Improving depressive symptoms in patients with schizophrenia using bilateral bipolar-nonbalanced prefrontal tDCS : Results from a double-blind sham-controlled trial

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BACKGROUND: Treating depressive symptoms in patients with schizophrenia is challenging. While transcranical Dicrect Current Stimulation (tDCS) improved other core symptoms of schizophrenia, conflicting results have been obtained on depressive symptoms. Thus, we aimed to expand current evidence on tDCS efficacy to improve depressive symptoms in patients with schizophrenia.

METHODS: A double-blind RCT was performed with patients randomized to 2 mA active-tDCS or sham-tDCS (15 daily sessions) with a bilateral bipolar-nonbalanced prefrontal placement (anode: left Dorsolateral prefrontal cortex; cathode: right orbitofrontal region). Clinical outcomes included variations of Calgary Depression Scale for Schizophrenia total score (CDSS) and of Depression-hopelessness and Guilty idea of reference-pathological guilt factors. Analysis of covariance was performed evaluating between-group changes over time. The presence/absence of probable clinically significant depression was determined when CDSS > 6.

RESULTS: As 50 outpatients were included (both groups, n = 25), significant improvements following active-tDCS were observed for CDSS total score (p = 0.001), Depression-hopelessness (p = 0.001) and Guilty idea of reference-pathological guilt (p = 0.03). Considering patients with CDSS>6 (n = 23), compared to sham, active-tDCS significantly improved CDSS total score (p < 0.001), Depression-hopelessness (p = 0.001) but Guilty idea of reference-pathological guilt only marginally improved (p = 0.051). Considering response rates of clinically significant depression, important reductions of CDSS score were observed (78 % of the sample scored ≤6; active-tDCS, n = 23; sham-tDCS, n = 16; p = 0.017). Early wakening item did not significantly change in any group.

LIMITATIONS: The study lacks a follow-up period and evaluation of tDCS effects on psychosocial functioning.

CONCLUSIONS: Bilateral bipolar-nonbalanced prefrontal tDCS is a successful protocol for the treatment of depressive symptoms in patients with schizophrenia.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:349

Enthalten in:

Journal of affective disorders - 349(2024) vom: 15. Feb., Seite 165-175

Sprache:

Englisch

Beteiligte Personen:

Lisoni, Jacopo [VerfasserIn]
Nibbio, Gabriele [VerfasserIn]
Baldacci, Giulia [VerfasserIn]
Zucchetti, Andrea [VerfasserIn]
Cicale, Andrea [VerfasserIn]
Zardini, Daniela [VerfasserIn]
Miotto, Paola [VerfasserIn]
Deste, Giacomo [VerfasserIn]
Barlati, Stefano [VerfasserIn]
Vita, Antonio [VerfasserIn]

Links:

Volltext

Themen:

Brain stimulation
DLPFC
Depression
Depressive symptoms
Journal Article
Randomized Controlled Trial
Schizophrenia
TDCS

Anmerkungen:

Date Completed 09.02.2024

Date Revised 09.02.2024

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1016/j.jad.2024.01.050

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM366899783