P 199. Prefrontal transcranial direct current stimulation (tDCS) changes negative symptoms and functional connectivity MRI (fcMRI) in a single case of treatment-resistant schizophrenia

Abstract

Background Transcranial Direct Current Stimulation (tDCS) has been associated with improvement in affective disorders. However, little is known about the influence oft tDCS on treatment-resistant schizophrenia with predominant negative symptoms. In this case study we looked on the effects of prefrontal tDCS on schizophrenic symptoms and functional MRI connectivity (fcMRI) changes. Methods The 19-year old patient was diagnosed with paranoid schizophrenia (DSM-IV: 295.30). He was treated with olanzapine 20 mg/day over 8 weeks without relevant psychopathological changes of paranoia and avolition. The patient underwent 10 tDCS sessions with the anode over the left DLPFC and the cathode over the right supraorbital region using a stimulation intensity of 2 mA and a stimulation duration of 20 min (Eldith Stimulator, electrode size: 7 times 5 cm2).The following clinical ratings and tests were used at baseline, after 5 and 10 tDCS treatments: PANSS, SANS, CDSS, SOPT, TMT. fcMRI was recorded at baseline, immediately after one tDCS sesion and after 10 days of tDCS (3.0 Tesla standard clinical scanner (Achieva TX, Philips Healthcare). Results After two weeks of tDCS treatment there was a considerable change in psychopathology. PANSS total score declined by 29%, SANS total score declined by 28%, Subjective feelings of depression (CDSS) were reduced by 82%. There was a pronounced improvement in the Trail Making Test (TMT) and the Self Ordered Pointing Task (SOPT). The fcMRI in the subgenual region was significantly reduced immediately after tDCS stimulation and this effect was even more extended after 10 days of tDCS (p Conclusion The significant fcMRI changes are consistent to the clinical and cognitive improvements of the patient. tDCS of the dorsolateral prefrontal cortex seems to be a promising tool for the treatment of negative symptoms in schizophrenia. However, larger studies are needed for investigating the role of the specific effects of tDCS on the symptom variety in schizophrenia. Download : Download high-res image (153KB) Download : Download full-size image