Neuromodulatory Effects of Adjunctive High Definition Transcranial Direct Current Stimulation (HDtDCS) on Auditory Verbal Hallucinations in Schizophrenia Patients: A Sham Controlled Diffusion Tensor Imaging Study

[摘要] Aims. To see the neuromodulatory effects of adjunctive HD-tDCSon white matter connectivity by using Diffusion Tensor Imaging(DTI) in schizophrenia patients with Auditory VerbalHallucinations (AVH)Methods. This was a randomized, double blind, sham controlledstudy. 40 patients of schizophrenia with prominent auditory verbal hallucinations and 10 age sex matched healthy controls wereselected. The patients were randomly assigned to 2 groups andwere given active or sham adjunctive HDtDCS (ActiveTreatment = 10 sessions of 2 mA current applied for 20 minutes,twice daily for 5 days, at left temporo-parietal Junction (TPJ);Sham treatment = 10 sessions of 1 mA current, twice daily for 5days was applied for 30 sec at left TPJ). Fractional anisotropy ofleft arcuate fasciculus by Diffusion tensor imaging was assessedand severity of schizophrenia symptoms and auditory hallucinations were rated on PANSS and PSYRATS-AH at baseline, after1st week (i.e. end of HDtDCS sessions) and 4 weeks after theend of the HDtDCS sessions). Patients received stable dose ofantipsychotics for the total study duration (equivalent to ormore than 400 mg of chlorpromazine) to eliminate confoundingbias. Fractional anisotropy of left arcuate fasciculus by Diffusiontensor imaging was assessed in healthy controls. DTI data wereanalysed by DSI Studio software. Statistical analysis was doneby SPSS version 25.Results.1. Both the patient groups were comparable with regard to sociodemographic variables and baseline clinical variables.2. There was no significant difference in the values of FractionalAnisotropy in Left Arcuate Fasciculus among the patients andhealthy controls at baseline.3. The group receiving active adjunctive HDtDCS, showed significant improvement in the frequency domain of AVH overtime, in time*group comparison by repeat measure ANOVAwith Mauchly’s test of sphericity and Greenhouse-Geisser correction [p = 0.011 and partial eta square = 0.129].4. There was no significant difference in change in the Fractionalanisotropy of the left arcuate fasciculus noted between thegroups over time.5. Application of HDtDCS was not associated with significantside effects, minor itching and mild burning sensation beingthe only reported side effectsConclusion. Adjunctive active HD-tDCS to the left temporoparietal junction showed a statistically significant improvementin frequency of auditory verbal hallucinations (AVH) in schizophrenia patients, when compared to sham stimulation.

[学科分类] 计算机科学（综合）