CAMPUS INNENSTADT KLINIK FÜR PSYCHIATRIE UND PSYCHOTHERAPIE

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CAMPUS INNENSTADT KLINIK FÜR PSYCHIATRIE UND PSYCHOTHERAPIE Transcranial direct current stimulation (tDCS) for the treatment of Phobic Postural Vertigo: A pilot study. Palm U.1, Kirsch V. 2, Kübler H. 2, Keeser D. 3, Padberg F. 1, Dieterich M. 2 1Ludwig-Maximilians-Universität, Klinik für Psychiatrie und Psychotherapie, München 2Ludwig-Maximilians-Universität, Neurologische Klinik, München 3Ludwig-Maximilians-Universität, Institut für klinische Radiologie, München Clinical results tDCS was well tolerated and no adverse effects occurred. Mean score of Vertigo Symptom Scale at baseline was 59±26, mean age was 45±12 years. Mean Beck Depression Inventory was 15 points at baseline, mean HADS 16 points, Dizziness Handicap Inventory mean sum score was 48 at baseline. Hospital Anxiety and Depression Scale and Dizziness Handicap Inventory showed significant improvement over time course (p= 0.0002-0.007, t-test, two-tailed, Bonferroni-corrected to level of significance p≤0.01) and a moderate to high correlation over time course (r= 0.469-0.858, Pearson), whereas Beck Depression Inventory showed no changes over time course (Figures 1+2). Age was not correlated to clinical improvement. Dizziness at baseline was not correlated to depression ratings. Background Phobic postural vertigo (PPV) is a disabling disease with explicit psychosomatic aspects and comorbid depressive and anxiety disorder . Transcranial direct current stimulation (tDCS) has been proven to improve depressive symptoms. Methods In this small pilot trial, 8 patients were treated with tDCS (2 mA, 20 min, anode: F3, cathode: FP2) over five days. Follow- up measures were performed after 1, 2, and 4 weeks. Fig. 1: DHI results (paired t-tests, two-tailed, Bonferroni-corrected). X-axis shows time course from days 1 and 5 and follow-up 1-3. Y-axis shows DHI score. Fig. 2: BDI and HADS results (paired t-tests, two-tailed, Bonferroni-corrected). X-axis shows time course from days 1-5 and follow-up 1-3. Y-axis shows depression score. Conclusions Although this small open study needs confirmation with objective rating instruments such as gait control, tDCS seems to be a promising tool for the improvement of depression and anxiety as well as vertigo in PPV patients. References Ferreira LS, Pereira CB, Rossini S, Kanashiro AM, Adda CC, Scaff M. Psychological assessment in patients with phobic postural vertigo. Arq Neuropsiquiatr 2010; 68: 224-227. Lahmann C, Henningsen P, Brandt T, Strupp M, Jahn K, Dieterich M, Eckhardt-Henn A, Feuerecker R, Dinkel A, Schmid G. Psychiatric comorbidity and psychosocial impairment among patients with vertigo and dizziness. J Neurol Neurosurg Psychiatry 2014, in press. Shiozawa P, Fregni F, Benseñor IM, Lotufo PA, Berlim MT, Daskalakis JZ, Cordeiro Q, Brunoni AR. Transcranial direct current stimulation for major depression: an updated systematic review and meta-analysis. Int J Neuropsychopharmacol 2014; 17:1443-1452. Mondino M, Bennabi D, Poulet E, Galvao F, Brunelin J, Haffen E. Can transcranial direct current stimulation (tDCS) alleviate symptoms and improve cognition in psychiatric disorders? World J Biol Psychiatry 2014; 15: 261-275. Schniepp R, Wuehr M, Pradhan C, Novozhilov S, Krafzcyk S, Brandt T, Jahn K. Nonlinear variability of body sway in patients with phobic postural vertigo. Schniepp R, Wuehr M, Huth S, Pradhan C, Brandt T, Jahn K. Gait characteristics of patients with phobic postural vertigo: effects of fear of falling, attention, and visual input. J Neurol 2014; 261: 738-746.