Abstract

Although transcranial direct current stimulation (tDCS) shows promise as a treatment for auditory verbal hallucinations in patients with schizophrenia, mechanisms through which tDCS may induce beneficial effects remain unclear. Evidence points to the involvement of neuronal plasticity mechanisms that are underpinned, amongst others, by brain-derived neurotrophic factor (BDNF) in its two main forms: pro and mature peptides. Here, we aimed to investigate whether tDCS modulates neural plasticity by measuring the acute effects of tDCS on peripheral mature BDNF levels in patients with schizophrenia. Blood samples were collected in 24 patients with schizophrenia before and after they received a single session of either active (20 min, 2 mA, n = 13) or sham (n = 11) frontotemporal tDCS with the anode over the left prefrontal cortex and the cathode over the left temporoparietal junction. We compared the tDCS-induced changes in serum mature BDNF (mBDNF) levels adjusted for baseline values between the two groups. The results showed that active tDCS was associated with a significantly larger decrease in mBDNF levels (mean −20% ± standard deviation 14) than sham tDCS (−8% ± 21) (F = 5.387; p = 0.030; η2 = 0.205). Thus, mature BDNF may be involved in the beneficial effects of frontotemporal tDCS observed in patients with schizophrenia.

Highlights

  • Auditory verbal hallucinations (AVH) are disabling and frequent symptoms in patients with schizophrenia

  • Since baseline mature BDNF (mBDNF) levels tended to differ between the two groups (p = 0.054), we added baseline mBDNF level as a covariate in the analysis to control for this factor

  • Our current findings do not support results from other studies reporting that noninvasive brain stimulation (NIBS) did not modulate brain-derived neurotrophic factor (BDNF) levels in patients with depression receiving high frequency repetitive transcranial magnetic stimulation (rTMS) [37], and in patients with uni- or bipolar depression receiving repeated sessions of frontal transcranial direct current stimulation (tDCS) with the anode placed over the left prefrontal cortex [15,16,17]

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Summary

Introduction

Auditory verbal hallucinations (AVH) are disabling and frequent symptoms in patients with schizophrenia. Physiological effects of tDCS are thought to be mediated by a modulation of the cortical excitability of brain regions situated under the location of electrodes [4]. The effects do not seem limited to the targeted cortical area and the modulatory effect may spread to a large network of inter-connected brain regions [5,6]. These local and regional effects can outlast the stimulation period, suggesting long-term potentiation (LTP)/long-term depression (LTD)-like mechanisms [7], which require activity-dependent brain-derived neurotrophic factor (BDNF) secretion [8,9]

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