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      The effect of noninvasive brain stimulation on anhedonia in patients with schizophrenia and depression: A systematic review and meta‐analysis

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          Abstract

          Anhedonia is a transdiagnostic symptom found in patients with schizophrenia and depression. Current pharmacological interventions for anhedonia are unsatisfactory in a considerable proportion of patients. There has been growing interest in applying noninvasive brain stimulation (NIBS) to patients with anhedonia. However, evidence for the efficacy of NIBS for anhedonia remain inconsistent. This study systematically identified all studies that measured anhedonia and applied NIBS in patients with schizophrenia or depression. We conducted a search using the various databases in English (PubMed, EBSCOHost (PsycInfo/PsycArticles), Web of Science) and Chinese (China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform) languages, and reviewed original research articles on NIBS published from January 1989 to July 2023. Our search had identified 15 articles for quantitative synthesis, with three concerning schizophrenia samples, 11 concerning samples with depression, and one concerning both clinical samples. We conducted a meta‐analysis based on the 15 included studies, and the results suggested that NIBS could improve anhedonia symptoms in schizophrenia patients and patients with depression, with a medium‐to‐large effect size. Our findings are preliminary, given the limited number of included studies. Future NIBS research should measure anhedonia as a primary outcome and should recruit transdiagnostic samples.

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          Most cited references52

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          Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and research.

          This article is based on a consensus conference, which took place in Certosa di Pontignano, Siena (Italy) on March 7-9, 2008, intended to update the previous safety guidelines for the application of transcranial magnetic stimulation (TMS) in research and clinical settings. Over the past decade the scientific and medical community has had the opportunity to evaluate the safety record of research studies and clinical applications of TMS and repetitive TMS (rTMS). In these years the number of applications of conventional TMS has grown impressively, new paradigms of stimulation have been developed (e.g., patterned repetitive TMS) and technical advances have led to new device designs and to the real-time integration of TMS with electroencephalography (EEG), positron emission tomography (PET) and functional magnetic resonance imaging (fMRI). Thousands of healthy subjects and patients with various neurological and psychiatric diseases have undergone TMS allowing a better assessment of relative risks. The occurrence of seizures (i.e., the most serious TMS-related acute adverse effect) has been extremely rare, with most of the few new cases receiving rTMS exceeding previous guidelines, often in patients under treatment with drugs which potentially lower the seizure threshold. The present updated guidelines review issues of risk and safety of conventional TMS protocols, address the undesired effects and risks of emerging TMS interventions, the applications of TMS in patients with implanted electrodes in the central nervous system, and safety aspects of TMS in neuroimaging environments. We cover recommended limits of stimulation parameters and other important precautions, monitoring of subjects, expertise of the rTMS team, and ethical issues. While all the recommendations here are expert based, they utilize published data to the extent possible.
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            Reconsidering anhedonia in depression: lessons from translational neuroscience.

            Anhedonia is a core symptom of major depressive disorder (MDD), the neurobiological mechanisms of which remain poorly understood. Despite decades of speculation regarding the role of dopamine (DA) in anhedonic symptoms, empirical evidence has remained elusive, with frequent reports of contradictory findings. In the present review, we argue that this has resulted from an underspecified definition of anhedonia, which has failed to dissociate between consummatory and motivational aspects of reward behavior. Given substantial preclinical evidence that DA is involved primarily in motivational aspects of reward, we suggest that a refined definition of anhedonia that distinguishes between deficits in pleasure and motivation is essential for the purposes of identifying its neurobiological substrates. Moreover, bridging the gap between preclinical and clinical models of anhedonia may require moving away from the conceptualization of anhedonia as a steady-state, mood-like phenomena. Consequently, we introduce the term "decisional anhedonia" to address the influence of anhedonia on reward decision-making. These proposed modifications to the theoretical definition of anhedonia have implications for research, assessment and treatment of MDD. Copyright © 2010 Elsevier Ltd. All rights reserved.
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              Transcranial direct current stimulation: State of the art 2008.

              Effects of weak electrical currents on brain and neuronal function were first described decades ago. Recently, DC polarization of the brain was reintroduced as a noninvasive technique to alter cortical activity in humans. Beyond this, transcranial direct current stimulation (tDCS) of different cortical areas has been shown, in various studies, to result in modifications of perceptual, cognitive, and behavioral functions. Moreover, preliminary data suggest that it can induce beneficial effects in brain disorders. Brain stimulation with weak direct currents is a promising tool in human neuroscience and neurobehavioral research. To facilitate and standardize future tDCS studies, we offer this overview of the state of the art for tDCS.
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                Author and article information

                Contributors
                rckchan@psych.ac.cn
                Journal
                Psych J
                Psych J
                10.1002/(ISSN)2046-0260
                PCHJ
                PsyCh Journal
                John Wiley & Sons Australia, Ltd (Melbourne )
                2046-0252
                2046-0260
                27 December 2023
                April 2024
                : 13
                : 2 ( doiID: 10.1002/pchj.v13.2 )
                : 166-175
                Affiliations
                [ 1 ] Shanghai Mental Health Center Shanghai Jiao Tong University School of Medicine Shanghai China
                [ 2 ] Neuropsychology and Applied Cognitive Neuroscience Laboratory CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences Beijing China
                [ 3 ] Department of Psychology University of Chinese Academy of Sciences Beijing China
                [ 4 ] Department of Psychiatry, School of Clinical Medicine The University of Hong Kong Hong Kong China
                Author notes
                [*] [* ] Correspondence

                Raymond C. K. Chan, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Beijing 100101, China.

                Email: rckchan@ 123456psych.ac.cn

                Author information
                https://orcid.org/0000-0002-6673-6569
                https://orcid.org/0000-0001-6880-5831
                https://orcid.org/0000-0001-9360-6244
                https://orcid.org/0000-0002-3414-450X
                Article
                PCHJ723
                10.1002/pchj.723
                10990806
                38151800
                d6b06dd0-d922-4df5-a365-e3cffb5d2492
                © 2023 The Authors. PsyCh Journal published by Institute of Psychology, Chinese Academy of Sciences and John Wiley & Sons Australia, Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 08 February 2023
                : 28 November 2023
                Page count
                Figures: 3, Tables: 2, Pages: 10, Words: 7286
                Funding
                Funded by: Scientific Foundation of Institute of Psychology, Chinese Academy of Sciences
                Award ID: E2CX3415CX
                Funded by: National Natural Science Foundation of China , doi 10.13039/501100001809;
                Award ID: 32100892
                Funded by: Research Funds from Shanghai Mental Health Center
                Award ID: 2020‐YJ07
                Categories
                Review Article
                Review Articles
                Custom metadata
                2.0
                April 2024
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.4.0 mode:remove_FC converted:03.04.2024

                anhedonia,depression,meta‐analysis,noninvasive brain stimulation,schizophrenia

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