T034 Transcranial brain stimulation in psychiatry – translational research towards treatment?

Abstract

Objectives Transcranial brain stimulation (TBS) techniques are promising as therapeutic interventions in psychiatry and few large randomized controlled trials (e.g. in depressive disorders) have opened the field for wider clinical applications. In addition, an enormous set of experimental data for TBS is available from human neurophysiology and cognitive neuroscience research. TBS has been investigated in cellular and animal models, though studies are not as numerous compared to research in humans. With this background, coordinated translational research is a neglected field and particularly promising in order to transfer preclinical knowledge to clinical applications and could be strengthened by establishing specific coordinated research programs. The German Center of Brain Stimulation (GCBS, www.gcbs.network ) funded by the German Federal Ministry of Research and Education (BMBF) since 2015 set out on this endeavor. Methods & results Three examples from the GCBS will be given to illustrate the added value of coordinated research in this field: (1) reverse translation, i.e. establishing complementary animal models for TBS protocols in humans and investigating their mechanisms of action, (2) The effect of transcranial direct current stimulation (tDCS) on working memory and learning serves as paradigm for translational research starting from animal models via experimental studies in humans to clinical applications in the field of behavioral training and psychotherapy. (3) High quality randomized controlled clinical trials (RCTs) which are mandatory for establishing therapeutic applications can be accompanied by basic research characterizing mechanisms of action. Two current randomized placebo-controlled trials (DepressionDC,clinicaltrials.gov: NCT02530164; Psychotherapy Plus,clinicaltrials.gov: NCT02633449) will be presented including a novel mode of controlled tDCS application; research questions from this trial for preclinical studies will be discussed. Conclusion In sum, the natural boundaries of translational research from bench to bed between cellular models/animal models, healthy subjects and patient populations need to be systematically addressed in order to speed up the process of TBS development towards treatment. These examples require forward and reverse translational research. The GCBS may serve as model for further coordinated programs following a recently established hub-and-spoke structure. Supported by the Federal Ministry of Research and Education (“Forschungsnetz fur psychische Erkrankungen”, German Center for Brain Stimulation – GCBS, FKZ: 01EE1403) .