Schizophrenia Clinical Trial
Official title:
Transcranial Direct Current Stimulation Influences on Cognitive Inhibition in Schizophrenia
A deficit in cognitive suppression is a trait of patients with schizophrenia. Cognitive suppression is the ability to control or suppress irrelevant responses and to adopt relevant responses instead. The purpose of this study is to investigate the effects of transcranial direct current stimulation (tDCS) on information suppression in schizophrenic patients. This is a noninvasive technique of brain stimulation that induces prolonged functional changes in the cerebral cortex through the application of a weak direct current to the scalp (Nitsche & Paulus, 2001). The aim of this study is to test whether bilateral tDCS over the dorsolateral prefrontal cortex (DLPFC) differentially modify performance on several cognitive tasks.
A deficit in cognitive suppression is a trait of patients with schizophrenia. Cognitive
suppression is the ability to control or suppress irrelevant information and to adopt
relevant responses instead. This ability is a basic skill which is essential to maintain a
normal well-adjusted life. We need to suppress distracting information in order to focus
attention, to suppress irrelevant cues in order to retrieve particular memories, and to
suppress habitual responses in order to make adaptive choices (Dillon & Pizzagalli, 2007).
The purpose of this study is to investigate the effects of transcranial direct current
stimulation (tDCS) on information suppression in schizophrenic patients. This is a
noninvasive technique of brain stimulation that induces prolonged functional changes in the
cerebral cortex through the application of a weak direct current to the scalp (Nitsche &
Paulus, 2001; Nitsche et al., 2003, 2004; Antal et al., 2004). The aim of this study is to
test whether anodal and cathodal tDCS differentially modify performance on several cognitive
tasks when applied to the left/right dorsolateral prefrontal cortex (DLPFC).
Sixty patients will be divided into four groups: 1) 15 schizophrenic subjects in a tDCS
treatment group; 2) 15 schizophrenic subjects in a sham tDCS group; 3) 15 healthy subjects in
a tDCS treatment group; 4) 15 healthy subjects in a sham tDCS group. All participants will
complete baseline tests including an n-back test, the Hayling test and metaphoric
comprehension test. The schizophrenic subjects only, will complete a bank of cognitive tests
as a baseline (MATRICS Consensus Cognitive Battery (MCCB). The first meeting for the
schizophrenic subjects only will be used to determine the best stimulation area (right/left
DLPFC) and type (anodal/ cathodal). Schizophrenic subjects in both the treatment and the
control groups will undergo six treatment sessions in total. The cognitive tests will be
given to all participants once again at the end of the study. In order to evaluate
improvement between the pre-test and the post-test, differences in reaction times and error
rate will be calculated for each participant.
This study is important for few reasons. First, this study focus on the difficulty of
suppressing irrelevant information, executive function ability essential to leading a normal
life. Special populations, and specifically people with schizophrenia, have difficulty
suppressing irrelevant information, and a correlation has been noted between this
characteristic and weak executive functioning capabilities. In this study we evaluate the
potential of minimizing these difficulties through use of tDCS. This particular tool was
chosen for the study because it is easy to use, non-invasive, and painless. Research has
shown that tDCS stimulation of the DLPFC can improve performance in cognitive tasks, a result
that has not been mirrored through use of medications. Second, in recognition of the
heterogeneity of schizophrenic patients (substantiated by the fact that the success of other
treatments varies from patient to patient), our study will perform tests to identify the
preferred stimulation region, DLPFC left/right. The results will help determine more
specifically if there is a degree of heterogeneity in terms of the region responsible for
suppressing irrelevant information . Related to this, we will be able to assess the impact of
stimulation, including whether or not stimulation benefits all schizophrenic patients or,
alternatively, if there are unknown variables involved which determine the relative success
of this treatment amongst individuals. In addition, we will be able to explore differences or
correlations between healthy subjects' verbal abilities in relation to the various tests
conducted, and assess the impact of these tests on healthy subjects' cognitive inhibition and
working memory. Finally, this study is critical because if the treatment method proves to be
successful, we would be able to extend this study to other populations that have difficulties
with executive functioning, and in addition, to examine the effect of electrical stimulation
on other cognitive abilities.
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