1. 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= , t-test, two-tailed, Bonferroni-corrected to level of significance p≤0.01) and a moderate to high correlation over time course (r= , 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.
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