Moving to accelerated protocols of tDCS in schizophrenic catatonia: A case report
Brain Stimulation
; 16(1):392, 2023.
Article
in English
| EMBASE | ID: covidwho-2299204
ABSTRACT
This is a case report of a 74-year-old woman with catatonic schizophrenia who was treated with transcranial Direct Current Stimulation (tDCS) in place of electroconvulsive therapy (ECT) during the Covid-19 pandemic that impacted access to ECT facilities. In 2021, the exceptional number of patients infected with SARS-Cov-2 led the French public hospital system to adjust its organization, temporarily redirecting anesthetists from ECT departments to ICUs. Our patient, who was hospitalized via the emergency department, presented schizophrenia with catatonic features. Due to the pandemic, ECT, which is considered the gold standard treatment for this condition, was not available. Therefore, tDCS, a neuromodulation technique that doesn't require general anesthesia, was recommended for this patient, and was delivered at the relatively (compared to standard protocols) accelerated rate of five sessions a day, five days a week. This protocol was chosen as accelerated rTMS had been shown to be effective against depression in recent trials (Cole et al. 2021), and one study had also reported this exact protocol as effective and harmless for a patient with schizophrenia (Mondino et al. 2021). The Bush-Francis Catatonia Rating Scale (BFCRS) was used to evaluate the severity of the catatonia. After 49 sessions, the clinical response was meaningful, with a BFCRS score of 16, compared to 36 at baseline. We then moved to five sessions a day, three days a week, and then two days a week. After 80 sessions, we noted the complete disappearance of catatonia (BFCRS = 6). This case provides evidence for the feasibility and tolerability of accelerated tDCS for patients with catatonia. Accelerated tDCS represents a potential alternative to ECT in the treatment of catatonia, and needs further randomized clinical studies to confirm its efficacy. Research Category and Technology and Methods Clinical Research 9. Transcranial Direct Current Stimulation (tDCS) Keywords tdcs, catatonia, covid-19, ECTCopyright © 2023
aged; anesthesist; case report; catatonia; catatonic schizophrenia; clinical article; clinical research; conference abstract; coronavirus disease 2019; depression; electroconvulsive therapy; emergency ward; feasibility study; female; general anesthesia; gold standard; human; neuromodulation; nonhuman; pandemic; public hospital; randomized controlled trial (topic); rating scale; repetitive transcranial magnetic stimulation; schizophrenia; Severe acute respiratory syndrome coronavirus 2; transcranial direct current stimulation
Full text:
Available
Collection:
Databases of international organizations
Database:
EMBASE
Type of study:
Case report
Language:
English
Journal:
Brain Stimulation
Year:
2023
Document Type:
Article
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