Home-based tDCS for schizophrenia: Exploring the feasibility of a standard operating procedure

IF 3.8 4区医学 Q1 PSYCHIATRY

Asian journal of psychiatry Pub Date : 2024-07-14 DOI:10.1016/j.ajp.2024.104150

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引用次数: 0

Abstract

Transcranial Direct Current Stimulation (tDCS), a safe and easy-to-administer noninvasive brain stimulation technique, holds promise in managing auditory verbal hallucinations (AVH) in schizophrenia. However, its short-lasting effect often leads to frequent hospital visits for booster/maintenance sessions, posing logistical challenges. Home-based tDCS offers a potential solution that improves accessibility; however, careful standardisation is required to ensure safe and effective application. We present a case of schizophrenia, where add-on home-based tDCS was administered based on a standard operating procedure (SOP) developed to address challenges unique to home administration, like device-related factors, patient and caregiver-related factors, and comprehensive caregiver training protocol. As a part of training, caregivers underwent observational learning, mannequin-based training for electrode placement, and assisted live-patient sessions. Pre and post-training competency assessments were done to ensure proficiency and safe administration. Over ten days, home-based tDCS sustained improvements in AVH without adverse effects. This case report supports the feasibility of home-based tDCS and provides a detailed SOP for implementing a safe and effective home-based tDCS treatment regime. This comprehensive SOP with a training protocol is notedly efficient for enhancing the accessibility and affordability of tDCS treatment protocols.

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基于家庭的 tDCS 治疗精神分裂症：探索标准操作程序的可行性

经颅直流电刺激（transcranial Direct Current Stimulation，tDCS）是一种安全且易于操作的非侵入性脑刺激技术，有望控制精神分裂症患者的听觉言语幻觉（AVH）。然而，由于其疗效短暂，患者往往需要经常到医院进行强化/维护治疗，这给后勤工作带来了挑战。基于家庭的 tDCS 提供了一种潜在的解决方案，提高了可及性；然而，要确保安全有效的应用，还需要仔细的标准化。我们介绍了一个精神分裂症病例，在该病例中，我们根据标准操作程序（SOP）实施了基于家庭的附加 tDCS，该程序是为解决家庭管理所面临的独特挑战而开发的，例如与设备相关的因素、与患者和护理人员相关的因素以及全面的护理人员培训协议。作为培训的一部分，护理人员接受了观察学习、基于人体模型的电极置放培训以及协助患者现场治疗。培训前和培训后都进行了能力评估，以确保操作熟练和安全。在十天的时间里，基于家庭的 tDCS 持续改善了 AVH，且无不良反应。本病例报告证实了居家 tDCS 的可行性，并为实施安全有效的居家 tDCS 治疗方案提供了详细的 SOP。这一全面的 SOP 以及培训协议对于提高 tDCS 治疗方案的可及性和可负担性具有显著的效率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Asian journal of psychiatry Medicine-Psychiatry and Mental Health

CiteScore

12.70

自引率

5.30%

发文量

297

审稿时长

35 days

期刊介绍： The Asian Journal of Psychiatry serves as a comprehensive resource for psychiatrists, mental health clinicians, neurologists, physicians, mental health students, and policymakers. Its goal is to facilitate the exchange of research findings and clinical practices between Asia and the global community. The journal focuses on psychiatric research relevant to Asia, covering preclinical, clinical, service system, and policy development topics. It also highlights the socio-cultural diversity of the region in relation to mental health.

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