Transcranial Direct Current Stimulation for the Treatment of Refractory Symptoms of Schizophrenia. Current Evidence and Future Directions
Transcranial Direct Current Stimulation for the Treatment of Refractory Symptoms of Schizophrenia. Current Evidence and Future Directions
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DOI：
10.2174/1381612821666150619093648
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发表时间：
2015-01-01
影响因子：
3.1
通讯作者：
Fecteau, Shirley
中科院分区：
文献类型：
--
作者：
Mondino, Marine;Brunelin, Jerome;Fecteau, Shirley
精神分裂症是一种严重而常见的神经精神障碍。尽管服用了抗精神病药物，高达30%的精神分裂症患者仍然报告了致残性耐药症状。经颅直流电刺激（tDCS）已被提出作为一种新的方法来缓解这些症状。在这里，我们回顾研究调查tDCS对精神分裂症患者的症状，认知，大脑活动和皮质可塑性的影响。我们提供了一个最新的和全面的概述tDCS在精神分裂症患者中的使用。更具体地说，我们首先介绍了tDCS对精神分裂症耐药症状的影响。我们报告说，tDCS应用于额颞区减少幻听，平均减少34%的症状。此外，在两个前额叶皮质上应用tDCS可以减少阴性症状和紧张症。我们讨论了需要进一步的假对照研究，以确认这些影响。其次，我们提出了tDCS对精神分裂症患者认知功能的影响。据报道，tDCS对学习、工作记忆、注意力和来源监测有积极影响。第三，我们回顾了tDCS对精神分裂症患者大脑活动的影响。虽然只有少数研究探讨了tDCS的影响，使用神经影像技术，这些研究有助于确定tDCS在精神分裂症的作用机制。第四，我们目前的tDCS皮质可塑性研究显示减少皮质可塑性的精神分裂症患者，tDCS可能有益的调节。最后，我们讨论了tDCS在精神分裂症患者中的安全性，以及提高该临床人群疗效的潜在方向。
Schizophrenia is a severe and frequent neuropsychiatric disorder. Despite antipsychotic medications, up to 30% of patients with schizophrenia still report disabling treatment-resistant symptoms. Transcranial direct current stimulation (tDCS) has been proposed as a novel method to alleviate such symptoms. Here, we review studies investigating the effects of tDCS on symptoms, cognition, brain activity and cortical plasticity in patients with schizophrenia. We provide an up-to-date and comprehensive overview of the use of tDCS in patients with schizophrenia. More specifically, we first present the effects of tDCS on treatment-resistant symptoms of schizophrenia. We report that tDCS applied over the frontotemporal regions reduced auditory hallucinations, with a mean 34% reduction of symptoms. Moreover, tDCS applied over both prefrontal cortices reduced negative symptoms and catatonia. We discuss the need for further sham-controlled studies to confirm these effects. Second, we present the impact of tDCS on cognitive functions in patients with schizophrenia. Positive effects of tDCS have been reported on learning, working memory, attention and source-monitoring. Third, we review the effects of tDCS on brain activity in patients with schizophrenia. Although only few studies investigated the effects of tDCS using neuroimaging technics, these studies are helpful at identifying the mechanisms of action of tDCS in schizophrenia. Fourth, we present tDCS studies on cortical plasticity showing reduced cortical plasticity in patients with schizophrenia that tDCS may beneficially modulate. Lastly, we discuss the safety aspects of tDCS in patients with schizophrenia and potential directions to improve efficacy for this clinical populations.