Individuals with schizophrenia typically suffer a range of cognitive deficits, including prominent deficits in working memory and executive function. These difficulties are strongly predictive of functional outcomes, but there is a paucity of effective therapeutic interventions targeting these deficits. Transcranial direct current stimulation is a novel neuromodulatory technique with emerging evidence of potential pro-cognitive effects; however, there is limited understanding of its mechanism. This was a double-blind randomized sham controlled pilot study of transcranial direct current stimulation on a working memory (n-back) and executive function (Stroop) task in 28 individuals with schizophrenia using functional magnetic resonance imaging. Study participants received 30 min of real or sham transcranial direct current stimulation applied to the left frontal cortex. The ‘real’ and ‘sham’ groups did not differ in online working memory task performance, but the transcranial direct current stimulation group demonstrated significant improvement in performance at 24 h post-transcranial direct current stimulation. Transcranial direct current stimulation was associated with increased activation in the medial frontal cortex beneath the anode; showing a positive correlation with consolidated working memory performance 24 h post-stimulation. There was reduced activation in the left cerebellum in the transcranial direct current stimulation group, with no change in the middle frontal gyrus or parietal cortices. Improved performance on the executive function task was associated with reduced activity in the anterior cingulate cortex. Transcranial direct current stimulation modulated functional activation in local task-related regions, and in more distal nodes in the network. Transcranial direct current stimulation offers a potential novel approach to altering frontal cortical activity and exerting pro-cognitive effects in schizophrenia.

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刺激思维：经颅直流电刺激精神分裂症的功能性 MRI 研究

精神分裂症患者通常会出现一系列认知缺陷，包括工作记忆和执行功能的显着缺陷。这些困难强烈预测功能结果，但缺乏针对这些缺陷的有效治疗干预措施。经颅直流电刺激是一种新的神经调节技术，具有潜在的促认知作用的新证据；然而，对其机制的了解有限。这是一项双盲随机假对照试验研究，使用功能性磁共振成像对 28 名精神分裂症患者的工作记忆 (n-back) 和执行功能 (Stroop) 任务进行经颅直流电刺激。研究参与者接受了应用于左侧额叶皮层的 30 分钟真实或假经颅直流电刺激。“真实”组和“假”组在在线工作记忆任务表现方面没有差异，但经颅直流电刺激组在经颅直流电刺激后 24 小时表现出显着改善。经颅直流电刺激与阳极下方内侧额叶皮层的激活增加有关；与刺激后 24 小时的综合工作记忆表现呈正相关。经颅直流电刺激组左侧小脑活动减少，额中回或顶叶皮质无变化。提高执行功能任务的表现与减少前扣带皮层的活动有关。经颅直流电刺激调节了局部任务相关区域以及网络中更远端节点的功能激活。经颅直流电刺激为改变额叶皮质活动和在精神分裂症中发挥促认知作用提供了一种潜在的新方法。