El Efecto de la Estimulación Eléctrica en las Funciones Ejecutivas, la Metacognición y la Regulación Emocional de los Adultos
Contenido principal del artículo
Resumen
Los estudios con estimulación eléctrica transcraneal han demostrado que existe una reducción en la sintomatología depresiva, pero aún no está claro si este tipo de intervención también puede mejorar las funciones cognitivas y las estrategias de regulación emocional en una mayor depresión. Este estudio examinó los efectos de la estimulación de la corriente continua transcraneal (ETCC) en la corteza de juego de retroceso en las funciones ejecutivas, metacognición de pensamientos y sentimientos y regulación emocional. Dieciocho adultos entre 18 y 40 años diagnosticados con mayor depresión fueron asignados aleatoriamente para la estimulación activa (n = 10) o simuladas (n = 8). Cada participante fue enviado a 10 sesiones activas o simuladas, etc. durante dos semanas. La gravedad de la depresión de los síntomas, las funciones ejecutivas, la metacognición y las estrategias de regulación emocional de los participantes se evaluaron al principio, inmediatamente después de la intervención y 3 meses después de la intervención. Se observó que el ETCC activo no tuvo un efecto mayor en las variables en comparación con la intervención simulada. Ambos grupos han aumentado la frecuencia de la regulación de los pensamientos y los sentimientos con el tiempo y reducen los síntomas depresivos después de la intervención. Los efectos no significativos de los ETCC en las variables evaluadas se discuten a la luz de estudios anteriores, que tienen resultados mixtos, corroborando y contrastando con los hallazgos encontrados aquí.
Descargas
Detalles del artículo
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
Los derechos de autor de los artículos publicados en Psicología: Teoría y Practica pertenecen a los autores, quienes otorgan a la Universidad Presbiteriana Mackenzie los derechos no exclusivos para publicar el contenido.
Citas
Aleixo, R., Bessa, J. R., & Abreu, N. (2022). Construção e Validação da Escala de Metacognição de Pensamentos e Sentimentos. Revista Iberoamericana de Diagnóstico y Evaluación – e Avaliação Psicológica RIDEP, 64(3), 71-80. https://doi.org/10.21865/RIDEP64.3.06
Ambrosini, A., & Coppola, G. (2020). Transcranial direct current stimulation. In Neuromodulation in Headache and Facial Pain Management: Principles, Rationale and Clinical Data (pp. 111-118). https://doi.org/10.1007/978-3-030-14121-9_8
Aparício, L. V., Rosa, V., Razza, L. M., Sampaio-Junior, B., Borrione, L., Valiengo, L., ... & Brunoni, A. R. (2019). Transcranial direct current stimulation (tDCS) for preventing major depressive disorder relapse: Results of a 6-month follow-up. Depression and Anxiety, 36(3), 262-268. https://doi.org/10.1002/da.22878
Barnhofer, T., Reess, T., Fissler, M., Winnebeck, E., Grimm, S., Gärtner, M., ... & Bajbouj, M. (2019). Effects of mindfulness training on emotion regulation in patients with depression: Reduced dorsolateral prefrontal cortex activation indexes early beneficial changes. Psychosomatic Medicine, 81(9), 818-828. https://doi.org/10.1097/PSY.0000000000000955
Brennan, S., McLoughlin, D. M., O’Connell, R., Bogue, J., O’Connor, S., McHugh, C., & Glennon, M. (2017). Anodal transcranial direct current stimulation of the left dorsolateral prefrontal cortex enhances emotion recognition in depressed patients and controls. Journal of Clinical and Experimental Neuropsychology, 39(4), 384-395. https://doi.org/10.1080/13803395.2016.1230595
Brunoni, A. R., Amadera, J., Berbel, B., Volz, M. S., Rizzerio, B. G., & Fregni, F. (2011). A systematic review on reporting and assessment of adverse effects associated with transcranial direct current stimulation. International Journal of Neuropsychopharmacology, 14(8), 1133-1145. https://doi.org/10.1017/S1461145710001690
Brunoni, A. R., Tortella, G., Benseñor, I. M., Lotufo, P. A., Carvalho, A. F., & Fregni, F. (2016). Cognitive effects of transcranial direct current stimulation in depression: Results from the SELECT-TDCS trial and insights for further clinical trials. Journal of Affective Disorders, 202, 46-52. https://doi.org/10.1016/j.jad.2016.03.066
Brunoni, A. R., Sampaio-Junior, B., Moffa, A. H., Aparício, L. V., Gordon, P., Klein, I., ... & Valiengo, L. (2018). Noninvasive brain stimulation in psychiatric disorders: A primer. Brazilian Journal of Psychiatry, 41, 70-81. https://doi.org/10.1590/1516-4446-2017-0018
Brunoni, A. R., Valiengo, L., Baccaro, A., Zanão, T. A., Oliveira, J. F. de, Goulart, A., ... & Fregni, F. (2013). The sertraline vs electrical current therapy for treating depression clinical study. JAMA Psychiatry, 70(4), 383-391. https://doi.org/10.1001/2013.jamapsychiatry.32
Cash, R. F., Cocchi, L., Lv, J., Fitzgerald, P. B., & Zalesky, A. (2021). Functional magnetic resonance imaging– guided personalization of transcranial magnetic stimulation treatment for depression. JAMA Psychiatry, 78(3), 337-339. https://doi.org/10.1001/jamapsychiatry.2020.3794
Chrysikou, E. G., Wing, E. K., & van Dam, W. O. (2022). Transcranial direct current stimulation over the prefrontal cortex in depression modulates cortical excitability in emotion regulation regions as measured by concurrent functional magnetic resonance imaging: An exploratory study. Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, 7(1), 85-94. https://doi.org/10.1016/j.bpsc.2019.12.004
Chua, E. F., Ahmed, R., & Garcia, S. M. (2017). Effects of HD-tDCS on memory and metamemory for general knowledge questions that vary by difficulty. Brain Stimulation, 10(2), 231-241. https://doi.org/10.1016/j.brs.2016.10.013
Doruk, D., Gray, Z., Bravo, G. L., Pascual-Leone, A., & Fregni, F. (2014). Effects of tDCS on executive function in Parkinson’s disease. Neuroscience Letters, 582, 27-31. https://doi.org/10.1016/j.neulet.2014.08.043
Duggan, M. C., Wang, L., Wilson, J. E., Dittus, R. S., Ely, E. W., & Jackson, J. C. (2017). The relationship between executive dysfunction, depression, and mental health-related quality of life in survivors of critical illness: Results from the BRAIN-ICU investigation. Journal of Critical Care, 37, 72-79. https://doi.org/10.1016/j.jcrc.2016.08.023
Fergusson, D., Aaron, S. D., Guyatt, G., & Hébert, P. (2002). Post-randomisation exclusions: The intention to treat principle and excluding patients from analysis. BMJ, 325(7365), 652-654. https://doi.org/10.1136/bmj.325.7365.652
Flournoy, J., & O’Hara, R. M. (2016). The impact of executive function on response to cognitive behavioral therapy in late‐life depression. International Journal of Geriatric Psychiatry, 31(4), 334-339. https://doi.org/10.1002/gps.4325
Fregni, F., El-Hagrassy, M. M., Pacheco-Barrios, K., Carvalho, S., Leite, J., Simis, M., ... & Brunoni, A. R. (2021). Evidence-based guidelines and secondary meta-analysis for the use of transcranial direct current stimulation in neurological and psychiatric disorders. International Journal of Neuropsychopharmacology, 24(4), 256-313. https://doi.org/10.1093/ijnp/pyaa051
Goodkind, M. S., Gallagher-Thompson, D., Thompson, L. W., Kesler, S. R., Anker, L., Ilieva, I. P., ... & Gunning, F. M. (2018). Age-related repetitive transcranial magnetic stimulation effects on executive function in depression: A systematic review. The American Journal of Geriatric Psychiatry, 26(3), 334-346. https://doi.org/10.1016/j.jagp.2017.09.002
Gouveia, V. V., Moura, H. M. D., Oliveira, I. C. V. D., Ribeiro, M. G. C., Rezende, A. T., & Brito, T. R. D. S. (2018). Emotional regulation questionnaire (ERQ): Evidence of construct validity and internal consistency. Psico-USF, 23, 461-471. https://doi.org/10.1590/1413-82712018230306
Gross, J. J., & John, O. P. (2003). Individual differences in two emotion regulation processes: Implications for affect, relationships, and well-being. Journal of Personality and Social Psychology, 85(2), 348. https://doi.org/10.1037/0022-3514.85.2.348
Gruber, M., Mauritz, M., Meinert, S., Grotegerd, D., de Lange, S. C., Grumbach, P., ... & Repple, J. (2023). Cognitive performance and brain structural connectome alterations in major depressive disorder. Psychological Medicine, 1-12. https://doi.org/10.1017/S0033291722004007
Gupta, S. K. (2011). Intention-to-treat concept: A review. Perspectives in Clinical Research, 2(3), 109. https:// doi.org/10.4103/2229-3485.83221
Hjemdal, O., Solem, S., Hagen, R., Kennair, L. E. O., Nordahl, H. M., & Wells, A. (2019). A randomized controlled trial of metacognitive therapy for depression: Analysis of 1-year follow-up. Frontiers in Psychology, 10, 1842. https://doi.org/10.3389/fpsyg.2019.01842
Imburgio, M. J., & Orr, J. M. (2018). Effects of prefrontal tDCS on executive function: Methodological considerations revealed by meta-analysis. Neuropsychologia, 117, 156-166. https://doi.org/10.1016/j.neuropsicologia.2018.04.022
Jelinek, L., Faissner, M., Moritz, S., & Kriston, L. (2019). Long-term efficacy of Metacognitive Training for Depression (D-MCT): A randomized controlled trial. British Journal of Clinical Psychology, 58(3), 245-259. https://doi.org/10.1111/bjc.12213
Jog, M. A., Anderson, C., Kubicki, A., & Boucher, M. (2023). Transcranial direct current stimulation (tDCS) in depression induces structural plasticity. Scientific Reports, 13, 2841. https://doi.org/10.1038/s41598-023-29792-6
Jog, M., Taraku, B., Boucher, M., Hellemann, G., Narr, K., & Woods, R. (2022). P342. Modulation of Depression-Relevant Circuitry by Transcranial Direct Current Stimulation (tDCS). Biological Psychiatry, 91(9), S225-S226. https://doi.org/10.1016/j.biopsych.2022.02.578
Joormann, J., & Stanton, C. H. (2016). Examining emotion regulation in depression: A review and future directions. Behaviour Research and Therapy, 86, 35-49. https://doi.org/10.1016/j.brat.2016.07.007
Joormann, J., & Vanderlind, W. M. (2014). Emotion regulation in depression: The role of biased cognition and reduced cognitive control. Clinical Psychological Science, 2(4), 402-421. https://doi.org/10.1177/2167702614536163
Kumar, S., Batist, J., Ghazala, Z., Zomorrodi, R. M., Brooks, H., Goodman, M., ... & Rajji, T. K. (2020). Effects of bilateral transcranial direct current stimulation on working memory and global cognition in older patients with remitted major depression: A pilot randomized clinical trial. International Journal of Geriatric Psychiatry, 35(10), 1233-1242. https://doi.org/10.1002/gps.5361
Lezama, R., Gómez-Ariza, C. J., & Bajo, M. T. (2024). Dissociating semantic integration and inhibitory control in the Remote Associates Test: A tDCS-EEG study. Creativity Research Journal, *36*(3), 1–27. https://doi.org/10.1080/10400419.2024.2373593
Li, Z., Chen, J., Feng, Y., Zhong, S., Tian, S., Dai, Z., ... & Jia, Y. (2021). Differences in verbal and spatial working memory in patients with bipolar II and unipolar depression: An MSI study. BMC Psychiatry, 21(1), 1-11. https://doi.org/10.1186/s12888-021-03595-3
Loo, C. K., Alonzo, A., Martin, D., Mitchell, P. B., Galvez, V., & Sachdev, P. (2012). Transcranial direct current stimulation for depression: 3-week randomised sham-controlled trial. The British Journal of Psychiatry, 200(1), 52-59. https://doi.org/10.1192/bjp.bp.111.097634
Marković, V., Vicario, C. M., Yavari, F., Salehinejad, M. A., & Nitsche, M. A. (2021). A systematic review on the effect of transcranial direct current and magnetic stimulation on fear memory and extinction. Frontiers in Human Neuroscience. https://doi.org/10.3389/fnhum.2021.655947
Marques, L. M., Morello, L. Y., & Boggio, P. S. (2018). Ventrolateral but not dorsolateral prefrontal cortex tDCS effectively impact emotion reappraisal–effects on emotional experience and interbeat interval. Scientific Reports, 8(1), 15295. https://doi.org/10.1038/s41598-018-33711-5
Martin, D. M., Moffa, A., Nikolin, S., Bennabi, D., Brunoni, A. R., Flannery, W., ... & Loo, C. K. (2018). Cognitive effects of transcranial direct current stimulation treatment in patients with major depressive disorder: An individual patient data meta-analysis of randomised sham-controlled trials. Neuroscience & Biobehavioral Reviews, 90, 137-145. https://doi.org/10.1016/j.neubiorev.2018.04.008
Masuda, F., Nakajima, S., Miyazaki, T., Tarumi, R., Ogyu, K., Wada, M., ... & Noda, Y. (2019). Clinical effectiveness of repetitive transcranial magnetic stimulation treatment in children and adolescents with neurodevelopmental disorders: A systematic review. Autism, 23(7), 1614-1629. https://doi.org/10.1177/1362361318822502
Moffa, A. H., Martin, D., Alonzo, A., Bennabi, D., Blumberger, D. M., Benseñor, I. M., ... & Brunoni, A. R. (2020). Efficacy and acceptability of transcranial direct current stimulation (tDCS) for major depressive disorder: An individual patient data meta-analysis. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 99, 109836. https://doi.org/10.1016/j.pnpbp.2019.109836
Mutz, J., Edgcumbe, D. R., Brunoni, A. R., & Fu, C. H. (2018). Efficacy and acceptability of non-invasive brain stimulation for the treatment of adult unipolar and bipolar depression: A systematic review and meta-analysis of randomised sham-controlled trials. Neuroscience & Biobehavioral Reviews, 92, 291-303. https://doi.org/10.1016/j.pnpbp.2019.109836
Nardo, D., Creasey, M., Negus, C., Pappa, K., Aghaeifar, A., Reid, A., Josephs, O., Callaghan, M. F., & Crinion, J. T. (2023). Transcranial direct current stimulation with functional magnetic resonance imaging: A detailed validation and operational guide. Wellcome Open Research, 6, 143. https://doi.org/10.12688/wellcomeopenres.16679.2
Narmashiri, A., & Akbari, F. (2025). The effects of transcranial direct current stimulation (tDCS) on cognitive functions: A systematic review and meta-analysis. Neuropsychology Review, 35, 126–152. https://doi.org/10.1007/s11065-023-09627-x
Nikolin, S., Moffa, A., Razza, L., Martin, D., Brunoni, A. R., Palm, U., Padberg, F., Bennabi, D., Haffen, E., Blumberger, D. M., Salehinejad, M. A., & Loo, C. K. (2023). Time-course of the tDCS antidepressant effect: An individual participant data meta-analysis. *Progress in Neuro-Psychopharmacology and Biological Psychiatry, 125*, 110752. https://doi.org/10.1016/j.pnpbp.2023.110752
Oathes, D. J., Balderston, N. L., Kording, K. P., DeLuisi, J. A., Perez, G. M., Medaglia, J. D., ... & Linn, K. A. (2021). Combining transcranial magnetic stimulation with functional magnetic resonance imaging for probing and modulating neural circuits relevant to affective disorders. Wiley Interdisciplinary Reviews: Cognitive Science, 12(4), e1553. https://doi.org/10.1002/wcs.1553
Palm, U., Schiller, C., Fintescu, Z., Obermeier, M., Keeser, D., Reisinger, E., ... & Padberg, F. (2012). Transcranial direct current stimulation in treatment resistant depression: A randomized double-blind placebo-controlled study. Brain Stimulation, 5(3), 242-251. https://doi.org/10.1016/j.brs.2011.08.005
Philip, N. S., Barredo, J., Aiken, E., & Carpenter, L. L. (2018). Neuroimaging mechanisms of therapeutic transcranial magnetic stimulation for major depressive disorder. Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, 3(3), 211-222. https://doi.org/10.1016/j.bpsc.2017.10.007
Razza, L. B., Moffa, A. H., Moreno, M. L., Carvalho, A. F., Padberg, F., Fregni, F., & Brunoni, A. R. (2018). A systematic review and meta-analysis on placebo response to repetitive transcranial magnetic stimulation for depression trials. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 81, 105-113. https://doi.org/10.1016/j.pnpbp.2017.10.016
Razza, L. B., Palumbo, P., Moffa, A. H., Carvalho, A. F., Solmi, M., Loo, C. K., & Brunoni, A. R. (2020). A systematic review and meta-analysis on the effects of transcranial direct current stimulation in depressive episodes. Depression and Anxiety, 37(7), 594-608. https://doi.org/10.1002/da.23004
Rezaei, M., Bagheri, M. M. S., & Ahmadi, M. (2021). Clinical and demographic predictors of response to anodal tDCS treatment in major depression disorder (MDD). Journal of Psychiatric Research, 138, 68-74. https://doi.org/10.1016/j.jpsychires.2021.03.047
Shimony, O., Einav, N., Bonne, O., Jordan, J. T., Van Vleet, T. M., & Nahum, M. (2021). The association between implicit and explicit affective inhibitory control, rumination and depressive symptoms. Scientific Reports, 11(1), 1-13. https://doi.org/10.1038/s41598-021-90875-3
Smet, S., Nikolin, S., Moffa, A., Suen, P., Vanderhasselt, M. A., Brunoni, A. R., & Razza, L. B. (2021). Determinants of sham response in tDCS depression trials: A systematic review and meta-analysis. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 109, 110261. https://doi.org/10.1016/j.pnpbp.2021.110261
Trivedi, M. H., & Greer, T. L. (2014). Cognitive dysfunction in unipolar depression: Implications for treatment. Journal of Affective Disorders, 152, 19-27. https://doi.org/10.1016/j.jad.2013.09.012
Vanderlind, W. M., Millgram, Y., Baskin-Sommers, A. R., Clark, M. S., & Joormann, J. (2020). Understanding positive emotion deficits in depression: From emotion preferences to emotion regulation. Clinical Psychology Review, 76, 101826. https://doi.org/10.1016/j.cpr.2020.101826
Vilgis, V., Gelardi, K. L., Helm, J. L., Forbes, E. E., Hipwell, A. E., Keenan, K., & Guyer, A. E. (2018). Dorsomedial prefrontal activity to sadness predicts later emotion suppression and depression severity in adolescent girls. Child Development, 89(3), 758-772. https://doi.org/10.1111/cdev.13023
Wong, H. L., Chan, W. C., Wong, Y. L., Wong, S. N., Yung, H. Y., Wong, S. M. C., & Cheng, P. W. C. (2019). High‐definition transcranial direct current stimulation—An open‐label pilot intervention in alleviating depressive symptoms and cognitive deficits in late‐life depression. CNS Neuroscience & Therapeutics, 25(11), 1244-1253. https://doi.org/10.1111/cns.13253
Woodham, R., Rimmer, R. M., Mutz, J., & Fu, C. H. (2021). Is tDCS a potential first line treatment for major depression? International Review of Psychiatry, 33(3), 250-265. https://doi.org/10.1080/09540261.2021.1879030
Zhang, Q., Li, X., Liu, X., Liu, S., Zhang, M., Liu, Y., ... & Wang, K. (2022). The effect of non-invasive brain stimulation on the downregulation of negative emotions: A meta-analysis. Brain Sciences, 12(6), 786. https://doi.org/10.3390/brainsci12060786
Zheng, E. Z., Wong, N. M. L., Yang, A. S. Y, & Lee, T. M. C. (2024). Evaluating the effects of tDCS on depressive and anxiety symptoms from a transdiagnostic perspective: a systematic review and meta-analysis of randomized controlled trials. Transl Psychiatry, 14(1), 295. https://doi.org/10.1038/s41398-024-03003-w
Zhou, H., Dang, L., Lam, L. W., Zhang, M. X., & Wu, A. M. (2021). A cross-lagged panel model for testing the bidirectional relationship between depression and smartphone addiction and the influences of maladaptive metacognition on them in Chinese adolescents. Addictive Behaviors, 120, 106978. https://doi.org/10.1016/j.addbeh.2021.106978