Evidence map›Paper›PMID 31617873›Full record

Trial reportJAMA psychiatry2020

Efficacy and Safety of Transcranial Direct Current Stimulation for Treating Negative Symptoms in Schizophrenia: A Randomized Clinical Trial.

Leandro da Costa Lane Valiengo, Stephan Goerigk, Pedro Caldana Gordon, Frank Padberg, Mauricio Henriques Serpa, Stephanie Koebe, Leonardo Afonso Dos Santos, Roger Alberto Marcos Lovera, Juliana Barbosa de Carvalho, Martinus van de Bilt and 4 more

4 registry-linked trialsOpen access · bronzeAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in JAMA psychiatry, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 68 papers, 13 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
68citing papers in PubMed, 13 pooled it
6.3field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02535676 phase3completednot on this map

Treatment of Negative Symptoms of Schizophrenia With Transcranial Direct Current Stimulation (tDCS): A Randomized, Double-blinded, Sham-controlled, Clinical Trial

TypeinterventionalSponsorUniversity of Sao PauloRan2014 to 2018Enrolled100ConditionsSchizophreniaArmsTranscranial Direct Current Stimulation
NCT05388539 nacompletednot on this mapstarted 2022, after this paper: background citation

TBS Treatment for Treatment-Resistant Depression: a Randomized, Sham-Controlled Trial

TypeinterventionalSponsorUniversity of Sao PauloRan2022 to 2024Enrolled100ConditionsMajor Depressive Disorder, Unipolar DepressionArmsTheta Burst Stimulation, Sham Stimulation
NCT06349369 naunknown statusnot on this mapstarted 2024, after this paper: background citation

Effect of Transcranial Direct Current Stimulation (tDCS) on Inflammatory Biomarkers in Chronic Schizophrenia: A Randomised Double-Blind Controlled Trial.

TypeinterventionalSponsorAll India Institute of Medical Sciences, BhubaneswarRan2024 to 2026Enrolled60ConditionsChronic SchizophreniaArmstranscranial direct current stimulation
NCT07196423 narecruitingnot on this mapstarted 2026, after this paper: background citation

Glutamate Changes as a New Neurocognitive Marker in Psychosis

TypeinterventionalSponsorUniversity of NottinghamRan2026 to 2027Enrolled106ConditionsFirst Episode Psychosis (FEP), PsychosisArmsTranscranial direct current stimulation (tDCS), Magnetic Resonance Imaging
3 · Its place in the literature

Who cites it

68 citing papers in PubMed, 13 syntheses or guidelines pooled it, 139 citations in OpenAlex.

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8 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors at 5 institutions in 2 countries.

Leandro da Costa Lane ValiengoLaboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry, Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBioN), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
Stephan GoerigkDepartment of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany.
Pedro Caldana GordonLaboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry, Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBioN), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
Frank PadbergDepartment of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany.
Mauricio Henriques SerpaLaboratory of Neuroimaging (LIM-21), Department and Institute of Psychiatry, Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBioN), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
Stephanie KoebeLaboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry, Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBioN), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
Leonardo Afonso Dos SantosInstituto Bairral de Psiquiatria, Itapira, Brazil.
Roger Alberto Marcos LoveraInstituto Bairral de Psiquiatria, Itapira, Brazil.
Juliana Barbosa de CarvalhoLaboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry, Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBioN), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
Martinus van de BiltLaboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry, Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBioN), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
Acioly L T LacerdaPrograma de Transtornos Afetivos, Laboratório Interdisciplinar de Neurociências Clínicas, Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil.
Helio ElkisDepartment and Institute of Psychiatry, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
Wagner Farid GattazLaboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry, Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBioN), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
Andre R BrunoniLaboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry, Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBioN), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
Universidade de São Paulo · BRLudwig-Maximilians-Universität München · DEHertie Institute for Clinical Brain Research · DEHospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo · BRUniversidade Federal de São Paulo · BR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Importance: Negative symptoms represent a substantial burden in schizophrenia. Although preliminary studies have suggested that transcranial direct current stimulation (tDCS) is effective for some clusters of symptoms, the clinical benefits for negative symptoms are unclear. Objective: To determine the efficacy and safety of tDCS vs sham as an add-on treatment for patients with schizophrenia and predominant negative symptoms. Design, Setting, and Participants: The double-blind Schizophrenia Treatment With Electric Transcranial Stimulation (STARTS) randomized clinical trial was conducted from September 2014 to March 2018 in 2 outpatient clinics in the state of São Paulo, Brazil. Patients with schizophrenia with stable negative and positive symptoms and a minimum score of 20 points in the negative symptoms subscale of the Positive and Negative Syndrome Scale (PANSS) were included. Interventions: Ten sessions of tDCS performed twice a day for 5 days or a sham procedure. The anode and the cathode were positioned over the left prefrontal cortex and the left temporoparietal junction, respectively. Main Outcomes and Measures: Change in the PANSS negative symptoms subscale score at week 6 was the primary outcome. Patients were followed-up for an additional 6 weeks. Results: Of the 100 included patients, 20 (20.0%) were female, and the mean (SD) age was 35.3 (9.3) years. A total of 95 patients (95.0%) finished the trial. In the intention-to-treat analysis, patients receiving active tDCS showed a significantly greater improvement in PANSS score compared with those receiving the sham procedure (difference, 2.65; 95% CI, 1.51-3.79; number needed to treat, 3.18; 95% CI, 2.12-6.99; P < .001). Response rates for negative symptoms (20% improvement or greater) were also higher in the active group (20 of 50 [40%]) vs the sham group (2 of 50 [4%]) (P < .001). These effects persisted at follow-up. Transcranial direct current stimulation was well tolerated, and adverse effects did not differ between groups, except for burning sensation over the scalp in the active group (43.8%) vs the sham group (14.3%) (P = .003). Conclusions and Relevance: Transcranial direct current stimulation was effective and safe in ameliorating negative symptoms in patients with schizophrenia. Trial Registration: ClinicalTrials.gov identifier: NCT02535676.

Indexed as

Transcranial Direct Current StimulationAdultAntipsychotic AgentsCombined Modality TherapyDouble-Blind MethodHumansMalePsychiatric Status Rating ScalesSchizophreniaSchizophrenic PsychologyTreatment OutcomeAntipsychotic Agents

Identifiers

PMID31617873
PMCPMC6802484
OpenAlexW2980825744

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.