Is tDCS an effective therapy for negative symptoms in patients with schizophrenia? A systematic review

Vanden Berghe Lieze, 2023
Schizophrenia is a debilitating mental illness that currently affects approximately 23.6 million people globally. One of its most challenging aspects is the presence of negative symptoms, which are reported to be just as burdening as the more commonly known hallucinations and delusions. Negative symptoms include loss of motivation, social withdrawal and flattened emotions, drastically affecting the patient’s social functioning and quality of life. Current treatment strategies for schizophrenia, such as antipsychotics, fall short in effectively improving these negative symptoms and are associated with numerous side effects. Considering the significant clinical and economic strain this problem imposes on society, it is crucial that other treatment modalities are explored. This is where transcranial direct current stimulation (tDCS), a type of non-invasive brain stimulation that has recently gained popularity in the field of mental health, could play a role. During a tDCS session, typically two electrodes are positioned on the patient’s scalp and a low electrical current is applied to modulate the activity in specific regions of the brain. By targeting the regions associated with negative symptoms, it holds the potential to ameliorate them. A very favourable aspect of tDCS, in contrast to antipsychotic drugs, is that its application is accompanied only by minor side effects. This systematic review aimed to update the current knowledge regarding tDCS as a treatment strategy for negative symptoms in schizophrenia patients by evaluating 18 studies of the highest quality. Since only seven out of the 18 studies showed a significant improvement in negative symptoms after tDCS treatment, it cannot yet be uniformly advised as an effective treatment strategy. It should however encourage researchers to further delve into the mechanisms of tDCS, even more so when taking into account the recency of this research field. In light of negative symptom alleviation being a crucial unmet need in psychiatry, it is imperative that future research continues to strive towards more effective and safe treatment modalities for schizophrenia patients. Only then, we may hope for a future in which they can live a more fulfilling life without the burden of their negative symptoms.

Promotor Chris Baeken
Opleiding Geneeskunde
Domein Psychiatrie
Kernwoorden tDCS Schizophrenia