Effects of transcranial electrical stimulation on working memory in patients with schizophrenia: A systematic review and meta-analysis

Yong Liu; Nannan Gu; Xinyi Cao; Yikang Zhu; Jijun Wang; Robert C Smith; Chunbo Li

doi:10.1016/j.psychres.2020.113656

Effects of transcranial electrical stimulation on working memory in patients with schizophrenia: A systematic review and meta-analysis

Psychiatry Res. 2021 Feb:296:113656. doi: 10.1016/j.psychres.2020.113656. Epub 2020 Dec 23.

Authors

Yong Liu¹, Nannan Gu¹, Xinyi Cao², Yikang Zhu¹, Jijun Wang³, Robert C Smith⁴, Chunbo Li⁵

Affiliations

¹ Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
² Clinical Neurocognitive Research Center, Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
³ Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Science, Shanghai, China; Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai, China.
⁴ Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA; Department of Psychiatry, New York University School of Medicine, New York, NY, USA.
⁵ Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Science, Shanghai, China; Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai, China; Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, China. Electronic address: licb@smhc.org.cn.

PMID: 33360429
DOI: 10.1016/j.psychres.2020.113656

Abstract

To investigate the immediate and lasting effects of transcranial electrical stimulation (tES) on working memory (WM) in schizophrenia. We performed a literature search to identify randomized controlled trials (RCTs) evaluating the ability of tES to ameliorate WM. Twelve studies were included: 215 patients in the active stimulation group and 214 in the sham stimulation group. Meta-analysis demonstrated a significant efficacy of tES on WM in follow up, a summary of one or more assessments weeks after the last tES session (standardized mean difference (SMD) 0.33, 95% confidence interval (CI) 0.04 to 0.62; p = 0.02; n = 190, 4 studies; I² = 33%) compared to sham tES, while non-significant results were observed for WM assessed immediately after the last tES session (SMD 0.14, 95% CI -0.12 to 0.41; p = 0.30; n = 417, 11 studies; I² = 41%) in schizophrenia. There was no significant difference between the two groups in tolerability and dropouts. Evidence of low quality indicates that effects of tES on WM in schizophrenia may appear a few weeks after the last tES session, but not always be present when tested immediately after the last tES session. Further large-scale RCTs with a parallel-group design, sample size estimation and a longer follow-up period are needed.

Keywords: Cognition; Schizophrenia; Transcranial electrical stimulation.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't
Review
Systematic Review

MeSH terms

Humans
Memory, Short-Term / physiology*
Schizophrenia / therapy*
Transcranial Direct Current Stimulation / adverse effects
Transcranial Direct Current Stimulation / methods*