Transcranial direct current stimulation in the treatment of anxiety and depression in patients with oral cancer during perioperative period

Gao, Zhi-biao; Zhang, Wenjuan; Tuo, Rui; Xiao, Xia; Cao, Wei-jing

doi:10.1097/md.0000000000030220

Cited by 3 publications

(2 citation statements)

References 26 publications

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“…In this context, tDCS may have a crucial role in alleviating anxiety symptoms by exerting a direct inhibitory influence on the amygdala through modulation of the prefrontal cortex and exerting an anxiolytic effect by activating cannabinoid receptor 1 in the amygdala . In line with a previous study, this trial confirmed that tDCS was effective in reducing the incidence of perioperative anxiety. Notably, a score of 8 or higher on the HADS-A subscale is defined as anxiety, and after 2 sessions of tDCS intervention (T3), the active tDCS group had anxiety scores of less than 8 before the operation, whereas scores in the control group still exceeded 8, which is considered a clinically significant score for reducing perioperative anxiety.…”

Section: Discussionsupporting

confidence: 88%

Transcranial Direct Current Stimulation for Anxiety During Laparoscopic Colorectal Cancer Surgery

Li,

Tao,

Chen

et al. 2024

JAMA Netw Open

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ImportancePerioperative anxiety is prevalent among patients undergoing surgical treatment of cancer and often influences their prognosis. Transcranial direct current stimulation (tDCS) has shown potential in the treatment of various anxiety-related disorders, but data on the impact of tDCS on perioperative anxiety are limited.ObjectiveTo evaluate the effect of tDCS in reducing perioperative anxiety among patients undergoing laparoscopic colorectal cancer (CRC) resection.Design, Setting, And ParticipantsThis randomized clinical trial was conducted from March to August 2023 at the Affiliated Hospital of Xuzhou Medical University. Patients aged 18 years or older undergoing elective laparoscopic radical resection for CRC were randomly assigned to either the active tDCS group or the sham tDCS group. Intention-to-treat data analysis was performed in September 2023.InterventionsPatients were randomly assigned to receive 2 sessions of either active tDCS or sham tDCS over the left dorsolateral prefrontal cortex on the afternoon of the day before the operation and in the morning of the day of operation.Main Outcomes and MeasuresThe main outcome was the incidence of perioperative anxiety from the day of the operation up to 3 days after the procedure, as measured using the Hospital Anxiety and Depression Scale-Anxiety (HADS-A) subscale (range: 0-21, with higher scores indicating more anxiety). Secondary outcomes included postoperative delirium (assessed by the Confusion Assessment Method or Confusion Assessment Method intensive care unit scale); pain (assessed by the 10-point Numeric Rating Scale [NRS], with scores ranging from 0 [no pain] to 10 [worst pain]); frailty (assessed by the Fatigue, Resistance, Ambulation, Illness and Loss of Weight [FRAIL] Index, with scores ranging from 0 [most robust] to 5 [most frail]; and sleep quality (assessed by the Pittsburgh Sleep Quality Index [PSQI], with scores ranging from 0 to 21 and higher scores indicating worse sleep quality) after the 2 sessions of the tDCS intervention.ResultsA total of 196 patients (mean [SD] age, 63.5 [11.0] years; 124 [63.3%] men) were recruited and randomly assigned to the active tDCS group (98 patients) or the sham tDCS group (98 patients). After the second tDCS intervention on the day of the operation, the incidence of perioperative anxiety was 38.8% in the active tDCS group and 70.4% in the sham tDCS group (relative risk, 0.55 [95% CI, 0.42-0.73]; P &lt; .001). Patients in the active tDCS group vs the sham tDCS group were less likely to have postoperative delirium (8.2% vs 25.5%) and, at 3 days after the operation, had lower median (IQR) pain scores (NRS, 1.0 [1.0-1.0] vs 2.0 [2.0-2.0]), better median (IQR) sleep quality scores (PSQI, 10.5 [10.0-11.0] vs 12.0 [11.0-13.0]), and lower median (IQR) FRAIL Index (2.0 [1.0-2.0] vs 2.0 [2.0-3.0]).Conclusions and RelevanceFindings of this randomized clinical trial indicate that administration of 2 preoperative sessions of tDCS was associated with a decreased incidence of perioperative anxiety in patients undergoing elective CRC resection. Active tDCS was also associated with better anxiety scores, pain levels, and sleep quality as well as reduced postoperative delirium and frailty. The findings suggest that tDCS may be a novel strategy for improving perioperative anxiety in patients undergoing CRC resection.Trial RegistrationChinese Clinical Trial Register Identifier: ChiCTR2300068859

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Section: Discussionsupporting

confidence: 88%

Transcranial Direct Current Stimulation for Anxiety During Laparoscopic Colorectal Cancer Surgery

Li,

Tao,

Chen

et al. 2024

JAMA Netw Open

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“…Cranial nerve stimulation with children with ADHD demonstrates improvements in cognition, mood, and sleep by engaging circuits involved in executive functioning and increasing frontal EEG spectral power [ 87 , 88 , 89 ]. Exciting results have been observed in adult cancer survivorship as well: better mental health outcomes [ 90 ], improved attention [ 91 ], and a case study exhibiting improved global cognitive, memory, executive function, and attention scores [ 92 ].…”

Section: Existing Therapeutic Interventions For Cognitive Impairmentmentioning

confidence: 99%

Clinical Potential of Transcranial Focused Ultrasound for Neurorehabilitation in Pediatric Cancer Survivors

VanGilder,

Tanner,

Krull

et al. 2024

Brain Sciences

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Cancer survivors are at a high risk for treatment-related late effects, particularly neurocognitive impairment in the attention and executive function domains. These can be compounded in pediatric populations still undergoing neural development, which has increased interest in survivorship studies and neurorehabilitation approaches to mitigate these effects. Cognitive training regimens have shown promise as a therapeutic intervention for improving cognitive function. Therapist-guided and computerized training programs with adaptive paradigms have been successfully implemented in pediatric populations, with positive outcomes on attention and working memory. Another interventional approach is neuromodulation to alter plasticity. Transcranial electrical stimulation can modulate cortical surface activity, and cranial nerve stimulation alters autonomic activity in afferent brainstem pathways. However, they are more systemic in nature and have diffuse spatial targeting. Transcranial focused ultrasound (tFUS) modulation overcomes these limitations with high spatial specificity and the ability to target deeper brain regions. In this review, we discuss the efficacy of tFUS for modulating specific brain regions and its potential utility to augment cognitive training programs as a complementary intervention.

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The Application of tDCS to Treat Pain and Psychocognitive Symptoms in Cancer Patients: A Scoping Review

Capetti,

Conti,

Marzorati

et al. 2024

Neural Plasticity

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Background. The use of transcranial direct current stimulation (tDCS) to modulate pain, psychological aspects, and cognitive functions has increased in recent years. The present scoping review aims to investigate the use of tDCS in cancer patients and its significant impact on psychocognitive and pain related symptoms. Methods. From the earliest available date to June 2023, a comprehensive search was conducted in three electronic scientific databases—PubMed, Scopus, and Embase—and other supplementary sources. Ten relevant studies were identified and included, comprising single case studies, randomized controlled trials, pilot studies, and one retrospective study. PRISMA guidelines for scoping reviews were followed. Results. These studies investigated the use of tDCS to improve pain and psychocognitive aspects in patients with various types of cancer, including breast, oral, bladder, lung, pancreatic, head and neck cancer, hepatocellular carcinoma, and meningioma. Overall, the results suggest that tDCS has shown efficacy in relieving pain, reducing anxiety and depression, and improving cognitive function in cancer patients. Conclusion. Due to the limited number and high heterogeneity of the existing literature in this field, more investigation and the establishment of standardized protocols would be required to obtain more conclusive evidence.

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Transcranial direct current stimulation in the treatment of anxiety and depression in patients with oral cancer during perioperative period

Cited by 3 publications

References 26 publications

Transcranial Direct Current Stimulation for Anxiety During Laparoscopic Colorectal Cancer Surgery

Transcranial Direct Current Stimulation for Anxiety During Laparoscopic Colorectal Cancer Surgery

Clinical Potential of Transcranial Focused Ultrasound for Neurorehabilitation in Pediatric Cancer Survivors

The Application of tDCS to Treat Pain and Psychocognitive Symptoms in Cancer Patients: A Scoping Review

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