| Purpose: To explore the effects of high-Definition transcranial direct current stimulation(HDtDCS)combined with drug therapy on the efficacy,cognition and attentional networks of patients with depression.Methods: General demographic data were collected,and the patients were randomly divided into the experimental group(active HD-tDCS+drugs)and the control group(sham HD-tDCS+drugs).The experimental group had 18 patients who completed the test and the control group had 22 patients who completed the test.The experimental group used 64-lead high-precision electrode caps to locate the brain region and used high-precision ring electrodes.The positive electrode was placed in the F3 brain region,and the negative electrodes were placed in the AF3,F5,FC3,and F1 brain region respectively.The experimental group was given 2m A current stimulation 5 times a week for two consecutive weeks,lasting 30 min each time.In the control group,60 s of 2m A current was only given as the pre-stimulation at the beginning,and the post-stimulation current was 0m A.Patients in the two groups were evaluated for depressive symptoms and cognitive function at baseline,week 1,week 2 and week 4,respectively,and the attention network test was completed.Statistical analysis was used to compare the differences between the two groups.Results:(1)At the first week,only the difference in the score reduction of the HAMD scale between the two groups was statistically significant(t=5.147,P<0.001).At the secnd week,the efficacy of the experimental group was better than that of the control group,and there were statistically significant differences in HAMD scale(t=-5.061,P<0.001),effective treatment rate(Z=-4.148,P < 0.001),and the score reduction of the HAMD scale(t=8.222,P<0.001).At the fourth week,only the HAMD scale difference between the two groups was statistically significant(Z=-2.046,P=0.041).(2)At the second week,the improvement of clinical symptoms of depression in the experimental group was better than that in the control group,including guilt(t=-2.575,P=0.014),suicide(Z=-2.521,P=0.012),work and interest(Z=-3.440,P=0.001),and sluggishness(Z=-2.839,P=0.005),somatic anxiety(Z=-3.052,P=0.002),gastrointestinal symptoms(Z=-2.528,P=0.011),systemic symptoms(Z=-1.995,P=0.046),hypochondria(Z=-2.402,P=0.016),self-awareness(Z=-3.231,P = 0.001),etc.At fourth week,the improvement in sexual symptoms(Z=-2.537,P=0.011)and self-awareness(Z=-2.502,P=0.012)was better in the experimental group than in the control group.(3)At the second week,there were statistically significant differences in MOCA(F=22.204,P<0.001)and MMSE(F=43.091,P<0.001)between the two groups.The improvement of executive function(Z=-2.222,P=0.026)and attention function(Z=-2.341,P=0.019)in the experimental group was better than that in the control group.At the fourth week,only the difference in MOCA(F=4.456,P=0.042)and MMSE(F=53.100,P<0.001)between the two groups was statistically significant.(4)In the attention network test,the experimental group performed better in executive network(F=15.608,P<0.001)and reaction time(F=13.009,P<0.001)than the control group at the first week,and the differences were statistically significant.At the second week,the experimental group performed better than the control group in orienting network(F=7.443,P=0.010),executive network(F=10.597,P=0.002),reaction time(F=7.394,P=0.010)and correct selection number(F=7.662,P=0.009),and the differences were statistically significant.At the fourth week,the experimental group was better than the control group in orienting network(F=6.694,P=0.014)and reaction time(F=4.218,P=0.047),and the differences were statistically significant.Conclusions: HD-TDCS is safe and effective in the treatment of depression.Early combined with HD-tDCS can quickly improve depression and some clinical symptoms.The improvement of cognitive function is better than simple drug treatment.It can improve the performance of partial attentional network function in patients with depression.The efficacy may be related to the length of treatment cycle. |
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