS is further affected by the complex regulatory environment; no tDCS devices are cleared by the U.S. Food and Drug Administration for clinical use. Older systems have grandfathered regulatory approval for treating mood, anxiety, and insomnia, although they have not demonstrated efficacy in rigorous trials. Furthermore, as the field of noninvasive brain stimulation advances, various side effects and contraindications are increasingly recognized. Over the last few years, research and consumer use of tDCS have outpaced education, thus providing little guidance for clinicians and trainees about how to understand tDCS. Therefore, this focused review includes those items psychiatric clinicians and trainees most need to understand tDCS, including basic electrical and neurophysiological principles, a brief review of efficacy data in major depressive disorder, and suggested guidelines about how to manage patients using tDCS.