The Effects of tDCS on Depressive Symptoms,Neurocognitive Function and HRV in Unipolar Depression and Bipolar Depression
To Investigate the Effect of Transcranial Direct Current Stimulation (tDCS) on Depressive Symptoms, Neurocognitive Function and Heart Rate Variability in Unipolar Depression and Bipolar Depression
調査の概要
詳細な説明
Background
Transcranial direct current stimulation 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 after-effects of anodal tDCS. Recently, tDCS has been reported to be a novel, non-invasive and safe therapeutic tool to treat neuropsychiatric disorders including depression. This therapeutic tool has been reported to show promising effect in treating unipolar and bipolar depression. However, the sample sizes have been small. Further work is needed to see if these early promising studies replicate. Much evidence has indicated that patients with depression show hypoactivity over left dorsolateral prefrontal cortex (DLPFC) and hyperactivity over right DLPFC. We therefore hypothesize that tDCS over DLPFC with anode placed at left DLPFC and cathode placed at right DLPFC would reduce depressive symptoms in patients with unipolar depression and bipolar depression.
The study aimed to investigate whether tDCS over DLPFC could modify depressive symptoms, neurocognitive function and heart rate variability of unipolar and bipolar depression.
Study design: open-label study.
Participants: 60 patients with unipolar depression and 60 with bipolar depression.
Others: see Arms and Interventions, Eligibility Criteria or Outcome Measures.
研究の種類
入学 (実際)
段階
- 適用できない
連絡先と場所
研究場所
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Taipei、台湾、114
- Tri-Service General Hospital
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
Patients who met DSM-IV-TR criteria for major depressive disorder and bipolar depression and had moderate to severe depression severity (HAM-D score more than 17) were included in the study.
Exclusion Criteria:
- pregnancy or breastfeeding.
- having epilepsy, severe physical illness, any current psychiatric comorbidity or history of substance dependence.
- having contraindications for transcranial electrical/magnetic stimulation.
- having intracranial metal foreign bodies.
- having a history of intracranial neoplasms or surgery, or a history of severe head injuries or cerebrovascular diseases.
研究計画
研究はどのように設計されていますか？
デザインの詳細
- 主な目的：処理
- 割り当て：なし
- 介入モデル：単一グループの割り当て
- マスキング：なし（オープンラベル）
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
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実験的：tDCS over DLPFC
Direct current (DC) generated by a DC stimulator (Eldith DC stimulator: www.
neuroconn.de/dc-stimulator_plus_en/)
was bilaterally delivered through a pair of saline-soaked surface sponge electrodes (35 cm2).
The anodal electrode was placed over the left dorsolateral prefrontal cortex (F3, International EEG System 10-20) and cathode electrode over F4.
Stimulation was applied at an intensity of 2 mA for 20 min, twice-daily on 5 consecutive weekdays.
The twice daily sessions were separated by at least 3 hours.
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We applied tDCS over dorsolateral prefrontal cortex (DLPFC) for these depressed patients.
Direct current (DC) generated by a DC stimulator (Eldith DC stimulator: www.
neuroconn.de/dc-stimulator_plus_en/)
was bilaterally delivered through a pair of saline-soaked surface sponge electrodes (35 cm2).
The anodal electrode was placed over the left dorsolateral prefrontal cortex (F3, International EEG System 10-20) and cathode electrode over F4.
Stimulation was applied at an intensity of 2 mA for 20 min, twice-daily on 5 consecutive weekdays.
The twice daily sessions were separated by at least 3 hours.
All patients were maintained on their treatment throughout the study period.
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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Changes from baseline score of Hamilton Depression Rating Scale (HAM-D) at the timepoint immediately after tDCS, at one week and one month after tDCS
時間枠：One month
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Depression severity
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One month
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Changes from baseline score of Young Mania Rating Scale (YMRS) at the timepoint immediately after tDCS, at one week and one month after tDCS
時間枠：One month
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Hypomania/mania severity
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One month
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Changes from baseline score of Hamilton Anxiety Rating Scale (HAM-A) at the timepoint immediately after tDCS, at one week and one month after tDCS
時間枠：One month
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Anxiety severity.
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One month
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Changes from basline heart rate variability (HRV) at the timepoint immediately after tDCS, at one week and one month after tDCS
時間枠：One month
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Index of autonomic functioning.
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One month
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Changes from baseline results of continuous performance test (CPT) at the timepoint immediately after tDCS, at one week and one month after tDCS
時間枠：One month
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Performance of prefrontal-mediated task.
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One month
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協力者と研究者
出版物と役立つリンク
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。
うつ病性障害、メジャーの臨床試験
tDCS over DLPFCの臨床試験
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Hospital de Clinicas de Porto Alegre完了
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