Current Status of Transcranial Direct Current Stimulation in Posttraumatic Stress and Other Anxiety Disorders.
Current Status of Transcranial Direct Current Stimulation in Posttraumatic Stress and Other Anxiety Disorders.
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DOI：
10.1007/s40473-016-0070-9
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发表时间：
2016-06
影响因子：
1.7
通讯作者：
Bikson M
中科院分区：
文献类型：
--
作者：
Hampstead BM;Briceño EM;Mascaro N;Mourdoukoutas A;Bikson M
已经确定了几种经验支持的创伤后应激障碍（PTSD）治疗方法，但相当数量的患者要么无法耐受这些方法，要么在治疗后仍有症状。经颅直流电刺激（tDCS）是一种耐受性良好的调节神经元兴奋性的方法，有望成为PTSD和相关疾病的新型干预措施。本文综述了PTSD神经回路受损的文献，并讨论了PTSD通常靶向的前额叶皮层（PFC）的基本原理。然后，我们回顾了少数先前的（案例）研究，评估了tDCS在PTSD（1项研究）和其他焦虑症（4项研究）患者。选择目标脑区的方法/理由和所用tDCS导联组合存在相当大的差异，这掩盖了数据中的任何明确趋势。最后，我们描述了我们正在进行的研究的基本原理，专门针对外侧颞叶皮层作为治疗创伤后应激障碍的过度觉醒和再体验症状的方法。总的来说，很明显，需要额外的工作来确定剂量（例如，疗程的强度和持续时间、疗程的数量）和最佳治疗目标，以及识别与现有治疗的协同效应。
Several empirically supported treatments have been identified for post-traumatic stress disorder (PTSD), yet a sizable number of patients are either unable to tolerate these approaches or remain symptomatic following treatment. Transcranial direct current stimulation (tDCS) is a well-tolerated method of modulating neuronal excitability that may hold promise as a novel intervention in PTSD and related disorders. The current review summarizes literature on the disrupted neural circuitry in PTSD and discusses the rationale for the commonly targeted prefrontal cortex (PFC) as it relates to PTSD. We then review the few prior (case) studies that have evaluated tDCS in patients with PTSD (1 study) and other anxiety disorders (4 studies). There was considerable variability in both the methods/justification for selecting the targeted brain region(s) and the tDCS montage used, which obscured any clear trends in the data. Finally, we describe the rationale for our ongoing study that specifically targets the lateral temporal cortex as a method of treating the symptoms of hyperarousal and re-experiencing in PTSD. Overall, it is clear that additional work is needed to establish dosing (e.g., intensity and duration of sessions, number of sessions) and optimal treatment targets as well as to identify synergistic effects with existing treatments.