Transcranial Direct Current Stimulation for Negative Symptoms of Schizophrenia: Why the Reader Must Choose a Clinically Relevant Outcome.

Transcranial Direct Current Stimulation for Negative Symptoms of Schizophrenia: Why the Reader Must Choose a Clinically Relevant Outcome. J Clin Psychiatry. 2020 Feb 04;81(1): Authors: Andrade C Abstract A recent, large, randomized controlled trial (RCT) of 10 twice-daily sessions of active vs sham transcranial direct current stimulation (tDCS), delivered across 5 consecutive days to schizophrenia patients with high negative symptom burden, found that active treatment was superior to sham treatment by a mean of 2.65 points on the Positive and Negative Syndrome Scale, negative subscale (PANSS-N), at 6 weeks. This was the primary endpoint of the study. Because a difference of 2.65 PANSS-N points between the average active vs sham tDCS patient is a very small advantage, it appears that the finding was statistically but not clinically significant; why this is so is explained in the context of how the PANSS-N is scored. The study also found that, with response defined as 20% attenuation of PANSS-N scores, significantly more (40% vs 4%) active than sham group patients responded at 6 weeks. This was one of many secondary outcomes that the study examined. Because response is a clinically important endpoint, it appears that the finding was clinically as well as statistically significant; why this is so is also explained in the context of PANSS-N scoring. As a final poser, whereas the advantage for active tDCS for both outcomes persisted at 12...
Source: Journal of Clinical Psychiatry - Category: Psychiatry Tags: J Clin Psychiatry Source Type: research