scholarly journals Transcranial direct current stimulation improves action-outcome monitoring in schizophrenia spectrum disorder

2020 ◽  
Author(s):  
Benjamin Straube ◽  
Bianca M van Kemenade ◽  
Tilo Kircher ◽  
Rasmus Schülke
Keyword(s):  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Efference Copy ◽  
Spectrum Disorder ◽  
Control Group ◽  
Schizophrenia Spectrum Disorder ◽  
Direct Current Stimulation ◽  
Schizophrenia Spectrum ◽  
Outcome Monitoring ◽  
Healthy Control

Abstract Patients with schizophrenia spectrum disorder often demonstrate impairments in action-outcome monitoring. Passivity phenomena and hallucinations, in particular, have been related to impairments of efference copy-based predictions which are relevant for the monitoring of outcomes produced by voluntary action. Frontal transcranial direct current stimulation has been shown to improve action-outcome monitoring in healthy subjects. However, whether transcranial direct current stimulation can improve action monitoring in patients with schizophrenia spectrum disorder remains unknown. We investigated whether transcranial direct current stimulation can improve the detection of temporal action-outcome discrepancies in patients with schizophrenia spectrum disorder. On 4 separate days, we applied sham or left cathodal/right anodal transcranial direct current stimulation in a randomised order to frontal (F3/F4), parietal (CP3/CP4) and frontoparietal (F3/CP4) areas of 19 patients with schizophrenia spectrum disorder and 26 healthy control subjects. Action-outcome monitoring was assessed subsequent to 10 min of sham/transcranial direct current stimulation (1.5 mA). After a self-generated (active) or externally generated (passive) key press, subjects were presented with a visual outcome (a dot on the screen), which was presented after various delays (0–417 ms). Participants had to detect delays between the key press and the visual consequence. Symptom subgroups were explored based on the presence or absence of symptoms related to a paranoid-hallucinatory syndrome. In general, delay-detection performance was impaired in the schizophrenia spectrum disorder compared to the healthy control group. Interaction analyses showed group-specific (schizophrenia spectrum disorder vs healthy control group) and symptom-specific (with/without relevant paranoid-hallucinatory symptoms) transcranial direct current stimulation effects. Post-hoc tests revealed that frontal transcranial direct current stimulation improved the detection of long delays in active conditions and reduced the proportion of false alarms in undelayed trials of the passive condition in patients. The patients with no or few paranoid-hallucinatory symptoms benefited especially from frontal transcranial direct current stimulation in active conditions, while improvement in the patients with paranoid-hallucinatory symptoms was predominantly reflected in reduced false alarm rates in passive conditions. These data provide some first evidence for the potential utility of transcranial direct current stimulation in improving efference copy mechanisms and action-outcome monitoring in schizophrenia spectrum disorder. Current data indicate that improving efference copy-related processes can be especially effective in patients with no or few positive symptoms, while intersensory matching (i.e. task-relevant in passive conditions) could be more susceptible to improvement in patients with paranoid-hallucinatory symptoms.

scholarly journals Feasibility, Acceptability, and Preliminary Impacts of Web-Based Patient Education on Patients With Schizophrenia Spectrum Disorder: Quasi-Experimental Cluster Study (Preprint)

2018 ◽  
Author(s):  
Anna Laine ◽  
Maritta Välimäki ◽  
Virve Pekurinen ◽  
Eliisa Löyttyniemi ◽  
Mauri Marttunen ◽  
...  
Keyword(s):  
Patient Education ◽  
Self Esteem ◽  
Spectrum Disorder ◽  
Control Group ◽  
Schizophrenia Spectrum Disorder ◽  
Web Based ◽  
Illness Cognition ◽  
Refusal Rate ◽  
Schizophrenia Spectrum ◽  
Quasi Experimental

BACKGROUND Web-based interventions are promising tools for increasing the understanding of illness and treatment among patients with serious mental disorders. OBJECTIVE This study aimed to test the feasibility and acceptability of a Web-based patient education intervention using a quasi-experimental cluster design to report feedback on patient education sessions and the website used and to report preliminary evidence of the intervention’s impact on patients with schizophrenia spectrum disorder. METHODS A single-blind, parallel, quasi-experimental cluster study over a 6-month period comparing Web-based education (n=33) with a nonequivalent control group (treatment as usual, n=24) for people with schizophrenia spectrum disorder was conducted. Participants (N=57) were recruited from one psychiatric hospital (6 wards). Feasibility was assessed by participants’ commitment (refusal rate, dropout rate) to the study. Acceptability was assessed as participants’ commitment to the intervention. Patient education sessions and website feedback were assessed by the patients and health care professionals. The preliminary impact of the sessions on patients’ self-efficacy, self-esteem, illness cognition, and knowledge level was measured at baseline and follow-ups (8 weeks, 6 months) with self-rated questionnaires. RESULTS The refusal rate among patients was high with no statistically significant difference (69% [74/107] in the intervention group, 76% [76/100] in the control group; <italic>P</italic>=.21). The same result was found for the dropout rates (48% [16/33] vs 58% [14/24]; <italic>P</italic>=.46). The acceptability of the intervention was good; 31 participants out of 33 (94%) completed all five sessions. Feedback on the intervention was mainly positive; three out of four subscales of session were rated above the midpoint of 4.0. Feedback on the website was also positive, with a grade of good for content (69%, 20/29 patients; 75%, 21/28 professionals), layout (62%, 18/29 patients; 61%, 17/28 professionals), and usability (62%, 18/29 patients; and 68%, 19/28 professionals). The patients using the intervention had significantly higher scores 6 months after the sessions in self-efficacy (baseline mean 26.12, SD 5.64 vs 6-month mean 29.24, SD 6.05; <italic>P</italic>=.003) and regarding knowledge level about schizophrenia (mean 11.39, SD 4.65 vs 6-month mean 15.06, SD 5.26; <italic>P</italic>=.002), and lower scores in the subscale of helplessness in illness cognition (mean 2.26, SD 0.96 vs 6-month mean 1.85, SD 0.59; <italic>P</italic>=.03). Differences from the control group were not significant. No differences were found in patients’ self-esteem or other subscales in illness cognition. CONCLUSIONS The patients were reluctant to participate in the study and tended to drop out before the follow-ups. Once they had participated, their acceptance of the intervention was high. A more effective recruitment strategy and monitoring method will be needed in future studies. To assess the impact of the intervention, a more rigorous study design with an adequately powered sample size will be used in cooperation with outpatient mental health services.

scholarly journals Transcranial Direct Current Stimulation (tDCS) over the Left Dorsal Lateral Prefrontal Cortex in Children with Autism Spectrum Disorder (ASD)

2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Jiujun Qiu ◽  
Xuejun Kong ◽  
Jihan Li ◽  
Jie Yang ◽  
Yiting Huang ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Prefrontal Cortex ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Sleep Habits ◽  
Lateral Prefrontal Cortex ◽  
Direct Current Stimulation ◽  
Children With Asd

Recently, transcranial direct current stimulation (tDCS) has been applied to relieve symptoms in individuals with autism spectrum disorder (ASD). In this prospective, parallel, single-blinded, randomized study, we investigate the modulation effect of three-week tDCS treatment at the left dorsal lateral prefrontal cortex (DLPFC) in children with ASD. 47 children with ASD were enrolled, and 40 (20 in each group) completed the study. The primary outcomes are Childhood Autism Rating Scale (CARS), Aberrant Behavior Checklist (ABC), and the Repetitive Behavior Scale-Revised (RBS-R). We found that children with ASD can tolerate three-week tDCS treatment with no serious adverse events detected. A within-group comparison showed that real tDCS, but not sham tDCS, can significantly reduce the scores of CARS, Children’s Sleep Habits Questionnaire (CSHQ), and general impressions in CARS (15th item). Real tDCS produced significant score reduction in the CSHQ and in CARS general impressions when compared to the effects of sham tDCS. The pilot study suggests that three-week left DLPFC tDCS is well-tolerated and may hold potential in relieving some symptoms in children with ASD.

scholarly journals Patient-Controlled Intravenous Morphine Analgesia Combined with Transcranial Direct Current Stimulation for Post-Thoracotomy Pain: A Cost-Effectiveness Study and A Feasibility for Its Future Implementation

2020 ◽  
Vol 17 (3) ◽  
pp. 816 ◽  
Author(s):  
Nemanja Rancic ◽  
Katarina Mladenovic ◽  
Nela V. Ilic ◽  
Viktorija Dragojevic-Simic ◽  
Menelaos Karanikolas ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Incremental Cost ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Cost Effectiveness Analysis ◽  
Control Group ◽  
Morphine Analgesia ◽  
Direct Current Stimulation ◽  
Effectiveness Analysis ◽  
Intravenous Morphine

This prospective randomized study aims to evaluate the feasibility and cost-effectiveness of combining transcranial direct current stimulation (tDCS) with patient controlled intravenous morphine analgesia (PCA-IV) as part of multimodal analgesia after thoracotomy. Patients assigned to the active treatment group (a-tDCS, n = 27) received tDCS over the left primary motor cortex for five days, whereas patients assigned to the control group (sham-tDCS, n = 28) received sham tDCS stimulations. All patients received postoperative PCA-IV morphine. For cost-effectiveness analysis we used data about total amount of PCA-IV morphine and maximum visual analog pain scale with cough (VASP-Cmax). Direct costs of hospitalization were assumed as equal for both groups. Cost-effectiveness analysis was performed with the incremental cost-effectiveness ratio (ICER), expressed as the incremental cost (RSD or US$) per incremental gain in mm of VASP-Cmax reduction. Calculated ICER was 510.87 RSD per VASP-Cmax 1 mm reduction. Conversion on USA market (USA data 1.325 US$ for 1 mg of morphine) revealed ICER of 189.08 US$ or 18960.39 RSD/1 VASP-Cmax 1 mm reduction. Cost-effectiveness expressed through ICER showed significant reduction of PCA-IV morphine costs in the tDCS group. Further investigation of tDCS benefits with regards to reduction of postoperative pain treatment costs should also include the long-term benefits of reduced morphine use.

scholarly journals Verbal Fluency in Mild Alzheimer’s Disease: Transcranial Direct Current Stimulation over the Dorsolateral Prefrontal Cortex

2021 ◽  
pp. 1-11
Author(s):  
Daniela Smirni ◽  
Massimiliano Oliveri ◽  
Eliana Misuraca ◽  
Angela Catania ◽  
Laura Vernuccio ◽  
...  
Keyword(s):  
Prefrontal Cortex ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Verbal Fluency ◽  
Dorsolateral Prefrontal Cortex ◽  
Control Group ◽  
Direct Current Stimulation ◽  
Cathodal Tdcs ◽  
Dorsolateral Prefrontal ◽  
The Right

Background: Recent studies showed that in healthy controls and in aphasic patients, inhibitory trains of repetitive transcranial magnetic stimulation (rTMS) over the right prefrontal cortex can improve phonemic fluency performance, while anodal transcranial direct current stimulation (tDCS) over the left prefrontal cortex can improve performance in naming and semantic fluency tasks. Objective: This study aimed at investigating the effects of cathodal tDCS over the left or the right dorsolateral prefrontal cortex (DLPFC) on verbal fluency tasks (VFT) in patients with mild Alzheimer’s disease (AD). Methods: Forty mild AD patients participated in the study (mean age 73.17±5.61 years). All participants underwent cognitive baseline tasks and a VFT twice. Twenty patients randomly received cathodal tDCS to the left or the right DLPFC, and twenty patients were assigned to a control group in which only the two measures of VFT were taken, without the administration of the tDCS. Results: A significant improvement of performance on the VFT in AD patients was present after tDCS over the right DLPFC (p = 0.001). Instead, no difference was detected between the two VFTs sessions after tDCS over the left DLPFC (p = 0.42). Furthermore, these results cannot be related to task learning effects, since no significant difference was found between the two VFT sessions in the control group (p = 0.73). Conclusion: These data suggest that tDCS over DLPFC can improve VFT performance in AD patients. A hypothesis is that tDCS enhances adaptive patterns of brain activity between functionally connected areas.

scholarly journals Investigation of the effect of Delayed Auditory Feedback and transcranial Direct Current Stimulation (DAF-tDCS) treatment for the enhancement of speech fluency in adults who stutter: a Randomized Controlled Trial

2020 ◽  
Author(s):  
Narges Moein ◽  
Reyhane Mohamadi ◽  
Reza Rostami ◽  
Michael Nitsche ◽  
Reza Zomorrodi ◽  
...  
Keyword(s):  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Auditory Feedback ◽  
Intervention Group ◽  
Control Group ◽  
Anodal Tdcs ◽  
Delayed Auditory Feedback ◽  
Direct Current Stimulation ◽  
Speech Fluency ◽  
Adults Who Stutter

Abstract Background: With a population prevalence of one percent, stuttering is among the main speech pathology-related topics of research. Adults who stutter may benefit from transcranial direct current stimulation (tDCS) as an adjunctive intervention for enhancing speech fluency. In this study, Delayed Auditory Feedback (DAF) was combined with tDCS applied over the superior temporal gyrus. It was anticipated that intervention caused improvements of speech fluency become more stable.Methods: A randomized, double-blind, sham-controlled clinical trial was conducted to investigate the effectiveness of intervention in enhancing speech fluency. Fifty participants were randomly allocated the intervention or control group. In the intervention group, participants received DAF combined with anodal tDCS, while the control group was exposed to sham tDCS simultaneously with DAF. Each subject participated in six intervention sessions. Speech fluency was assessed before intervention as baseline, as well as immediately, one week and six weeks after intervention.Results: In the intervention group, the percentage of stuttered syllables was significantly reduced immediately, one week and six weeks after the intervention, as compared with the control group. The scores of the Stuttering Severity Instrument, also showed a significant reduction in the intervention group compared with the control group. No significant difference was found in the Overall Assessment of the Speaker’s Experience of Stuttering questionnaire scores between the two patient two groups after intervention.Conclusion: The results of this study propose anodal tDCS as an adjunctive method to increase speech fluency in stuttering for a prolonged time course after intervention, when combined with fluency therapy.Trial registration: This trial was registered in ClinicalTrial.gov before recruiting the subjects. The registration number is NCT03990168 and the date of registration is June 18, 2019. https://clinicaltrials.gov/ct2/show/NCT03990168

scholarly journals Transcranial direct current stimulation (tDCS) in addition to walking training on walking, mobility, and reduction of falls in Parkinson’s disease: study protocol for a randomized clinical trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Lucas Rodrigues Nascimento ◽  
Ester Miyuki Nakamura-Palacios ◽  
Augusto Boening ◽  
Daniel Lyrio Cabral ◽  
Alessandra Swarowsky ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Fear Of Falling ◽  
Cortical Excitability ◽  
Freezing Of Gait ◽  
Step Length ◽  
Control Group ◽  
Direct Current Stimulation

Abstract Background Transcranial direct current stimulation (tDCS) has the potential to modulate cortical excitability and enhance the effects of walking training in people with Parkinson’s disease. This study will examine the efficacy of the addition of tDCS to a task-specific walking training to improve walking and mobility and to reduce falls in people with Parkinson’s disease. Methods This is a two-arm, prospectively registered, randomized trial with concealed allocation, blinded assessors, participants and therapists, and intention-to-treat analysis. Twenty-four individuals with Parkinson’s disease, categorized as slow or intermediate walkers (walking speeds ≤ 1.0 m/s), will be recruited. The experimental group will undertake a 30-min walking training associated with tDCS, for 4 weeks. The control group will undertake the same walking training, but with sham-tDCS. The primary outcome will be comfortable walking speed. Secondary outcomes will include walking step length, walking cadence, walking confidence, mobility, freezing of gait, fear of falling, and falls. Outcomes will be collected by a researcher blinded to group allocation at baseline (week 0), after intervention (week 4), and 1 month beyond intervention (week 8). Discussion tDCS associated with walking training may help improve walking of slow and intermediate walkers with Parkinson’s disease. If walking is enhanced, the benefits may be accompanied by better mobility and reduced fear of falling, and individuals may experience greater free-living physical activity at home and in the community. Trial registration Brazilian Registry of Clinical Trials (ReBEC) RBR-6bvnx6. Registered on September 23, 2019

scholarly journals Cerebellar Transcranial Direct Current Stimulation in Children with Autism Spectrum Disorder: A Pilot Study on Efficacy, Feasibility, Safety, and Unexpected Outcomes in Tic Disorder and Epilepsy

2021 ◽  
Vol 11 (1) ◽  
pp. 143
Author(s):  
Giordano D’Urso ◽  
Elena Toscano ◽  
Veronica Sanges ◽  
Anne Sauvaget ◽  
Christine E. Sheffer ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Pilot Study ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Time Course ◽  
Social Withdrawal ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Tic Disorder ◽  
Direct Current Stimulation

Patients with autism spectrum disorder (ASD) display distinctive neurophysiological characteristics associated with significant cognitive, emotional, and behavioral symptoms. Transcranial direct current stimulation (tDCS) applied to the frontal or temporoparietal lobes has demonstrated potential to reduce the severity of ASD-related symptoms. Recently, the cerebellum has been identified as a brain area involved in ASD pathophysiology. In this open-label pilot study, seven ASD patients aged between 9 and 13 years underwent 20 daily sessions of 20 min cathodal stimulation of the right cerebellar lobe. At the end of the treatment, the Aberrant Behavior Checklist (ABC) scores showed a 25% mean reduction in global severity of symptoms, with a more pronounced reduction in the “social withdrawal and lethargy” (−35%), “hyperactivity and noncompliance” (−26%), and “irritability, agitation, and crying” (−25%) subscales. Minor and no improvement were observed in the “stereotypic behavior” (−18%) and “inappropriate speech” (−0%) subscales, respectively. Improvements were not detected in the two patients who were taking psychotropic drugs during the study. Clinical response showed a symptom-specific time course. Quality of sleep and mood improved earlier than hyperactivity and social withdrawal. The treatment was generally accepted by patients and well tolerated. No serious adverse events were reported. Stimulation also appeared to markedly reduce the severity of tics in a patient with comorbid tic disorder and led to the disappearance of a frontal epileptogenic focus in another patient with a history of seizures. In conclusion, cerebellar tDCS is safe, feasible, and potentially effective in the treatment of ASD symptoms among children. Strategies to improve recruitment and retention are discussed.

Transcranial Direct Current Stimulation and Cognition in Neuropsychiatric Disorders: Systematic Review of the Evidence and Future Directions

2020 ◽  
pp. 107385842093616
Author(s):  
Valentina Ciullo ◽  
Gianfranco Spalletta ◽  
Carlo Caltagirone ◽  
Nerisa Banaj ◽  
Daniela Vecchio ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cognitive Impairment ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Neuropsychiatric Disorders ◽  
Schizophrenia Spectrum Disorders ◽  
Future Directions ◽  
Direct Current Stimulation ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders

Transcranial direct current stimulation (tDCS) has been implemented in neuropsychiatric disorders characterized by cognitive impairment. However, methodological heterogeneity challenges conclusive remarks. Through a critical analysis of previous conflicting findings and in the light of current neurobiological models of pathophysiology, we qualitatively assessed the effects of tDCS in neuropsychiatric disorders that share neurobiological underpinnings, as to evaluate whether stimulation can improve cognitive deficits in patients’ cohorts. We performed a systematic review of tDCS studies targeting cognitive functions in mental disorders and pathological cognitive aging. Data from 41 studies, comprising patients with diagnosis of mood disorders, schizophrenia-spectrum disorders, Alzheimer’s disease (AD), and mild cognitive impairment (MCI), were included. Results indicate that tDCS has the capacity to enhance processing speed, working memory, and executive functions in patients with mood and schizophrenia-spectrum disorders. The evidence of a positive effect on general cognitive functioning and memory is either inconclusive in AD, or weak in MCI. Future directions are discussed for developing standardized stimulation protocols and for translating the technique therapeutic potential into effective clinical practice.

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