Trends in Psychiatry and Psychotherapy
https://trends.org.br/article/doi/10.1590/2237-6089-2015-0043
Trends in Psychiatry and Psychotherapy
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Effect of transcranial direct current stimulation (tDCS) over the prefrontal cortex combined with cognitive training for treating schizophrenia: a sham-controlled randomized clinical trial

Efeito da estimulação transcraniana por corrente contínua (ETCC) sobre o córtex pré-frontal combinada a treinamento cognitivo para o tratamento da esquizofrenia: ensaio clínico randomizado simulação controlado

Pedro Shiozawa; July Silveira Gomes; Daniella Valverde Ducos; Henrique Teruo Akiba; Álvaro Machado Dias; Alisson Paulino Trevizol; Ricardo R. Uchida; Natasza Orlov; Quirino Cordeiro

http://dx.doi.org/10.1590/2237-6089-2015-0043 Trends Psychiatry Psychother, vol.38, n3, p.175-177, 2016
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Abstract

Abstract Introduction: We report a transcranial direct current stimulation (tDCS) protocol over the dorsolateral prefrontal cortex (DLPFC) combined with cognitive training in schizophrenia. Method: We assessed psychotic symptoms in nine patients using the Positive and Negative Syndrome Scale (PANSS). All evaluations were scored at baseline, at the end of the intervention protocol, and during a 4-week follow-up. The tDCS protocol consisted of 10 consecutive sessions over 5-day periods. We placed the cathode over the right and the anode over the left DLPFC. For sham stimulation, we turned the device off after 60 seconds. Cognitive training consisted of the administration of N-back and sequence learning tasks. Results: We performed an analysis of covariance (ANCOVA) to adjust for the dependent variable PANSS, considering the interaction with baseline severity scores (p = 0.619). Mixed analysis of variance (ANOVA) showed no statistical significance between the groups regarding final PANSS scores. Conclusion: The results failed to demonstrate that the concomitant use of tDCS and cognitive training is effective to improve clinical outcomes in patients with schizophrenia. The present findings should be analyzed with care, considering the small sample size. Larger controlled trials on electric/cognitive stimulation should be produced in order to enhance therapeutic strategies in schizophrenia.

Keywords

Schizophrenia, cognition, transcranial direct current stimulation

Resumo

Resumo Introdução: Descrevemos os resultados de protocolo de estimulação transcraniana por corrente contínua (ETCC) sobre o córtex pré-frontal dorsolateral combinado a treinamento cognitivo para o tratamento de esquizofrenia. Métodos: Avaliamos os sintomas psicóticos em nove pacientes utilizando a Positive and Negative Syndrome Scale (PANSS). As avaliações foram realizadas antes, ao fim do protocolo de tratamento, e após 4 semanas de seguimento. O protocolo de ETCC consistiu em 10 sessões consecutivas em períodos de 5 dias. O cátodo foi posicionado à direita e o ânodo à esquerda sobre o córtex pré-frontal dorsolateral. Para estimulação simulada, o equipamento foi desligado após 60 segundos. O treinamento cognitivo consistiu na administração de tarefas N-back e aprendizado sequencial. Resultados: Utilizamos análise de covariância (ANCOVA) ajustada à variável dependente PANSS, considerando a interação com a gravidade antes da ETCC (p = 0.619). A análise de variância (ANOVA) não mostrou diferença significativa entre os grupos em relação à PANSS final. Conclusão: Os resultados falharam em demonstrar que o uso concomitante de ETCC e treinamento cognitivo é efetivo na melhora do desfecho clínico em pacientes com esquizofrenia. Os achados devem ser avaliados com cuidado, considerando a amostra pequena. Estudos maiores sobre estimulação elétrica/cognitiva devem ser produzidos a fim de melhorar estratégias terapêuticas na esquizofrenia.

Palavras-chave

Esquizofrenia, cognição, estimulação transcraniana por corrente contínua

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