经颅直流电刺激对精神分裂症认知功能的影响:一项双盲随机对照试验的4 周随访
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国家建设高水平大学公派研究生项目(CSC 201606230115)


Effects of tDCS on cognitive deficits in patients with schizophrenia: results from a randomized controlled trial with 4-week follow-up
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    摘要:

    目的 探索经颅直流电刺激(tDCS)干预对精神分裂症患者认知功能的作用。方法 纳入 具有认知功能损害的精神分裂症住院患者39 例,随机分为刺激组和伪刺激组。两组疗程均为连续10 个 工作日,每日进行一次tDCS 干预。电极阳极置于患者左侧背外侧前额叶区,阴极置于右侧眶上缘区, 电流强度2 mA,干预时间20 min。研究期间患者均接受常规治疗。采用中文版MATRICS 认知成套测验 (MCCB)、节奏听觉串行加法任务(PASAT)、CogState 成套测验(CogState Battery)、“看眼读心”测验(RMET) 进行治疗基线和干预结束后4 周的认知功能评定。结果 除社会认知外,刺激组在各领域分值及MCCB 总分上均高于对照组,但是仅在信息处理速度上组间差异有统计学意义(F=4.087,P=0.051)。刺激组中 MCCB 总分改善的患者的基线认知功能显著优于未改善患者(Z=0.085,P=0.011)。结论 tDCS 对信息 处理速度的调控上具有一定维持作用,但仍需要大样本研究进一步证实。

    Abstract:

    Objective To explore the effects of transcranial direct current stimulation( tDCS) intervention on cognitive function in schizophrenic patients. Methods A total of 39 schizophrenic patients with cognitive impairment were randomly assigned into active tDCS group and sham tDCS group. All patients received daily active-tDCS or sham-tDCS on 10 consecutive work days as an adjunctive therapy to treatment as usual. The anode was placed over the left dorsolateral prefrontal cortex with the cathode over the right supraorbital ridge. The active tDCS was given continuously for 20 min at 2 mA. For the sham tDCS, the electric current lasted only 40 seconds though the electrodes remained in place for 20 min. The MATRICS Consensus Cognitive Battery (MCCB), the Paced Auditory Serial Addition Task( PASAT), the CogState Battery, and the Reading the Mind In the Eyes Test( RMET) were administered at baseline and four weeks after the last session to evaluate the changes in cognitive functions. Results The patients in the active tDCS group showed a non-significant superiority over those in the sham tDCS group in most of the cognitive domains at the four-week follow-up. Nevertheless, only processing speed yielded a trend preferring the active tDCS group( F=4.087, P=0.051). In the active tDCS group, a better global cognitive function at baseline predicted a higher MCCB composite score at the follow-up (Z=0.085,P=0.011). Conclusions There remained some cognitive modulation effects four weeks after the end of 10 sessions of tDCS. However, larger sample studies are on demand to confirm our findings.

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王怡然 李伟 蒋江灵 曹歆轶 王继军 金华 John M. Davis Robert C. Smith 李春波.经颅直流电刺激对精神分裂症认知功能的影响:一项双盲随机对照试验的4 周随访[J].神经疾病与精神卫生,2018,18(4):
DOI :10.3969/j. issn.1009-6574.2018.04.001.

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  • 在线发布日期: 2018-08-21