欢迎来到OAJRC平台！

核心 CSCIED

期刊栏目

投稿

审稿

期刊目次

加入编委

期刊订阅

添加您的邮件地址以接收即将发行期刊数据：

当前位置：国际临床研究杂志 > 2026年 10卷 (4)期

Open Access Article

International Journal of Clinical Research. 2026; 10: (4) ; 146-151 ; DOI: 10.12208/j.ijcr.20260208.

Observation of the efficacy of transcranial direct current stimulation on negative symptoms and insight in schizophrenia patients
经颅直流电刺激对精神分裂症患者阴性症状和自知力的疗效观察

作者： 张晓东 *, 李珂, 张云霞

安阳市第七人民医院河南安阳

*通讯作者：张晓东,单位：安阳市第七人民医院河南安阳；

安阳市重点研发与推广专项（项目编号：2023C01SF229）

发布时间: 2026-04-29 总浏览量: 128

PDF 全文下载引用本文

摘要

目的评估阳极刺激左背外侧前额叶皮层、阴极刺激左颞顶交界区的经颅直流电刺激（tDCS）方案对慢性精神分裂症患者阴性症状及自知力的疗效与安全性。方法将患者随机分为刺激组（n=30）和伪刺激组（n=30）。刺激组接受2 mA tDCS，每日2次，每周5天，持续2周（共20次）；伪刺激组接受假刺激。分别于基线、治疗2周末和6周末采用阳性和阴性症状量表（PANSS）进行精神症状评估；于基线和治疗2周末采用个人与社会功能量表（PSP）评估社会功能、自知力与治疗态度问卷（ITAQ）及贝克认知自知力量表（BCIS）评估自知力。结果重复测量方差分析显示，阴性症状分（N分）的组别、时间及交互效应均显著（P＜0.05），刺激组在治疗2周末和6周末的N分均显著低于伪刺激组（P＜0.01）。刺激组ITAQ评分、BCIS中的自我反思及综合指数评分在治疗2周末的改善显著优于伪刺激组（P＜0.05），但自我确定性评分组间无显著差异。两组PSP评分在治疗2周末均较前提升（P＜0.001），组间有统计学差异。两组不良事件发生率无显著差异。不良事件均为轻度，无严重不良事件发生。结论 tDCS可安全、有效改善慢性精神分裂症患者的阴性症状、自知力和社会功能，值得临床推广应用。

关键词： 经颅直流电刺激；精神分裂症；阴性症状；自知力；社会功能

Abstract

Objective To evaluate the efficacy and safety of transcranial direct current stimulation (tDCS) with anodal stimulation over the left dorsolateral prefrontal cortex and cathodal stimulation over the left temporoparietal junction in patients with chronic schizophrenia for negative symptoms and insight.
Methods Patients were randomly divided into a stimulation group (n=30) and a sham stimulation group (n=30). The stimulation group received 2 mA tDCS, twice daily, five days per week, for two weeks (total of 20 sessions), while the sham group received sham stimulation. Positive and Negative Syndrome Scale (PANSS) was used to assess psychiatric symptoms at baseline, the end of the second week, and the end of the sixth week of treatment. Personal and Social Performance Scale (PSP), Insight and Treatment Attitudes Questionnaire (ITAQ), and Beck Cognitive Insight Scale (BCIS) were used to evaluate social functioning and insight at baseline and the end of the second week of treatment.
Results Repeated measures ANOVA showed significant effects of group, time, and interaction on negative symptom scores (N scores) (P<0.05). At the end of the second and sixth weeks of treatment, the N scores in the stimulation group were significantly lower than those in the sham group (P<0.01). The ITAQ scores and the self-reflection and comprehensive index scores in the BCIS in the stimulation group showed significantly greater improvement at the end of the second week of treatment compared to the sham group (P<0.05), but no significant difference was observed in the self-certainty scores between groups. Both groups showed improved PSP scores at the end of the second week of treatment (P<0.001), with a statistically significant difference between groups. No significant difference was found in the incidence of adverse events between the two groups.
Conclusion tDCS can safely and effectively improve negative symptoms, insight, and social functioning in patients with chronic schizophrenia, and is worthy of clinical promotion and application.

Key words： Transcranial direct current stimulation; Schizophrenia; Negative symptoms; Insight; Social function

参考文献 References

[1] GBD 2017 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet, 2018; 392(10159): 1789–1858.

[2] Rabinowitz, J., Levine, S. Z., Garibaldi, G., Bugarski-Kirola, D., Berardo, C. G., & Kapur, S. Negative symptoms have greater impact on functioning than positive symptoms in schizophrenia: analysis of CATIE data. Schizophrenia Res.2012; 137(1-3), 147–150.

[3] Davis, B. J., Lysaker, P. H., Salyers, M. P., & Minor, K. S. The insight paradox in schizophrenia: A meta-analysis of the relationship between clinical insight and quality of life. Schizophrenia Res.2020;223, 9–17.

[4] 杨晓婕,李占江,郭志华,马云,付兆燕,闫丽琼,屈英,王向群.精神分裂症患者生活质量与自知力及精神症状的关系[J].中国健康心理学杂志,2015;23(5):645-648.

[5] Fusar-Poli P, Papanastasiou E, Stahl D, et al. Treatments of negative symptoms in schizophrenia: meta-analysis of 168 randomized placebo-controlled trials. Schizophrenia Bul. 2015; 41(4): 892–899.

[6] Lysaker, P. H., Pattison, M. L., Leonhardt, B. L., Phelps, S., & Vohs, J. L. Insight in schizophrenia spectrum disorders: relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments. World psychiatry.2018;17(1: 12–23.

[7] Zhou Y, Fan L, Qiu C, Jiang T. Prefrontal cortex and the dysconnectivity hypothesis of schizophrenia. Neurosci Bull.2015; 31(2):207-219.

[8] Xavier RM, Vorderstrasse A. Neurobiological basis of insight in schizophrenia: A Systematic Review. [J]. Nursing Res., 2016; 65(3): 224–237.

[9] Brunelin J, Mondino M, Gassab L, et al. Examining transcranial direct-current stimulation (tDCS) as a treatment for hallucinations in schizophrenia. Am J Psychiatry. 2012, 169(7): 719–724.

[10] Nitsche, M. A., & Paulus, W. Excitability changes induced in the human motor cortex by weak transcranial direct current stimulation. J Physiol, 527 Pt 3(Pt 3):633–639.

[11] Valiengo L, Goerigk S, Gordon PC, et al. Efficacy and safety of transcranial direct current stimulation for treating negative symptoms in schizophrenia: a randomized clinical trial. JAMA Psychiatry, 2020; 77(2): 121–129.

[12] Chang CC, Tzeng NS, Chao CY, Yeh CB, Chang HA. The effects of add-on fronto-temporal transcranial direct current stimulation (tDCS) on auditory verbal hallucinations, other psychopathological symptoms, and insight in schizophrenia: a randomized, double-blind, sham-controlled trial. Int J Neuropsychopharmacol. 2018; 21(11): 979–987.

[13] American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th ed. Arlington, VA: American Psychiatric Publishing, 2013.

[14] Kay SR, Fiszbein A, Opler LA. The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophrenia Bull, 1987, 13(2): 261–276.

[15] 刘华清,张培琰,尚岚,等.精神分裂症的自知力:"自知力与治疗态度问卷表"的应用.上海精神医学. 1995;7(3):2-5,60.

[16] Kao YC, Liu YP. The Beck Cognitive Insight Scale (BCIS): translation and validation of the Taiwanese version. BMC Psychiatry.2010; 10:27.

[17] Kao YC, Wang TS, Lu CW, Liu YP. Assessing cognitive insight in nonpsychiatric individuals and outpatients with schizophrenia in Taiwan: an investigation using the Beck Cognitive Insight Scale. BMC Psychiatry. 2011;11:170.

[18] 司天梅,舒良,田成华,等.个体和社会功能量表中文版在精神分裂症患者中的信效度.中国心理卫生杂志,2009; 23(11):790-794.

[19] Chang, C. C., Kao, Y. C., Chao, C. Y., Tzeng, N. S., & Chang, H. A. Examining bi-anodal transcranial direct current stimulation (tDCS) over bilateral dorsolateral prefrontal cortex coupled with bilateral extracephalic references as a treatment for negative symptoms in non-acute schizophrenia patients: A randomized, double-blind, sham-controlled trial. Prog Neuropsychopharmacology Biol Psychiatry.2020; 96, 109715.

[20] Sanfilipo M, Lafargue T, Rusinek H, et al. Volumetric measure of the frontal and temporal lobe regions in schizophrenia: relationship to negative symptoms. ArchGen Psychiatry .2000; 57(5): 471–480.

[21] Friston KJ. The disconnection hypothesis[J]. Schizophrenia Res, 1998; 30(2): 115–125.

[22] Shiozawa, P., Gomes, J. S., Ducos, D. V.,et al.. Effect of transcranial direct current stimulation (tDCS) over the prefrontal cortex combined with cognitive training for treating schizophrenia: a sham-controlled randomized clinical trial. Trends Psychiatry Psychother.2016; 38(3), 175–177.

[23] Fitzgerald, P. B., McQueen, S., Daskalakis, Z. J., & Hoy, K. E. A negative pilot study of daily bimodal transcranial direct current stimulation in schizophrenia. Brain Stimul. 2014;7(6), 813–816.

[24] Bose, A, Shivakumar, V, Narayanaswamy, JC, et al. Insight facilitation with add-on tDCS in schizophrenia. SCHIZOPHR RES. Schizophr Res.2014; 156 (1): 63-5.

[25] Kim, J., Ozzoude, M., Nakajima, S.,et al. Insight and medication adherence in schizophrenia: An analysis of the CATIEtrial. Neuropharmacology.2020; 168:107634.

[26] Chang, C. C., Kao, Y. C., Chao, C. Y., Tzeng, N. S., & Chang, H. A. The Effects of Bi-Anodal tDCS Over the Prefrontal Cortex Regions with Extracephalic Reference Placement on Insight Levels and Cardio-Respiratory and Autonomic Functions in Schizophrenia Patients and Exploratory Biomarker Analyses for Treatment Response. Int Journal of Neuropsychopharmacol. 2021;24(1), 40–53.

引用本文

张晓东, 李珂, 张云霞, 经颅直流电刺激对精神分裂症患者阴性症状和自知力的疗效观察[J]. 国际临床研究杂志, 2026; 10: (4) : 146-151.

入驻平台

回到顶部

搜索文章: