Transcranial Direct Current Stimulation-Psychiatric Application and Its Current Status

경두개 직류 자극-정신과적 활용과 현황

  • 김평규 ((주)와이브레인 기업부설 연구소) ;
  • 김도형 ((주)와이브레인 기업부설 연구소)
  • Received : 2017.08.07
  • Accepted : 2017.10.17
  • Published : 2017.11.30

Abstract

Transcranial direct current stimulation (TDCS) is a clinically safe and effective method of delivering weak electric current to modulate cortical activities. And based on the cumulating scientific evidences, the method is recommended to treat major depressive disorder (MDD) and other psychiatric disorders. In this paper, we review the development of TDCS in the rising field of neuromodulation. Then with suggested biochemical and physical mechanism of TDCS, we summarize the reported cases of using TDCS to alleviate major neuropsychiatric disorders. And, in particular, the treatment of MDD is highlighted as an illustrative example of using TDCS. We discuss here the therapeutic potentials of this method in psychiatry. And in closing remarks, we evaluate the current technical limitations and suggest the future directions of this method in both the clinical and research aspects.

Keywords

References

  1. Luan S, Williams I, Nikolic K, Constandinou TG. Neuromodulation: present and emerging methods. Front Neuroeng 2014;7:27.
  2. Tyler WJ. Noninvasive neuromodulation with ultrasound? A continuum mechanics hypothesis. Neuroscientist 2011;17:25-36. https://doi.org/10.1177/1073858409348066
  3. Hameroff S, Trakas M, Duffield C, Annabi E, Gerace MB, Boyle P, et al. Transcranial ultrasound (TUS) effects on mental states: a pilot study. Brain Stimul 2013;6:409-415. https://doi.org/10.1016/j.brs.2012.05.002
  4. Jang C, Park HJ, Chang WS, Pae C, Chang JW. Immediate and longitudinal alterations of functional networks after thalamotomy in essential tremor. Front Neurol 2016;7:184.
  5. Yoo SS, Bystritsky A, Lee JH, Zhang Y, Fischer K, Min BK, et al. Focused ultrasound modulates region-specific brain activity. Neuroimage 2011;56:1267-1275. https://doi.org/10.1016/j.neuroimage.2011.02.058
  6. Huhn M, Tardy M, Spineli LM, Kissling W, Forstl H, Pitschel-Walz G, et al. Efficacy of pharmacotherapy and psychotherapy for adult psychiatric disorders: a systematic overview of meta-analyses. JAMA Psychiatry 2014;71:706-715. https://doi.org/10.1001/jamapsychiatry.2014.112
  7. Hollis C, Morriss R, Martin J, Amani S, Cotton R, Denis M, et al. Technological innovations in mental healthcare: harnessing the digital revolution. Br J Psychiatry 2015;206:263-265. https://doi.org/10.1192/bjp.bp.113.142612
  8. Hasey GM. Transcranial magnetic stimulation: using a law of physics to treat psychopathology. J Psychiatry Neurosci 1999;24:97-101.
  9. Pascual-Leone A, Rubio B, Pallardo F, Catala MD. Rapid-rate transcranial magnetic stimulation of left dorsolateral prefrontal cortex in drug-resistant depression. Lancet 1996;348:233-237. https://doi.org/10.1016/S0140-6736(96)01219-6
  10. Leiknes KA, Cooke MJ, Jarosch-von Schweder L, Harboe I, Hoie B. Electroconvulsive therapy during pregnancy: a systematic review of case studies. Arch Womens Ment Health 2015;18:1-39. https://doi.org/10.1007/s00737-013-0389-0
  11. Fregni F, Nitsche MA, Loo CK, Brunoni AR, Marangolo P, Leite J, et al. Regulatory considerations for the clinical and research use of transcranial direct current stimulation (tDCS): review and recommendations from an expert panel. Clin Res Regul Aff 2015;32:22-35. https://doi.org/10.3109/10601333.2015.980944
  12. Zaghi S, Acar M, Hultgren B, Boggio PS, Fregni F. Noninvasive brain stimulation with low-intensity electrical currents: putative mechanisms of action for direct and alternating current stimulation. Neuroscientist 2010;16:285-307. https://doi.org/10.1177/1073858409336227
  13. Priori A, Hallett M, Rothwell JC. Repetitive transcranial magnetic stimulation or transcranial direct current stimulation? Brain Stimul 2009;2:241-245. https://doi.org/10.1016/j.brs.2009.02.004
  14. Nitsche MA, Boggio PS, Fregni F, Pascual-Leone A. Treatment of depression with transcranial direct current stimulation (tDCS): a review. Exp Neurol 2009;219:14-19. https://doi.org/10.1016/j.expneurol.2009.03.038
  15. Kim JW, Lee J. Application of transcranial direct current stimulation in psychiatry. J Korean Neuropsychiatr Assoc 2016;55:158-167. https://doi.org/10.4306/jknpa.2016.55.3.158
  16. Wagner T, Fregni F, Fecteau S, Grodzinsky A, Zahn M, Pascual-Leone A. Transcranial direct current stimulation: a computer-based human model study. Neuroimage 2007;35:1113-1124. https://doi.org/10.1016/j.neuroimage.2007.01.027
  17. Bikson M, Datta A, Elwassif M. Establishing safety limits for transcranial direct current stimulation. Clin Neurophysiol 2009;120:1033-1034. https://doi.org/10.1016/j.clinph.2009.03.018
  18. Underwood E. NEUROSCIENCE. Cadaver study challenges brain stimulation methods. Science 2016;352:397. https://doi.org/10.1126/science.352.6284.397
  19. Nitsche MA, Paulus W. Excitability changes induced in the human motor cortex by weak transcranial direct current stimulation. J Physiol 2000;527 Pt 3:633-639. https://doi.org/10.1111/j.1469-7793.2000.t01-1-00633.x
  20. Bikson M, Grossman P, Thomas C, Zannou AL, Jiang J, Adnan T, et al. Safety of transcranial direct current stimulation: evidence based update 2016. Brain Stimulation 2016;9:641-661. https://doi.org/10.1016/j.brs.2016.06.004
  21. Brunoni AR, Amadera J, Berbel B, Volz MS, Rizzerio BG, Fregni F. A systematic review on reporting and assessment of adverse effects associated with transcranial direct current stimulation. Int J Neuropsychopharmacol 2011;14:1133-1145. https://doi.org/10.1017/S1461145710001690
  22. Kessler SK, Turkeltaub PE, Benson JG, Hamilton RH. Differences in the experience of active and sham transcranial direct current stimulation. Brain Stimul 2012;5:155-162. https://doi.org/10.1016/j.brs.2011.02.007
  23. Brunoni A, Loo C, Nitsche M. Safety and tolerability. In: Brunoni A, Nitsche M, Loo C, editors. Transcranial Direct Current Stimulation in Neuropsychiatric Disorders. 1st ed. Cham: Springer;2016. p.343-350.
  24. Matsumoto H, Ugawa Y. Adverse events of tDCS and tACS: a review. Clin Neurophysiol Pract 2017;2:19-25. https://doi.org/10.1016/j.cnp.2016.12.003
  25. Bindman LJ, Lippold OC, Redfearn JW. Long-lasting changes in the level of the electrical activity of the cerebral cortex produced bypolarizing currents. Nature 1962;196:584-585. https://doi.org/10.1038/196584a0
  26. Rahman A, Reato D, Arlotti M, Gasca F, Datta A, Parra LC, et al. Cellular effects of acute direct current stimulation: somatic and synaptic terminal effects. J Physiol 2013;591:2563-2578. https://doi.org/10.1113/jphysiol.2012.247171
  27. Paulus W. Transcranial electrical stimulation (tES-tDCS; tRNS, tACS) methods. Neuropsychol Rehabil 2011;21:602-617. https://doi.org/10.1080/09602011.2011.557292
  28. Liebetanz D, Nitsche MA, Tergau F, Paulus W. Pharmacological approach to the mechanisms of transcranial DC-stimulation-induced after-effects of human motor cortex excitability. Brain 2002;125:2238-2247. https://doi.org/10.1093/brain/awf238
  29. Podda MV, Cocco S, Mastrodonato A, Fusco S, Leone L, Barbati SA, et al. Anodal transcranial direct current stimulation boosts synaptic plasticity and memory in mice via epigenetic regulation of Bdnf expression. Sci Rep 2016;6:22180. https://doi.org/10.1038/srep22180
  30. Pelletier SJ, Cicchetti F. Cellular and molecular mechanisms of action of transcranial direct current stimulation: evidence from in vitro and in vivo models. Int J Neuropsychopharmacol 2015;18:pyu047.
  31. Okamoto K, Bosch M, Hayashi Y. The roles of CaMKII and F-actin in the structural plasticity of dendritic spines: a potential molecular identity of a synaptic tag? Physiology (Bethesda) 2009;24:357-366.
  32. Dent EW, Baas PW. Microtubules in neurons as information carriers. J Neurochem 2014;129:235-239. https://doi.org/10.1111/jnc.12621
  33. Autry AE, Monteggia LM. Brain-derived neurotrophic factor and neuropsychiatric disorders. Pharmacol Rev 2012;64:238-258. https://doi.org/10.1124/pr.111.005108
  34. Zhang H, Ozbay F, Lappalainen J, Kranzler HR, van Dyck CH, Charney DS, et al. Brain derived neurotrophic factor (BDNF) gene variants and Alzheimer's disease, affective disorders, posttraumatic stress disorder, schizophrenia, and substance dependence. Am J Med Genet B Neuropsychiatr Genet 2006;141B:387-393. https://doi.org/10.1002/ajmg.b.30332
  35. Borroni B, Archetti S, Costanzi C, Grassi M, Ferrari M, Radeghieri A, et al. Role of BDNF Val66Met functional polymorphism in Alzheimer's disease-related depression. Neurobiol Aging 2009;30:1406-1412. https://doi.org/10.1016/j.neurobiolaging.2007.11.023
  36. Monai H, Ohkura M, Tanaka M, Oe Y, Konno A, Hirai H, et al. Calcium imaging reveals glial involvement in transcranial direct current stimulation-induced plasticity in mouse brain. Nat Commun 2016;7:11100. https://doi.org/10.1038/ncomms11100
  37. Araque A, Navarrete M. Glial cells in neuronal network function. Philos Trans R Soc Lond B Biol Sci 2010;365:2375-2381. https://doi.org/10.1098/rstb.2009.0313
  38. Radman T, Ramos RL, Brumberg JC, Bikson M. Role of cortical cell type and morphology in subthreshold and suprathreshold uniform electric field stimulation in vitro. Brain Stimul 2009;2:215-228, 228.e1-e3. https://doi.org/10.1016/j.brs.2009.03.007
  39. Hummel FC, Celnik P, Pascual-Leone A, Fregni F, Byblow WD, Buetefisch CM, et al. Controversy: Noninvasive and invasive cortical stimulation show efficacy in treating stroke patients. Brain Stimul 2008;1:370-382. https://doi.org/10.1016/j.brs.2008.09.003
  40. Chervyakov AV, Chernyavsky AY, Sinitsyn DO, Piradov MA. Possible mechanisms underlying the therapeutic effects of transcranial magnetic stimulation. Front Hum Neurosci 2015;9:303.
  41. Costain R, Redfearn JW, Lippold OC. A controlled trial of the therapeutic effect of polarization of the brain in depressive illness. Br J Psychiatry 1964;110:786-799. https://doi.org/10.1192/bjp.110.469.786
  42. Redfearn JW, Lippold OC, Costain R. A preliminary account of the clinical effects of polarizing the brain in certain psychiatric disorders. Br J Psychiatry 1964;110:773-785. https://doi.org/10.1192/bjp.110.469.773
  43. Moffa AH, Valiengo L, Shiozawa P, Brunoni AR. Novel neurotherapeutics in psychiatry: use and rationale of transcranial direct current stimulation in major depressive disorder. Rev Psiquiatr Clin 2014;41:15-20. https://doi.org/10.1590/0101-60830004111520
  44. Au J, Katz B, Buschkuehl M, Bunarjo K, Senger T, Zabel C, et al. Enhancing working memory training with transcranial direct current stimulation. J Cogn Neurosci 2016;28:1419-1432. https://doi.org/10.1162/jocn_a_00979
  45. Coffman BA, Clark VP, Parasuraman R. Battery powered thought: enhancement of attention, learning, and memory in healthy adults using transcranial direct current stimulation. Neuroimage 2014;85 Pt 3:895-908. https://doi.org/10.1016/j.neuroimage.2013.07.083
  46. Ehsani F, Bakhtiary AH, Jaberzadeh S, Talimkhani A, Hajihasani A. Differential effects of primary motor cortex and cerebellar transcranial direct current stimulation on motor learning in healthy individ uals: a randomized double-blind sham-controlled study. Neurosci Res 2016;112:10-19. https://doi.org/10.1016/j.neures.2016.06.003
  47. Brunoni AR, Nitsche MA, Bolognini N, Bikson M, Wagner T, Merabet L, et al. Clinical research with transcranial direct current stimulation (tDCS): challenges and future directions. Brain Stimul 2012;5:175-195. https://doi.org/10.1016/j.brs.2011.03.002
  48. Duman RS, Aghajanian GK, Sanacora G, Krystal JH. Synaptic plasticity and depression: new insights from stress and rapid-acting antidepressants. Nat Med 2016;22:238-249. https://doi.org/10.1038/nm.4050
  49. Krishnan V, Nestler EJ. The molecular neurobiology of depression. Nature 2008;455:894-902. https://doi.org/10.1038/nature07455
  50. Manji HK, Drevets WC, Charney DS. The cellular neurobiology of depression. Nat Med 2001;7:541-547. https://doi.org/10.1038/87865
  51. Grimm S, Beck J, Schuepbach D, Hell D, Boesiger P, Bermpohl F, et al. Imbalance between left and right dorsolateral prefrontal cortex in major depression is linked to negative emotional judgment: an fMRI study in severe major depressive disorder. Biol Psychiatry 2008;63:369-376. https://doi.org/10.1016/j.biopsych.2007.05.033
  52. Drevets WC, Price JL, Furey ML. Brain structural and functional abnormalities in mood disorders: implications for neurocircuitry models of depression. Brain Struct Funct 2008;213:93-118. https://doi.org/10.1007/s00429-008-0189-x
  53. Brunoni AR, Valiengo L, Baccaro A, Zanao TA, de Oliveira JF, Vieira GP, et al. Sertraline vs. eLectrical current therapy for treating depression clinical trial--SELECT TDCS: design, rationale and objectives. Contemp Clin Trials 2011;32:90-98. https://doi.org/10.1016/j.cct.2010.09.007
  54. Brunoni AR, Valiengo L, Baccaro A, Zanao TA, de Oliveira JF, Goulart A, et al. The sertraline vs. electrical current therapy for treating depression clinical study: results from a factorial, randomized, controlled trial. JAMA Psychiatry 2013;70:383-391. https://doi.org/10.1001/2013.jamapsychiatry.32
  55. Gandiga PC, Hummel FC, Cohen LG. Transcranial DC stimulation (tDCS): a tool for double-blind sham-controlled clinical studies in brain stimulation. Clin Neurophysiol 2006;117:845-850. https://doi.org/10.1016/j.clinph.2005.12.003
  56. Rigonatti SP, Boggio PS, Myczkowski ML, Otta E, Fiquer JT, Ribeiro RB, et al. Transcranial direct stimulation and fluoxetine for the treatment of depression. Eur Psychiatry 2008;23:74-76. https://doi.org/10.1016/j.eurpsy.2007.09.006
  57. Dedoncker J, Brunoni AR, Baeken C6, Vanderhasselt MA. The effect of the interval-between-sessions on prefrontal transcranial direct current stimulation (tDCS) on cognitive outcomes: a systematic review and meta-analysis. J Neural Transm (Vienna) 2016;123:1159-1172. https://doi.org/10.1007/s00702-016-1558-x
  58. Mulquiney PG, Hoy KE, Daskalakis ZJ, Fitzgerald PB. Improving working memory: exploring the effect of transcranial random noise stimulation and transcranial direct current stimulation on the dorsolateral prefrontal cortex. Clin Neurophysiol 2011;122:2384-2389. https://doi.org/10.1016/j.clinph.2011.05.009
  59. Ohn SH, Park CI, Yoo WK, Ko MH, Choi KP, Kim GM, et al. Timedependent effect of transcranial direct current stimulation on the enhancement of working memory. Neuroreport 2008;19:43-47. https://doi.org/10.1097/WNR.0b013e3282f2adfd
  60. Boggio PS, Bermpohl F, Vergara AO, Muniz AL, Nahas FH, Leme PB, et al. Go-no-go task performance improvement after anodal transcranial DC stimulation of the left dorsolateral prefrontal cortex in major depression. J Affect Disord 2007;101:91-98. https://doi.org/10.1016/j.jad.2006.10.026
  61. Wolkenstein L, Plewnia C. Amelioration of cognitive control in depression by transcranial direct current stimulation. Biol Psychiatry 2013;73:646-651. https://doi.org/10.1016/j.biopsych.2012.10.010
  62. Blumberger DM, Tran LC, Fitzgerald PB, Hoy KE, Daskalakis ZJ. A randomized double-blind sham-controlled study of transcranial direct current stimulation for treatment-resistant major depression. Front Psychiatry 2012;3:74.
  63. Lefaucheur JP, Antal A, Ayache SS, Benninger DH, Brunelin J, Cogiamanian F, et al. Evidence-based guidelines on the therapeutic use of transcranial direct current stimulation (tDCS). Clin Neurophysiol 2017;128:56-92. https://doi.org/10.1016/j.clinph.2016.10.087
  64. Loo CK, Sachdev P, Martin D, Pigot M, Alonzo A, Malhi GS, et al. A double-blind, sham-controlled trial of transcranial direct current stimulation for the treatment of depression. Int J Neuropsychopharmacol 2010;13:61-69. https://doi.org/10.1017/S1461145709990411
  65. Fregni F, Boggio PS, Nitsche MA, Marcolin MA, Rigonatti SP, Pascual-Leone A. Treatment of major depression with transcranial direct current stimulation. Bipolar Disord 2006;8:203-204. https://doi.org/10.1111/j.1399-5618.2006.00291.x
  66. Berlim MT, Van den Eynde F, Daskalakis ZJ. Clinical utility of transcranial direct current stimulation (tDCS) for treating major depression: a systematic review and meta-analysis of randomized, doubleblind and sham-controlled trials. J Psychiatr Res 2013;47:1-7. https://doi.org/10.1016/j.jpsychires.2012.09.025
  67. Kalu UG, Sexton CE, Loo CK, Ebmeier KP. Transcranial direct current stimulation in the treatment of major depression: a meta-analysis. Psychol Med 2012;42:1791-1800. https://doi.org/10.1017/S0033291711003059
  68. Valiengo L, Bensenor IM, Goulart AC, de Oliveira JF, Zanao TA, Boggio PS, et al. The sertraline versus electrical current therapy for treating depression clinical study (select-TDCS): results of the crossover and follow-up phases. Depress Anxiety 2013;30:646-653. https://doi.org/10.1002/da.22079
  69. Shiozawa P, Fregni F, Bensenor IM, Lotufo PA, Berlim MT, Daskalakis JZ, et al. Transcranial direct current stimulation for major depression: an updated systematic review and meta-analysis. Int J Neuropsychopharmacol 2014;17:1443-1452. https://doi.org/10.1017/S1461145714000418
  70. Brunoni AR, Moffa AH, Fregni F, Palm U, Padberg F, Blumberger DM, et al. Transcranial direct current stimulation for acute major depressive episodes: meta-analysis of individual patient data. Br J Psychiatry 2016;208:522-531. https://doi.org/10.1192/bjp.bp.115.164715
  71. Vigod S, Dennis CL, Daskalakis Z, Murphy K, Ray J, Oberlander T, et al. Transcranial direct current stimulation (tDCS) for treatment of major depression during pregnancy: study protocol for a pilot randomized controlled trial. Trials 2014;15:366. https://doi.org/10.1186/1745-6215-15-366
  72. Lehman AF, Lieberman JA, Dixon LB, McGlashan TH, Miller AL, Perkins DO, et al. Practice guideline for the treatment of patients with schizophrenia, second edition. Am J Psychiatry 2004;161:1-56. https://doi.org/10.1176/appi.ajp.161.1.1
  73. Alonzo A, Aaronson S, Bikson M, Husain M, Lisanby S, Martin D, et al. Study design and methodology for a multicentre, randomised controlled trial of transcranial direct current stimulation as a treatment for unipolar and bipolar depression. Contemp Clin Trials 2016;51:65-71. https://doi.org/10.1016/j.cct.2016.10.002
  74. Brunoni AR, Ferrucci R, Bortolomasi M, Vergari M, Tadini L, Boggio PS, et al. Transcranial direct current stimulation (tDCS) in unipolar vs. bipolar depressive disorder. Prog Neuropsychopharmacol Biol Psychiatry 2011;35:96-101. https://doi.org/10.1016/j.pnpbp.2010.09.010
  75. Brunoni AR, Moffa AH, Sampaio-Junior B, Galvez V, Loo CK. Treatment-emergent mania/hypomania during antidepressant treatment with transcranial direct current stimulation (tDCS): a systematic review and meta-analysis. Brain Stimul 2017;10:260-262. https://doi.org/10.1016/j.brs.2016.11.005
  76. Pereira Junior Bde S, Tortella G, Lafer B, Nunes P, Bensenor IM, Lotufo PA, et al. The bipolar depression electrical treatment trial (BETTER): design, rationale, and objectives of a randomized, shamcontrolled trial and data from the pilot study phase. Neural Plast 2015;2015:684025.
  77. Green IW, Glausier JR. Different paths to core pathology: the equifinal model of the schizophrenia syndrome. Schizophr Bull 2016;42:542-549. https://doi.org/10.1093/schbul/sbv136
  78. Lewis DA, Levitt P. Schizophrenia as a disorder of neurodevelopment. Annu Rev Neurosci 2002;25:409-432. https://doi.org/10.1146/annurev.neuro.25.112701.142754
  79. Pulver AE. Search for schizophrenia susceptibility genes. Biol Psychiatry 2000;47:221-230. https://doi.org/10.1016/S0006-3223(99)00281-4
  80. Lewis DA, Lieberman JA. Catching up on schizophrenia: natural history and neurobiology. Neuron 2000;28:325-334. https://doi.org/10.1016/S0896-6273(00)00111-2
  81. Rajji TK, Ismail Z, Mulsant BH. Age at onset and cognition in schizophrenia: meta-analysis. Br J Psychiatry 2009;195:286-293. https://doi.org/10.1192/bjp.bp.108.060723
  82. Riglin L, Collishaw S, Richards A, Thapar AK, Maughan B, O'Donovan MC, et al. Schizophrenia risk alleles and neurodevelopmental outcomes in childhood: a population-based cohort study. Lancet Psychiatry 2017;4:57-62. https://doi.org/10.1016/S2215-0366(16)30406-0
  83. Lefebvre S, Demeulemeester M, Leroy A, Delmaire C, Lopes R, Pins D, et al. Network dynamics during the different stages of hallucinations in schizophrenia. Hum Brain Mapp 2016;37:2571-2586. https://doi.org/10.1002/hbm.23197
  84. Harrison PJ, Law AJ. Neuregulin 1 and schizophrenia: genetics, gene expression, and neurobiology. Biol Psychiatry 2006;60:132-140. https://doi.org/10.1016/j.biopsych.2005.11.002
  85. Weickert CS, Hyde TM, Lipska BK, Herman MM, Weinberger DR, Kleinman JE. Reduced brain-derived neurotrophic factor in prefrontal cortex of patients with schizophrenia. Mol Psychiatry 2003;8:592-610. https://doi.org/10.1038/sj.mp.4001308
  86. Kendler KS. A joint history of the nature of genetic variation and the nature of schizophrenia. Mol Psychiatry 2015;20:77-83. https://doi.org/10.1038/mp.2014.94
  87. Straub RE, MacLean CJ, O'Neill FA, Burke J, Murphy B, Duke F, et al. A potential vulnerability locus for schizophrenia on chromosome 6p24-22: evidence for genetic heterogeneity. Nat Genet 1995;11:287-293. https://doi.org/10.1038/ng1195-287
  88. Walsh T, McClellan JM, McCarthy SE, Addington AM, Pierce SB, Cooper GM, et al. Rare structural variants disrupt multiple genes in neurodevelopmental pathways in schizophrenia. Science 2008;320:539-543. https://doi.org/10.1126/science.1155174
  89. Siekmeier PJ, vanMaanen DP. Dopaminergic contributions to hippocampal pathophysiology in schizophrenia: a computational study. Neuropsychopharmacology 2014;39:1713-1721. https://doi.org/10.1038/npp.2014.19
  90. Johnsen MS. Aspects of the NMDA receptor hypofunction hypothesis of schizophrenia : Neurobiology in schizophrenia [dissertation]. Oslo: University of Oslo;2011.
  91. O'Connor WT, O'Shea SD. Clozapine and GABA transmission in schizophrenia disease models: establishing principles to guide treatments. Pharmacol Ther 2015;150:47-80. https://doi.org/10.1016/j.pharmthera.2015.01.005
  92. Schwartz TL, Sachdeva S, Stahl SM. Glutamate neurocircuitry: theoretical underpinnings in schizophrenia. Front Pharmacol 2012;3:195.
  93. Kim DH, Stahl SM. Antipsychotic drug development. In: Swerdlow NR, editors. Behavioral Neurobiology of Schizophrenia and Its Treatment. 1st ed. New York, NY: Springer;2010. P.123-139.
  94. Leucht S, Cipriani A, Spineli L, Mavridis D, Orey D, Richter F, et al. Comparative efficacy and tolerability of 15 antipsychotic drugs in schizophrenia: a multiple-treatments meta-analysis. The Lancet 2013;382:951-962. https://doi.org/10.1016/S0140-6736(13)60733-3
  95. Stahl SM. Stahl's Essential Psychopharmacology: Neuroscientific Basis and Practical Applications. 4th ed. Cambridge: Cambridge University Press;2013.
  96. Andersen SL. Commentary on the special issue on the adolescent brain: Adolescence, trajectories, and the importance of prevention. Neurosci Biobehav Rev 2016;70:329-333. https://doi.org/10.1016/j.neubiorev.2016.07.012
  97. Giovanoli S, Engler H, Engler A, Richetto J, Feldon J, Riva MA, et al. Preventive effects of minocycline in a neurodevelopmental two-hit model with relevance to schizophrenia. Transl Psychiatry 2016;6:e772. https://doi.org/10.1038/tp.2016.38
  98. Moritz S, Andreou C, Klingberg S, Thoering T, Peters MJ. Assessment of subjective cognitive and emotional effects of antipsychotic drugs. Effect by defect? Neuropharmacology 2013;72:179-186. https://doi.org/10.1016/j.neuropharm.2013.04.039
  99. Cole JC, Green Bernacki C, Helmer A, Pinninti N, O'reardon JP. Efficacy of transcranial magnetic stimulation (TMS) in the treatment of schizophrenia: a review of the literature to date. Innov Clin Neurosci 2015;12:12-19.
  100. Slotema CW, Aleman A, Daskalakis ZJ, Sommer IE. Meta-analysis of repetitive transcranial magnetic stimulation in the treatment of auditory verbal hallucinations: update and effects after one month. Schizophr Res 2012;142:40-45. https://doi.org/10.1016/j.schres.2012.08.025
  101. Aleman A, Sommer IE, Kahn RS. Efficacy of slow repetitive transcranial magnetic stimulation in the treatment of resistant auditory hallucinations in schizophrenia: a meta-analysis. J Clin Psychiatry 2007;68:416-421. https://doi.org/10.4088/JCP.v68n0310
  102. d'Alfonso AA, Aleman A, Kessels RP, Schouten EA, Postma A, van Der Linden JA, et al. Transcranial magnetic stimulation of left auditory cortex in patients with schizophrenia: effects on hallucinations and neurocognition. J Neuropsychiatry Clin Neurosci 2002;14:77-79. https://doi.org/10.1176/jnp.14.1.77
  103. Lee SH, Kim W, Chung YC, Jung KH, Bahk WM, Jun TY, et al. A double blind study showing that two weeks of daily repetitive TMS over the left or right temporoparietal cortex reduces symptoms in patients with schizophrenia who are having treatment-refractory auditory hallucinations. Neurosci Lett 2005;376:177-181. https://doi.org/10.1016/j.neulet.2004.11.048
  104. Stanford AD, Sharif Z, Corcoran C, Urban N, Malaspina D, Lisanby SH. rTMS strategies for the study and treatment of schizophrenia: a review. Int J Neuropsychopharmacol 2008;11:563-576.
  105. Arumugham SS, Thirthalli J, Andrade C. Efficacy and safety of combining clozapine with electrical or magnetic brain stimulation in treatment-refractory schizophrenia. Expert Rev Clin Pharmacol 2016;9:1245-1252. https://doi.org/10.1080/17512433.2016.1200971
  106. George MS, Aston-Jones G. Noninvasive techniques for probing neurocircuitry and treating illness: vagus nerve stimulation (VNS), transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS). Neuropsychopharmacology 2010;35:301-316. https://doi.org/10.1038/npp.2009.87
  107. Minzenberg MJ, Carter CS. Developing treatments for impaired cognition in schizophrenia. Trends Cogn Sci 2012;16:35-42. https://doi.org/10.1016/j.tics.2011.11.017
  108. Shergill SS, Murray RM, McGuire PK. Auditory hallucinations: a review of psychological treatments. Schizophr Res 1998;32:137-150. https://doi.org/10.1016/S0920-9964(98)00052-8
  109. Lawrie SM, Buechel C, Whalley HC, Frith CD, Friston KJ, Johnstone EC. Reduced frontotemporal functional connectivity in schizophrenia associated with auditory hallucinations. Biol Psychiatry 2002;51:1008-1011. https://doi.org/10.1016/S0006-3223(02)01316-1
  110. Jardri R, Pouchet A, Pins D, Thomas P. Cortical activations during auditory verbal hallucinations in schizophrenia: a coordinatebased meta-analysis. Am J Psychiatry 2011;168:73-81. https://doi.org/10.1176/appi.ajp.2010.09101522
  111. Brunelin J, Mondino M, Gassab L, Haesebaert F, Gaha L, Suaud- Chagny MF, et al. Examining transcranial direct-current stimulation (tDCS) as a treatment for hallucinations in schizophrenia. Am J Psychiatry 2012;169:719-724. https://doi.org/10.1176/appi.ajp.2012.11071091
  112. Shiozawa P, da Silva ME, Cordeiro Q, Fregni F, Brunoni AR. Transcranial direct current stimulation (tDCS) for the treatment of persistent visual and auditory hallucinations in schizophrenia: a case study. Brain Stimul 2013;6:831-833. https://doi.org/10.1016/j.brs.2013.03.003
  113. Andrade C. Once- to twice-daily, 3-year domiciliary maintenance transcranial direct current stimulation for severe, disabling, clozapine-refractory continuous auditory hallucinations in schizophrenia. J ECT 2013;29:239-242. https://doi.org/10.1097/YCT.0b013e3182843866
  114. Mondino M, Haesebaert F, Poulet E, Suaud-Chagny MF, Brunelin J. Fronto-temporal transcranial direct current stimulation (tDCS) reduces source-monitoring deficits and auditory hallucinations in patients with schizophrenia. Schizophr Res 2015;161:515-516. https://doi.org/10.1016/j.schres.2014.10.054
  115. Mondino M, Jardri R, Suaud-Chagny MF, Saoud M, Poulet E, Brunelin J. Effects of fronto-temporal transcranial direct current stimulation on auditory verbal hallucinations and resting-state functional connectivity of the left temporo-parietal junction in patients with schizophrenia. Schizophr Bull 2016;42:318-326. https://doi.org/10.1093/schbul/sbv114
  116. Fitzgerald PB, McQueen S, Daskalakis ZJ, Hoy KE. A negative pilot study of daily bimodal transcranial direct current stimulation in schizophrenia. Brain Stimul 2014;7:813-816. https://doi.org/10.1016/j.brs.2014.08.002
  117. Frohlich F, Burrello TN, Mellin JM, Cordle AL, Lustenberger CM, Gilmore JH, et al. Exploratory study of once-daily transcranial direct current stimulation (tDCS) as a treatment for auditory hallucinations in schizophrenia. Eur Psychiatry 2016;33:54-60. https://doi.org/10.1016/j.eurpsy.2015.11.005
  118. Palm U, Keeser D, Hasan A, Kupka MJ, Blautzik J, Sarubin N, et al. Prefrontal transcranial direct current stimulation for treatment of schizophrenia with predominant negative symptoms: a doubleblind, sham-controlled proof-of-concept study. Schizophr Bull 2016;42:1253-1261. https://doi.org/10.1093/schbul/sbw041
  119. Smith RC, Boules S, Mattiuz S, Youssef M, Tobe RH, Sershen H, et al. Effects of transcranial direct current stimulation (tDCS) on cognition, symptoms, and smoking in schizophrenia: A randomized controlled study. Schizophr Res 2015;168:260-266. https://doi.org/10.1016/j.schres.2015.06.011
  120. Gomes JS, Shiozawa P, Dias AM, Valverde Ducos D, Akiba H, Trevizol AP, et al. Left dorsolateral prefrontal cortex anodal tDCS effects on negative symptoms in schizophrenia. Brain Stimul 2015;8:989-991. https://doi.org/10.1016/j.brs.2015.07.033
  121. Mattai A, Miller R, Weisinger B, Greenstein D, Bakalar J, Tossell J, et al. Tolerability of transcranial direct current stimulation in childhood-onset schizophrenia. Brain Stimul 2011;4:275-280. https://doi.org/10.1016/j.brs.2011.01.001
  122. Rassovsky Y, Dunn W, Wynn J, Wu AD, Iacoboni M, Hellemann G, et al. The effect of transcranial direct current stimulation on social cognition in schizophrenia: A preliminary study. Schizophr Res 2015;165:171-174. https://doi.org/10.1016/j.schres.2015.04.016
  123. Dani JA, Jenson D, Broussard JI, De Biasi M. Neurophysiology of nicotine addiction. J Addict Res Ther 2011;S1. pii: 001.
  124. Volkow ND, Wang GJ, Tomasi D, Baler RD. Unbalanced neuronal circuits in addiction. Curr Opin Neurobiol 2013;23:639-648. https://doi.org/10.1016/j.conb.2013.01.002
  125. Volkow ND, Baler RD. Addiction science: uncovering neurobiological complexity. Neuropharmacology 2014;76 Pt B:235-249. https://doi.org/10.1016/j.neuropharm.2013.05.007
  126. Gowin JL, Mackey S, Paulus MP. Altered risk-related processing in substance users: imbalance of pain and gain. Drug Alcohol Depend 2013;132:13-21. https://doi.org/10.1016/j.drugalcdep.2013.03.019
  127. Hone-Blanchet A, Fecteau S. The use of non-invasive brain stimulation in drug addictions. In: Kadosh RC, editors. The Stimulated Brain: Cognitive Enhancement Using Non-Invasive Brain Stimulation. Oxford: Elsevier;2014. p.425.
  128. Bellamoli E, Manganotti P, Schwartz RP, Rimondo C, Gomma M, Serpelloni G. rTMS in the treatment of drug addiction: an update about human studies. Behav Neurol 2014;2014:815215.
  129. Yavari F, Shahbabaie A, Leite J, Carvalho S, Ekhtiari H, Fregni F. Noninvasive brain stimulation for addiction medicine: from monitoring to modulation. Prog Brain Res 2016;224:371-399.
  130. Rachid F. Neurostimulation techniques in the treatment of nicotine dependence: a review. Am J Addict 2016;25:436-451. https://doi.org/10.1111/ajad.12405
  131. Boggio PS, Sultani N, Fecteau S, Merabet L, Mecca T, Pascual-Leone A, et al. Prefrontal cortex modulation using transcranial DC stimulation reduces alcohol craving: a double-blind, sham-controlled study. Drug Alcohol Depend 2008;92:55-60. https://doi.org/10.1016/j.drugalcdep.2007.06.011
  132. Weber MJ, Messing SB, Rao H, Detre JA, Thompson-Schill SL. Prefrontal transcranial direct current stimulation alters activation and connectivity in cortical and subcortical reward systems: a tDCSfMRI study. Hum Brain Mapp 2014;35:3673-3686. https://doi.org/10.1002/hbm.22429
  133. Mishra BR, Praharaj SK, Katshu MZ, Sarkar S, Nizamie SH. Comparison of anticraving efficacy of right and left repetitive transcranial magnetic stimulation in alcohol dependence: a randomized double-blind study. J Neuropsychiatry Clin Neurosci 2015;27:e54-e59. https://doi.org/10.1176/appi.neuropsych.13010013
  134. Klauss J, Penido Pinheiro LC, Silva Merlo BL, de Almeida Correia Santos G, Fregni F, Nitsche MA, et al. A randomized controlled trial of targeted prefrontal cortex modulation with tDCS in patients with alcohol dependence. Int J Neuropsychopharmacol 2014;17:1793-1803. https://doi.org/10.1017/S1461145714000984
  135. Batista EK, Klauss J, Fregni F, Nitsche MA, Nakamura-Palacios EM. A randomized placebo-controlled trial of targeted prefrontal cortex modulation with bilateral tDCS in patients with crack-cocaine dependence. Int J Neuropsychopharmacol 2015;18. pii: pyv066.
  136. Boggio PS, Liguori P, Sultani N, Rezende L, Fecteau S, Fregni F. Cumulative priming effects of cortical stimulation on smoking cue-induced craving. Neurosci Lett 2009;463:82-86. https://doi.org/10.1016/j.neulet.2009.07.041
  137. Jansen JM, Daams JG, Koeter MW, Veltman DJ, van den Brink W, Goudriaan AE. Effects of non-invasive neurostimulation on craving: a meta-analysis. Neurosci Biobehav Rev 2013;37:2472-2480. https://doi.org/10.1016/j.neubiorev.2013.07.009
  138. Boggio PS, Zaghi S, Villani AB, Fecteau S, Pascual-Leone A, Fregni F. Modulation of risk-taking in marijuana users by transcranial direct current stimulation (tDCS) of the dorsolateral prefrontal cortex (DLPFC). Drug Alcohol Depend 2010;112:220-225. https://doi.org/10.1016/j.drugalcdep.2010.06.019
  139. Shahbabaie A, Golesorkhi M, Zamanian B, Ebrahimpoor M, Keshvari F, Nejati V, et al. State dependent effect of transcranial direct current stimulation (tDCS) on methamphetamine craving. Int J Neuropsychopharmacol 2014;17:1591-1598. https://doi.org/10.1017/S1461145714000686
  140. Goldman RL, Borckardt JJ, Frohman HA, O'Neil PM, Madan A, Campbell LK, et al. Prefrontal cortex transcranial direct current stimulation (tDCS) temporarily reduces food cravings and increases the self-reported ability to resist food in adults with frequent food craving. Appetite 2011;56:741-746. https://doi.org/10.1016/j.appet.2011.02.013
  141. de Wit SJ, de Vries FE, van der Werf YD, Cath DC, Heslenfeld DJ, Veltman EM, et al. Presupplementary motor area hyperactivity during response inhibition: a candidate endophenotype of obsessive-compulsive disorder. Am J Psychiatry 2012;169:1100-1108. https://doi.org/10.1176/appi.ajp.2012.12010073
  142. Eddy KT, Dutra L, Bradley R, Westen D. A multidimensional meta-analysis of psychotherapy and pharmacotherapy for obsessivecompulsive disorder. Clin Psychol Rev 2004;24:1011-1030. https://doi.org/10.1016/j.cpr.2004.08.004
  143. Pediatric OCD Treatment Study (POTS) Team. Cognitive-behavior therapy, sertraline, and their combination for children and adolescents with obsessive-compulsive disorder: the Pediatric OCD Treatment Study (POTS) randomized controlled trial. JAMA 2004;292:1969-1976. https://doi.org/10.1001/jama.292.16.1969
  144. Abelson JL, Curtis GC, Sagher O, Albucher RC, Harrigan M, Taylor SF, et al. Deep brain stimulation for refractory obsessive-compulsive disorder. Biol Psychiatry 2005;57:510-516. https://doi.org/10.1016/j.biopsych.2004.11.042
  145. Ruffini C, Locatelli M, Lucca A, Benedetti F, Insacco C, Smeraldi E. Augmentation effect of repetitive transcranial magnetic stimulation over the orbitofrontal cortex in drug-resistant obsessive-compulsive disorder patients: a controlled investigation. Prim Care Companion J Clin Psychiatry 2009;11:226-230. https://doi.org/10.4088/PCC.08m00663
  146. Posner J, Marsh R, Maia TV, Peterson BS, Gruber A, Simpson HB. Reduced functional connectivity within the limbic cortico-striatothalamo-cortical loop in unmedicated adults with obsessive-compulsive disorder. Hum Brain Mapp 2014;35:2852-2860. https://doi.org/10.1002/hbm.22371
  147. Pauls DL, Abramovitch A, Rauch SL, Geller DA. Obsessive-compulsive disorder: an integrative genetic and neurobiological perspective. Nat Rev Neurosci 2014;15:410-424. https://doi.org/10.1038/nrn3746
  148. Berlim MT, Neufeld NH, Van den Eynde F. Repetitive transcranial magnetic stimulation (rTMS) for obsessive-compulsive disorder (OCD): an exploratory meta-analysis of randomized and shamcontrolled trials. J Psychiatr Res 2013;47:999-1006. https://doi.org/10.1016/j.jpsychires.2013.03.022
  149. D'Urso G, Brunoni AR, Mazzaferro MP, Anastasia A, de Bartolomeis A, Mantovani A. Transcranial direct current stimulation for obsessive-compulsive disorder: a randomized, controlled, partial crossover trial. Depress Anxiety 2016;33:1132-1140. https://doi.org/10.1002/da.22578
  150. Goncalves OF, Carvalho S, Leite J, Pocinho F, Relvas J, Fregni F. Obsessive compulsive disorder as a functional interhemispheric imbalance at the thalamic level. Med Hypotheses 2011;77:445-447. https://doi.org/10.1016/j.mehy.2011.06.004
  151. Biederman J. Attention-deficit/hyperactivity disorder: a selective overview. Biol Psychiatry 2005;57:1215-1220. https://doi.org/10.1016/j.biopsych.2004.10.020
  152. Sagvolden T, Johansen EB, Aase H, Russell VA. A dynamic developmental theory of attention-deficit/hyperactivity disorder (ADHD) predominantly hyperactive/impulsive and combined subtypes. Behav Brain Sci 2005;28:397-419; discussion 419-468.
  153. Kuczenski R, Segal DS. Locomotor effects of acute and repeated threshold doses of amphetamine and methylphenidate: relative roles of dopamine and norepinephrine. J Pharmacol Exp Ther 2001;296:876-883.
  154. Solanto MV. Dopamine dysfunction in AD/HD: integrating clinical and basic neuroscience research. Behav Brain Res 2002;130:65-71. https://doi.org/10.1016/S0166-4328(01)00431-4
  155. Frodl T, Skokauskas N. Meta-analysis of structural MRI studies in children and adults with attention deficit hyperactivity disorder indicates treatment effects. Acta Psychiatr Scand 2012;125:114-126. https://doi.org/10.1111/j.1600-0447.2011.01786.x
  156. Cortese S, Kelly C, Chabernaud C, Proal E, Di Martino A, Milham MP, et al. Toward systems neuroscience of ADHD: a metaanalysis of 55 fMRI studies. Am J Psychiatry 2012;169:1038-1055. https://doi.org/10.1176/appi.ajp.2012.11101521
  157. Bloch Y, Harel EV, Aviram S, Govezensky J, Ratzoni G, Levkovitz Y. Positive effects of repetitive transcranial magnetic stimulation on attention in ADHD subjects: a randomized controlled pilot study. World J Biol Psychiatry 2010;11:755-758. https://doi.org/10.3109/15622975.2010.484466
  158. Cachoeira CT, Leffa DT, Mittelstadt SD, Mendes LST, Brunoni AR, Pinto JV, et al. Positive effects of transcranial direct current stimulation in adult patients with attention-deficit/hyperactivity disorder-a pilot randomized controlled study. Psychiatry Res 2017;247:28-32. https://doi.org/10.1016/j.psychres.2016.11.009
  159. Hart H, Radua J, Nakao T, Mataix-Cols D, Rubia K. Meta-analysis of functional magnetic resonance imaging studies of inhibition and attention in attention-deficit/hyperactivity disorder: exploring task-specific, stimulant medication, and age effects. JAMA Psychiatry 2013;70:185-198. https://doi.org/10.1001/jamapsychiatry.2013.277
  160. Soff C, Sotnikova A, Christiansen H, Becker K, Siniatchkin M. Transcranial direct current stimulation improves clinical symptoms in adolescents with attention deficit hyperactivity disorder. J Neural Transm (Vienna) 2017;124:133-144. https://doi.org/10.1007/s00702-016-1646-y
  161. Margolis A, Milham MP. 44.0 neural circuitry underlying three common and often co-occurring childhood disorders: autism spectrum disorder, attention-deficit/hyperactivity disorder, and learning disorder. Journal of the American Academy of Child & Adolescent Psychiatry 2016;55:S328.
  162. Herbert MR, Harris GJ, Adrien KT, Ziegler DA, Makris N, Kennedy DN, et al. Abnormal asymmetry in language association cortex in autism. Ann Neurol 2002;52:588-596. https://doi.org/10.1002/ana.10349
  163. Floris DL, Chura LR, Holt RJ, Suckling J, Bullmore ET, Baron-Cohen S, et al. Psychological correlates of handedness and corpus callosum asymmetry in autism: the left hemisphere dysfunction theory revisited. J Autism Dev Disord 2013;43:1758-1772. https://doi.org/10.1007/s10803-012-1720-8
  164. Kleinhans NM, Muller RA, Cohen DN, Courchesne E. Atypical functional lateralization of language in autism spectrum disorders. Brain Res 2008;1221:115-125. https://doi.org/10.1016/j.brainres.2008.04.080
  165. Amatachaya A, Jensen MP, Patjanasoontorn N, Auvichayapat N, Suphakunpinyo C, Janjarasjitt S, et al. The short-term effects of transcranial direct current stimulation on electroencephalography in children with autism: a randomized crossover controlled trial. Behav Neurol 2015;2015:928631.
  166. Kuo HI, Bikson M, Datta A, Minhas P, Paulus W, Kuo MF, et al. Comparing cortical plasticity induced by conventional and highdefinition 4$\times$1 ring tDCS: a neurophysiological study. Brain stimulation 2013;6:644-648. https://doi.org/10.1016/j.brs.2012.09.010
  167. Edwards D, Cortes M, Datta A, Minhas P, Wassermann EM, Bikson M. Physiological and modeling evidence for focal transcranial electrical brain stimulation in humans: a basis for high-definition tDCS. Neuroimage 2013;74:266-275. https://doi.org/10.1016/j.neuroimage.2013.01.042
  168. Ruffini G, Mateu OR, Pascual-Leone A, Fox MD, Miranda PMC. Method and a system for optimizing the configuration of multisite transcranial current stimulation and a computer-readable medium. Barcelona S.L.: Neuroelectrics;2013.
  169. Castillo-Saavedra L, Gebodh N, Bikson M, Diaz-Cruz C, Brandao R, Coutinho L, et al. Clinically effective treatment of fibromyalgia pain with high-definition transcranial direct current stimulation: phase II open-label dose optimization. J Pain 2016;17:14-26. https://doi.org/10.1016/j.jpain.2015.09.009
  170. Geva AB, Stern Y, Reches A. Neurophysiological data analysis using spatiotemporal parcellation. Herzliya: Elminda Ltd.;2013.
  171. Paulus W, Nitsche MA, Antal A. Application of transcranial electric stimulation (tDCS, tACS, tRNS): From motor-evoked potentials towards modulation of behaviour. European Psychologist 2016;21:4-14. https://doi.org/10.1027/1016-9040/a000242
  172. Dimov LF, Franciosi AC, Campos AC, Brunoni AR, Pagano RL. Top-down effect of direct current stimulation on the nociceptive response of rats. PLoS One 2016;11:e0153506. https://doi.org/10.1371/journal.pone.0153506
  173. Taylor AG, Goehler LE, Galper DI, Innes KE, Bourguignon C. Top-down and bottom-up mechanisms in mind-body medicine: development of an integrative framework for psychophysiological research. Explore (NY) 2010;6:29-41. https://doi.org/10.1016/j.explore.2009.10.004
  174. Tyler WJ, Boasso AM, Mortimore HM, Silva RS, Charlesworth JD, Marlin MA, et al. Transdermal neuromodulation of noradrenergic activity suppresses psychophysiological and biochemical stress responses in humans. Sci Rep 2015;5:13865. https://doi.org/10.1038/srep13865
  175. Fregni F, Boggio PS, Nitsche MA, Rigonatti SP, Pascual-Leone A. Cognitive effects of repeated sessions of transcranial direct current stimulation in patients with depression. Depress Anxiety 2006;23:482-484. https://doi.org/10.1002/da.20201
  176. Boggio PS, Rigonatti SP, Ribeiro RB, Myczkowski ML, Nitsche MA, Pascual-Leone A, et al. A randomized, double-blind clinical trial on the efficacy of cortical direct current stimulation for the treatment of major depression. Int J Neuropsychopharmacol 2008;11:249-254. https://doi.org/10.1017/S1461145707007833
  177. Loo CK, Alonzo A, Martin D, Mitchell PB, Galvez V, Sachdev P. Transcranial direct current stimulation for depression: 3-week, randomised, sham-controlled trial. Br J Psychiatry 2012;200:52-59. https://doi.org/10.1192/bjp.bp.111.097634
  178. Palm U, Schiller C, Fintescu Z, Obermeier M, Keeser D, Reisinger E, et al. Transcranial direct current stimulation in treatment resistant depression: a randomized double-blind, placebo-controlled study. Brain Stimul 2012;5:242-251. https://doi.org/10.1016/j.brs.2011.08.005