García-Fernández Lorena, Romero-Ferreiro Verónica, Padilla Sergio, Wynn Rolf, Pérez-Gálvez Bartolomé, Álvarez-Mon Miguel Ángel, Sánchez-Cabezudo Ángeles, Rodriguez-Jimenez Roberto
Clinical Medicine Department, Universidad Miguel Hernández, Investigador. Cibersam isciii, Crta. Nacional 332 s/n, Alicante 03550, Spain; Psychiatry Department, Hospital Universitario de San Juan, Alicante, Spain; CIBERSAM-ISCIII (Biomedical Research Networking Centre for Mental Health), Spain.
CIBERSAM-ISCIII (Biomedical Research Networking Centre for Mental Health), Spain; European University of Madrid, Madrid, Spain; Health Research Institute Hospital 12 de Octubre (imas12), Madrid, Spain.
Psychiatry Res. 2025 Feb;344:116308. doi: 10.1016/j.psychres.2024.116308. Epub 2024 Dec 2.
This study aimed to examine the cognitive effects of tDCS and the subjective cognitive improvement perceived by patients with schizophrenia. A total of 173 outpatients diagnosed with schizophrenia were recruited for this double-blind, randomized, placebo-controlled trial. Two different stimulation modes were applied: 2 mA 20 minutes active tDCS and sham tDCS. Ten daily sessions over 10 consecutive weekdays were applied, using a bifrontal montage (F3/F4). The Positive and Negative Syndrome Scale for Schizophrenia and the MATRICS Consensus Cognitive Battery (MCCB) were administered at baseline. The MCCB and a scale designed for measuring subjective cognitive improvement were administered to evaluate the outcomes. Post hoc comparisons revealed significant effects between the two types of interventions in Working Memory (EMM difference = 2.716, p < .001) and Neurocognition (EMM difference = 1.289, p = .007. Chi-squared tests demonstrated a significant association between subjective improvement and the treatment group, χ² (2) = 10.413, p = .005, Cramer's V = 0.295. A higher proportion of patients in active tDCS (68.6%) reported cognitive improvement compared to sham tDCS (31.4%). We concluded that tDCS can enhance cognition and generate a satisfactory perception of cognitive improvement in patients with schizophrenia.
本研究旨在探讨经颅直流电刺激(tDCS)对精神分裂症患者的认知影响以及患者所感知到的主观认知改善情况。本双盲、随机、安慰剂对照试验共招募了173名被诊断为精神分裂症的门诊患者。采用了两种不同的刺激模式:2毫安、20分钟的主动tDCS和伪刺激tDCS。使用双额部电极贴片(F3/F4),在连续10个工作日内每天进行10次治疗。在基线时使用了精神分裂症阳性和阴性症状量表以及MATRICS共识认知成套测验(MCCB)。使用MCCB和一个专门设计用于测量主观认知改善的量表来评估结果。事后比较显示,两种干预措施在工作记忆方面(估计边际均值差异=2.716,p<0.001)和神经认知方面(估计边际均值差异=1.289,p=0.007)存在显著差异。卡方检验表明主观改善与治疗组之间存在显著关联,χ²(2)=10.413,p=0.005,克莱姆相关系数V=0.295。与伪刺激tDCS组(31.4%)相比,主动tDCS组中报告认知改善的患者比例更高(68.6%)。我们得出结论,tDCS可以增强精神分裂症患者的认知能力,并使患者对认知改善产生满意的感受。