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目的:观察靶向前额叶前部皮质（aPFC）的高精度经颅直流电刺激（tDCS）对精神分裂症患者前瞻性记忆（PM）缺陷的改善作用及安全性。方法:纳入自2022年3月至2023年3月首都医科大学附属北京安定医院精神科门诊收治的38例存在PM缺陷的精神分裂症患者，采用随机信封法将其分为真刺激组和伪刺激组，各19例。真刺激组刺激电流强度为2 mA，持续时间为20 min。伪刺激组刺激电流强度同真刺激组，但持续时间为40 s。2组受试者均治疗2次/d，持续5 d。治疗前、治疗后1周通过实验室线索非聚焦PM范式评估受试者PM功能，通过阳性与阴性症状量表（PANSS）、MATRICS共识认知成套测验（MCCB）中文版评估受试者临床症状与认知功能。干预结束时通过tDCS不良反应问卷评估治疗安全性。结果:2组受试者在PM试次正确率、PM试次反应时间上组别与时间（治疗前、治疗后1周）的交互作用均不显著（ P>0.05）。与治疗前比较，真刺激组治疗后1周PM试次正确率明显提高[（0.38±0.22）% vs. （0.57±0.28）%]，差异有统计学意义（ P<0.05）；而伪刺激组2个时间点的PM试次正确率[（0.56±0.25）% vs. （0.67±0.25）%]、PM试次反应时间[（2 216.46±570.03） ms vs. （2 059.59±378.41） ms]差异均无统计学意义（ P>0.05）。临床症状与认知功能方面，治疗后1周，真刺激组与伪刺激组PANSS、MCCB评分所有指标差异均无统计学意义（ P>0.05）；并且2组所有指标上的时间（治疗前、治疗后1周）与组别的交互作用不显著（ P>0.05）。不良反应方面，与伪刺激组相比，真刺激组皮肤发红项目评分明显升高，差异有统计学意义（ P<0.05）；其余不良反应评分差异均无统计学意义（ P>0.05）。所有患者均未出现严重不良反应事件。 结论:本研究暂未发现高精度tDCS靶向aPFC治疗改善精神分裂症患者PM缺陷的阳性结果，但现有结果提示其存在改善趋势，可为后续改善精神分裂症PM缺陷的大样本临床试验提供初步证据。

Objective:To investigate the efficacy and safety of high-precision transcranial direct current stimulation (tDCS) targeting the anterior prefrontal cortex (aPFC) in prospective memory (PM) deficits in patients with schizophrenia.Methods:A total of 38 schizophrenia patients with PM deficits admitted to Outpatient Department of Psychiatry, Beijing Anding Hospital Affiliated to Capital Medical University from March 2022 to March 2023 were included and divided into true stimulus group ( n=19) and pseudo-stimulus group ( n=19) by random envelope method. Two mA stimulation current intensity with duration of 20 min was given to the true stimulus group, and same stimulation current intensity with duration of 40 s was given to the pseudo-stimulus group twice daily for 5 d. PM function was assessed by Cued Unfocused Laboratory Prospective Memory Task before and 1 week after stimulation, cognitive function and severity of clinical symptoms were evaluated by Positive and Negative Symptom Scale (PANSS) and Chinese version of MATRICS consensus cognition test (MCCB). Safety was assessed by tDCS adverse reaction questionnaire at the end of stimulation. Results:The time (before and 1 week after stimulation) and group interactions of PM trial accuracy and PM trial response time between the two groups were not significantly different ( P>0.05). Compared with that before stimulation, the PM trial accuracy 1 week after stimulation was significantly improved in the true stimulus group ([0.38±0.22] % vs. [0.57±0.28] %, P<0.05). No significant difference in PM trial accuracy ([0.56±0.25] % vs. [0.67±0.25] %) or PM trial response time ([2 216.46±570.03] ms vs. [2 059.59±378.41] ms) between before and 1 week after stimulation was noted in the pseudo-stimulus group ( P>0.05). In terms of severity of clinical symptoms and cognitive function, no significant difference in PANSS or MCCB scores were noted between the true stimulus group and pseudo-stimulus group 1 week after treatment ( P>0.05); no significant difference was noted between the two groups in time (before and 1 week after stimulation) and group interaction of all indexes ( P>0.05). In terms of adverse reactions, compared with the pseudo-stimulus group, the true stimulus group had significantly higher score of "skin redness" ( P<0.05); no significant differences in scores of other adverse reactions were noted between the two groups ( P>0.05). No serious adverse events occurred in all patients. Conclusion:In this study, no positive results have been found in improving PM deficits in patients with schizophrenia with high-precision tDCS targeting aPFC, but existing results suggest an improved trend, which can provide preliminary evidence for subsequent large-sample clinical trials to improve PM deficits in schizophrenia.