title: Effect of transcranial direct current stimulation (tDCS) over the prefrontal cortex combined with cognitive training for treating schizophrenia: a sham-controlled randomized clinical trial.
abstract: We report a transcranial direct current stimulation (tDCS) protocol over the dorsolateral prefrontal cortex (DLPFC) combined with cognitive training in schizophrenia.
  We assessed psychotic symptoms in nine patients using the Positive and Negative Syndrome Scale (PANSS). All evaluations were scored at baseline, at the end of the intervention protocol, and during a 4-week follow-up. The tDCS protocol consisted of 10 consecutive sessions over 5-day periods. We placed the cathode over the right and the anode over the left DLPFC. For sham stimulation, we turned the device off after 60 seconds. Cognitive training consisted of the administration of N-back and sequence learning tasks.
  We performed an analysis of covariance (ANCOVA) to adjust for the dependent variable PANSS, considering the interaction with baseline severity scores (p = 0.619). Mixed analysis of variance (ANOVA) showed no statistical significance between the groups regarding final PANSS scores.
  The results failed to demonstrate that the concomitant use of tDCS and cognitive training is effective to improve clinical outcomes in patients with schizophrenia. The present findings should be analyzed with care, considering the small sample size. Larger controlled trials on electric/cognitive stimulation should be produced in order to enhance therapeutic strategies in schizophrenia.
authors.affiliation: Centro Interdisciplinar de Neuromodulação Clínica, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, Brazil.
authors.forename: Pedro
authors.initials: P
authors.lastname: Shiozawa
authors.affiliation: Centro Interdisciplinar de Neuromodulação Clínica, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, Brazil.|Laboratório Interdisciplinar de Neurociências Clínicas, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
authors.forename: July Silveira
authors.initials: JS
authors.lastname: Gomes
authors.affiliation: Centro Interdisciplinar de Neuromodulação Clínica, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, Brazil.|Laboratório Interdisciplinar de Neurociências Clínicas, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
authors.forename: Daniella Valverde
authors.initials: DV
authors.lastname: Ducos
authors.affiliation: Centro Interdisciplinar de Neuromodulação Clínica, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, Brazil.|Laboratório Interdisciplinar de Neurociências Clínicas, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
authors.forename: Henrique Teruo
authors.initials: HT
authors.lastname: Akiba
authors.affiliation: Laboratório Interdisciplinar de Neurociências Clínicas, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
authors.forename: Álvaro Machado
authors.initials: ÁM
authors.lastname: Dias
authors.affiliation: Centro Interdisciplinar de Neuromodulação Clínica, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, Brazil.
authors.forename: Alisson Paulino
authors.initials: AP
authors.lastname: Trevizol
authors.affiliation: Centro Interdisciplinar de Neuromodulação Clínica, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, Brazil.
authors.forename: Ricardo R
authors.initials: RR
authors.lastname: Uchida
authors.affiliation: Institute of Psychiatry, King's College London, London, United Kingdom.
authors.forename: Natasza
authors.initials: N
authors.lastname: Orlov
authors.affiliation: Centro Interdisciplinar de Neuromodulação Clínica, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, Brazil.
authors.forename: Quirino
authors.initials: Q
authors.lastname: Cordeiro
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D015928:Cognitive Behavioral Therapy / Q000379:methods; D003131:Combined Modality Therapy / Q000379:methods*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017397:Prefrontal Cortex / Q000503:physiopathology; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000503:physiopathology / Q000628:therapy*; D012565:Schizophrenic Psychology; D012720:Severity of Illness Index; D065908:Transcranial Direct Current Stimulation / Q000379:methods*; D016896:Treatment Outcome