Evaluation of the efficacy of transcranial direct current stimulation in the treatment of cognitive symptomatology in the early stages of psychosis: study protocol for a double-blind randomized controlled trial

Abstract

Background Cognitive deficits are core symptoms of schizophrenia that occur from the early stages of the disorder. There is reliable evidence that cognitive deficits are associated with outcomes in schizophrenia; thus, early treatment could be particularly important. Studies with different neuromodulation techniques involving subjects with schizophrenia suggest that application of transcranial direct current stimulation (tDCS) with inhibitory stimulation over the left temporo-parietal cortex and excitatory stimulation over the left dorsolateral prefrontal cortex could ameliorate positive, negative, and cognitive symptoms. The aim of the present study protocol is to evaluate the efficacy of tDCS in the treatment of cognitive symptomatology in the early stages of psychosis. Methods/design Seventy patients in the early stages of psychosis will be randomly allocated to receive 20 min of active 2-mA tDCS or sham stimulation once a day for 10 consecutive weekdays. The anode will be placed over the left dorsolateral prefrontal cortex and the cathode over the left temporo-parietal cortex. Neuropsychological and psychiatric assessments will be performed at baseline and at 1 and 3 months following the end of the intervention (sustained effect). Discussion The development and utilization of potentially effective neuroenhancement tools such as the non-invasive brain stimulation technique tDCS for the treatment and rehabilitation of cognitive impairment in the early stages of schizophrenia may contribute to improving outcomes of the disorder and eventually provide a further understanding of the nature of the complex and dynamic neural processes underlying those abnormalities. Trial registration ClinicalTrials.gov, NCT03071484 . Registered on 7 March 2017. Electronic supplementary material The online version of this article (10.1186/s13063-019-3288-5) contains supplementary material, which is available to authorized users.

Frontoparietal anodal tDCS reduces ketamine-induced oscillopathies

“…The behavior-to-cognitive variables should therefore probably also be followed. Moreover, the efficacy of fronto-temporo-parietal tDCS (20 min of 2 mA tDCS or sham stimulation once a day for 10 consecutive weekdays) was tested in the treatment of cognitive symptomatology in the early stages of psychosis [ 38 ].…”

“…Additionally, in patients with schizophrenia, anodal tDCS can reduce the gamma event-related synchronization [ 37 ]. Also, the use of tDCS has a great potential in the treatment of cognitive symptomatology in early psychosis [ 38 ]. Nevertheless, the tDCS-induced immediate and downstream effects are transient and the parameters of tDCS remain to be further investigated to better understand their impact on network and cellular activities.…”

Cognitive rehabilitation in people with autism spectrum disorder: a systematic review of emerging virtual reality-based approaches

“…Given the challenges that exist in improving the health status of children and adults, paying attention to emerging approaches to improve cognitive abilities seems to be a way forward. Cognitive rehabilitation includes a wide range of treatment methods that can be performed by different rehabilitation specialists [14]. Cognitive rehabilitation helps to restore normal functioning and compensate for cognitive deficits in people with brain damage or people with cognitive impairment [15].…”

Efficacy and auditory biomarker analysis of fronto-temporal transcranial direct current stimulation (tDCS) in targeting cognitive impairment associated with recent-onset schizophrenia: study protocol for a multicentric randomized double-blind sham-controlled trial

“…Future trials are needed to verify results of cognitive improvement after tDCS in larger schizophrenia samples with adequate sham control and randomization. In that sense, additional tDCS trials in schizophrenia are ongoing and receive important fundings from governments and foundations across the world (23,24). Despite these promising aspects, two areas of uncertainty warrant additional attention.…”