Schizophrenia Clinical Trial
Official title:
To Investigate the Effects of Transcranial Direct Current Stimulation on Auditory Hallucination, Insight, Neurocognitive Function, Heart Rate Variability, Psychosocial Functioning and Quality of Life in Patients With Schizophrenia
The study aimed to investigate whether transcranial direct current stimulation could modify auditory hallucination, insight, neurocognitive function, heart rate variability, psychosocial functioning and quality of life in patients with schizophrenia.
Transcranial direct current stimulation (tDCS), a novel, non-invasive and safe
neuro-modulating technique, has been developed as a new therapeutic option for
neuropsychiatric disorders. It encompasses the induction of a relatively weak constant
current flow through the cerebral cortex via scalp electrodes. Dependent on stimulation
polarity, this results in a modulation of cortical excitability and spontaneous neural
activity. The technique was established in the 1950s and 1960s primarily in animals. In these
early studies it was shown that subthreshold DC stimulation increases spontaneous neuronal
activity if the anode is placed above or within the cortex, while exposure to cathodal
polarity results in reduced activity. This is caused by a subthreshold membrane
depolarization by anodal and a hyperpolarization by cathodal stimulation. It was demonstrated
in humans that the after-effects of tDCS depend on modifications of NMDA receptor-efficacy.
The after-effects of tDCS are blocked by the NMDA receptor antagonist dextromethorphan, and
prolonged by the partial NMDA receptor-agonist D-cycloserine. This tDCS polarity-dependent
alteration of NMDA receptor function seems to be initiated by the respective membrane
potential shift and probably by the accompanying cortical activity modification,because it is
prevented by the sodium channel blocker carbamazepine. Intraneuronal calcium concentration
also contributes, because calcium channel antagonists eliminate the excitability-enhancing
aftereffects of anodal tDCS. Recently, tDCS has been found to improve psychopathological
symptoms (auditory hallucination in particular), cognitive deficits and insight of
schizophrenia and also strengthen cardiac autonomic function in healthy subjects. Further
replication studies are needed.
The study aimed to investigate whether transcranial direct current stimulation could modify
auditory hallucination, insight, neurocognitive function, heart rate variability,
psychosocial functioning and quality of life in patients with schizophrenia.
Study design: randomized double-blind, sham-controlled study design.
Participants: 60 patients having a diagnosis of schizophrenia or schizoaffective with
refractory auditory verbal hallucinations (defined as the persistence of daily auditory
verbal hallucinations without remission in spite of antipsychotic medications at an adequate
dosage for at least 3 months), aged 20-65 years.
Others: see Arms and Interventions, Eligibility Criteria or Outcome Measures.
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