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Transkranielle Gleichstromstimulation bei depressiven Störungen

Transcranial direct current stimulation for depressive disorders

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Zusammenfassung

Depressive Störungen gehören zu den weltweit häufigsten psychischen Erkrankungen, doch sprechen etwa 20–30 % der Patienten nicht ausreichend auf eine leitliniengerechte Behandlung an. Aus neurowissenschaftlichen Untersuchungen ist bekannt, dass die Aktivität des präfrontalen Kortex bei depressiven Patienten Veränderungen aufweist, welche sich jedoch nach einer erfolgreichen psychopharmakologischen oder kognitiv-verhaltenstherapeutischen Behandlung wieder normalisieren. Eine direkte Modulation der Aktivität im präfrontalen Kortex mithilfe nichtinvasiver Hirnstimulationsverfahren wie beispielsweise der transkraniellen Gleichstromstimulation („transcranial direct current stimulation“, tDCS) könnte daher ein neuer, vielsprechender und innovativer Ansatz zur Behandlung depressiver Störungen sein. Da zudem erste Befunde aus der neuropsychologischen Forschung darauf hindeuten, dass sich positive tDCS-Effekte durch eine simultane Aktivierung des stimulierten Gehirnareals durch äußere Einflüsse (wie z. B. dem Bearbeiten kognitiver Trainingsaufgaben) noch verstärken lassen, wird im nachfolgenden Artikel vor allem die Möglichkeit diskutiert, tDCS-Interventionen mit kognitiv-emotionalen Lernprozessen im Rahmen einer Psychotherapie zu kombinieren, um in Zukunft stärkere antidepressive und möglicherweise auch nachhaltigere therapeutische Effekte erzielen zu können.

Summary

Major depressive disorders are one of the most prevalent psychiatric disorders worldwide but approximately 20–30 % of patients do not respond to standard guideline conform treatment. Recent neuroimaging studies in depressive patients revealed altered activation patterns in prefrontal brain areas and that successful cognitive behavioral therapy and psychopharmacological interventions are associated with a reversal of these neural alterations. Therefore, a direct modulation of prefrontal brain activation by non-invasive brain stimulation techniques, such as transcranial direct current stimulation (tDCS) seems to be a promising and innovative approach for the treatment of depressive disorders. In addition, recent neuropsychological findings indicated an augmentation of positive tDCS effects by simultaneous external activation of the stimulated brain area, for example by cognitive training tasks. Based on these findings, the possibility to augment cognitive-emotional learning processes during cognitive behavioral therapy by simultaneous tDCS to increase antidepressive therapeutic effects is discussed in this article.

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Förderung

Die Arbeit wurde unterstützt durch den Forschungsverbund GCBS (German Center for Brain Stimulation), gefördert vom Bundesministerium für Bildung und Forschung (BMBF, Förderkennzeichen: 01EE1403F und 01EE1403G).Einhaltung ethischer Richtlinien

Einhaltung ethischer Richtlinien

Interessenkonflikt. S. Aust und U. Palm geben an, dass kein Interessenkonflikt besteht. F. Padberg: Brainsway Inc., neuroConn GmbH, Mag&More. M. Bajbouj: Deutsche Forschungsgemeinschaft, Bundesministerium für Bildung und Forschung, Medtronic.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Center for Affective Sciences, Klinik für Psychiatrie und Psychotherapie, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Deutschland

    S. Aust & M. Bajbouj

  2. Sektion für Psychosomatische Medizin und Psychotherapie und Munich Center for Brain Stimulation, Klinik für Psychiatrie und Psychotherapie, LMU Klinikum der Universität München, München, Deutschland

    U. Palm & F. Padberg

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  1. S. Aust
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  2. U. Palm
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  3. F. Padberg
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  4. M. Bajbouj
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Correspondence to S. Aust.

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Aust, S., Palm, U., Padberg, F. et al. Transkranielle Gleichstromstimulation bei depressiven Störungen. Nervenarzt 86, 1492–1499 (2015). https://doi.org/10.1007/s00115-015-4322-9

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  • DOI: https://doi.org/10.1007/s00115-015-4322-9

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