A double-blind, sham-controlled trial of transcranial direct current stimulation for the treatment of depression
A double-blind, sham-controlled trial of transcranial direct current stimulation for the treatment of depression
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DOI：
10.1017/s1461145709990411
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发表时间：
2010-02-01
影响因子：
4.8
通讯作者：
Mitchell, Philip
中科院分区：
文献类型：
--
作者：
Loo, Colleen K.;Sachdev, Perminder;Mitchell, Philip
最近的两项假对照研究发现，经颅直流电刺激（tDCS）是治疗抑郁症的有效方法。由于tDCS是无痛的，相对安全和廉价的，它在治疗抑郁症的疗效值得进一步研究。这项双盲、随机研究在与先前阳性研究相同的刺激参数下（1 mA电流强度，5次治疗，主动或假治疗，隔日给药），在40名抑郁症参与者中测试了tDCS。阳极刺激集中在左背外侧前额叶皮层，阴极放置在对侧眼眶的侧面。tDCS持续进行，每位参与者总共进行了10次活动会话。由精神病学家评估者使用蒙哥马利-阿斯伯格和其他抑郁评定量表对治疗情况进行盲测。在一个tDCS会议之前和之后立即评估心理速度，并在每组五个会议之后评估注意力，额叶执行功能，工作记忆和语言学习。总体抑郁评分在10次tDCS治疗后显著改善，但在5次治疗、假手术对照阶段没有组间差异。tDCS被认为是安全的，对神经心理功能没有不良影响，只有轻微的副作用。建议使用增强的刺激参数，在更长的治疗期内进一步评估tDCS在抑郁症中的疗效。
Two recent sham-controlled studies found that transcranial direct current stimulation (tDCS) was an effective treatment for depression. As tDCS is painless, relatively safe and inexpensive, its efficacy in treating depression warrants further investigation. This double-blind, randomized study tested tDCS at the same stimulation parameters as a previous positive study (1 mA current strength, five treatment sessions, active or sham, given on alternate days) in 40 depressed participants. Anodal stimulation was centred over the left dorsolateral prefrontal cortex, with the cathode placed on the lateral aspect of the contralateral orbit. tDCS was continued up to a total of ten active sessions per participant. Mood outcomes were measured by psychiatrist raters blind to treatment condition using the Montgomery-Asberg and other depression rating scales. Psychomotor speed was assessed immediately before and after a single tDCS session and attention, frontal executive function, working memory and verbal learning were assessed after each group of five sessions. Overall depression scores improved significantly over ten tDCS treatments, but there was no between-group difference in the five-session, sham-controlled phase. tDCS was found to be safe, with no adverse effects on neuropsychological function, and only minor side-effects. It is recommended that the efficacy of tDCS in depression be further evaluated over a longer treatment period, using enhanced stimulation parameters.