Effect of transcranial direct current stimulation (tDCS) over the prefrontal cortex combined with cognitive training for treating schizophrenia: a sham-controlled randomized clinical trial

Pedro Shiozawa; July Silveira Gomes; Daniella Valverde Ducos; Henrique Teruo Akiba; Álvaro Machado Dias; Alisson Paulino Trevizol; Ricardo R Uchida; Natasza Orlov; Quirino Cordeiro

doi:10.1590/2237-6089-2015-0043

Effect of transcranial direct current stimulation (tDCS) over the prefrontal cortex combined with cognitive training for treating schizophrenia: a sham-controlled randomized clinical trial

Pedro Shiozawa, July Silveira Gomes, Daniella Valverde Ducos, Henrique Teruo Akiba, Álvaro Machado Dias, Alisson Paulino Trevizol, Ricardo R Uchida, Natasza Orlov, Quirino Cordeiro

School of Psychology

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Abstract

Introduction:: We report a transcranial direct current stimulation (tDCS) protocol over the dorsolateral prefrontal cortex (DLPFC) combined with cognitive training in schizophrenia.

Method:: We assessed psychotic symptoms in nine patients using the Positive and Negative Syndrome Scale (PANSS). All evaluations were scored at baseline, at the end of the intervention protocol, and during a 4-week follow-up. The tDCS protocol consisted of 10 consecutive sessions over 5-day periods. We placed the cathode over the right and the anode over the left DLPFC. For sham stimulation, we turned the device off after 60 seconds. Cognitive training consisted of the administration of N-back and sequence learning tasks.

Results:: We performed an analysis of covariance (ANCOVA) to adjust for the dependent variable PANSS, considering the interaction with baseline severity scores (p = 0.619). Mixed analysis of variance (ANOVA) showed no statistical significance between the groups regarding final PANSS scores.

Conclusion:: The results failed to demonstrate that the concomitant use of tDCS and cognitive training is effective to improve clinical outcomes in patients with schizophrenia. The present findings should be analyzed with care, considering the small sample size. Larger controlled trials on electric/cognitive stimulation should be produced in order to enhance therapeutic strategies in schizophrenia.

Original language	English
Pages (from-to)	175-177
Number of pages	3
Journal	Trends in psychiatry and psychotherapy
Volume	38
Issue number	3
DOIs	https://doi.org/10.1590/2237-6089-2015-0043
Publication status	Published - 14 Oct 2016

Keywords

Adult
Analysis of Variance
Cognitive Therapy
Combined Modality Therapy
Double-Blind Method
Female
Follow-Up Studies
Humans
Male
Prefrontal Cortex
Psychiatric Status Rating Scales
Schizophrenia
Schizophrenic Psychology
Severity of Illness Index
Transcranial Direct Current Stimulation
Treatment Outcome
Journal Article
Randomized Controlled Trial

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Effect of transcranial direct current stimulation (tDCS) over the prefrontal cortex combined with cognitive training for treating schizophreniaLicence: CC BY

Cite this

Shiozawa, P., Gomes, J. S., Ducos, D. V., Akiba, H. T., Dias, Á. M., Trevizol, A. P., Uchida, R. R., Orlov, N., & Cordeiro, Q. (2016). Effect of transcranial direct current stimulation (tDCS) over the prefrontal cortex combined with cognitive training for treating schizophrenia: a sham-controlled randomized clinical trial. Trends in psychiatry and psychotherapy, 38(3), 175-177. https://doi.org/10.1590/2237-6089-2015-0043

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title = "Effect of transcranial direct current stimulation (tDCS) over the prefrontal cortex combined with cognitive training for treating schizophrenia: a sham-controlled randomized clinical trial",

abstract = "Introduction:: We report a transcranial direct current stimulation (tDCS) protocol over the dorsolateral prefrontal cortex (DLPFC) combined with cognitive training in schizophrenia.Method:: We assessed psychotic symptoms in nine patients using the Positive and Negative Syndrome Scale (PANSS). All evaluations were scored at baseline, at the end of the intervention protocol, and during a 4-week follow-up. The tDCS protocol consisted of 10 consecutive sessions over 5-day periods. We placed the cathode over the right and the anode over the left DLPFC. For sham stimulation, we turned the device off after 60 seconds. Cognitive training consisted of the administration of N-back and sequence learning tasks.Results:: We performed an analysis of covariance (ANCOVA) to adjust for the dependent variable PANSS, considering the interaction with baseline severity scores (p = 0.619). Mixed analysis of variance (ANOVA) showed no statistical significance between the groups regarding final PANSS scores.Conclusion:: The results failed to demonstrate that the concomitant use of tDCS and cognitive training is effective to improve clinical outcomes in patients with schizophrenia. The present findings should be analyzed with care, considering the small sample size. Larger controlled trials on electric/cognitive stimulation should be produced in order to enhance therapeutic strategies in schizophrenia.",

keywords = "Adult, Analysis of Variance, Cognitive Therapy, Combined Modality Therapy, Double-Blind Method, Female, Follow-Up Studies, Humans, Male, Prefrontal Cortex, Psychiatric Status Rating Scales, Schizophrenia, Schizophrenic Psychology, Severity of Illness Index, Transcranial Direct Current Stimulation, Treatment Outcome, Journal Article, Randomized Controlled Trial",

author = "Pedro Shiozawa and Gomes, {July Silveira} and Ducos, {Daniella Valverde} and Akiba, {Henrique Teruo} and Dias, {{\'A}lvaro Machado} and Trevizol, {Alisson Paulino} and Uchida, {Ricardo R} and Natasza Orlov and Quirino Cordeiro",

year = "2016",

month = oct,

day = "14",

doi = "10.1590/2237-6089-2015-0043",

language = "English",

volume = "38",

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Shiozawa, P, Gomes, JS, Ducos, DV, Akiba, HT, Dias, ÁM, Trevizol, AP, Uchida, RR, Orlov, N & Cordeiro, Q 2016, 'Effect of transcranial direct current stimulation (tDCS) over the prefrontal cortex combined with cognitive training for treating schizophrenia: a sham-controlled randomized clinical trial', Trends in psychiatry and psychotherapy, vol. 38, no. 3, pp. 175-177. https://doi.org/10.1590/2237-6089-2015-0043

Effect of transcranial direct current stimulation (tDCS) over the prefrontal cortex combined with cognitive training for treating schizophrenia: a sham-controlled randomized clinical trial. / Shiozawa, Pedro; Gomes, July Silveira; Ducos, Daniella Valverde et al.
In: Trends in psychiatry and psychotherapy, Vol. 38, No. 3, 14.10.2016, p. 175-177.

Research output: Contribution to journal › Article › peer-review

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T1 - Effect of transcranial direct current stimulation (tDCS) over the prefrontal cortex combined with cognitive training for treating schizophrenia

T2 - a sham-controlled randomized clinical trial

AU - Shiozawa, Pedro

AU - Gomes, July Silveira

AU - Ducos, Daniella Valverde

AU - Akiba, Henrique Teruo

AU - Dias, Álvaro Machado

AU - Trevizol, Alisson Paulino

AU - Uchida, Ricardo R

AU - Orlov, Natasza

AU - Cordeiro, Quirino

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KW - Prefrontal Cortex

KW - Psychiatric Status Rating Scales

KW - Schizophrenia

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KW - Severity of Illness Index

KW - Transcranial Direct Current Stimulation

KW - Treatment Outcome

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