Mechanisms and clinical advances in transcranial alternating current stimulation for the treatment of depression

doi:10.3969/j.issn.1672-6731.2026.01.013

Abstract

Abstract:

Transcranial alternating current stimulation (tACS) is a non-invasive neuromodulation technique that applies low-intensity sinusoidal currents at specific frequencies to interact with endogenous neural oscillations. By modulating neuronal firing synchrony, tACS can improve neural functions. In recent years, this technique has shown potential in the treatment of depression. This article reviews advances in the application of various tACS modalities in depression, discusses optimization strategies and future directions, and provides insights for clinical practice and further research.

Key words: Depressive disorder, Electric stimulation therapy, Review

摘要：

经颅交流电刺激作为一种非侵入性神经调控技术，通过特定频率的交流电与内源性神经振荡相互作用，调节神经元放电同步性，改善神经功能。近年该项技术在抑郁症的治疗中展现出潜力。本文综述不同类型经颅交流电刺激在抑郁症中的应用进展，探讨其优化策略及发展方向，为临床实践和临床研究提供参考。

关键词: 抑郁症, 电刺激疗法, 综述

CLC Number:

R741
R651

Xin YANG, Shu-zhe WANG, Shen LI. Mechanisms and clinical advances in transcranial alternating current stimulation for the treatment of depression[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2026, 26(1): 92-98.

杨鑫, 王书哲, 李申. 经颅交流电刺激治疗抑郁症机制研究与应用进展[J]. 中国现代神经疾病杂志, 2026, 26(1): 92-98.

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URL: https://journal11.magtechjournal.com/cjcnn/EN/10.3969/j.issn.1672-6731.2026.01.013

https://journal11.magtechjournal.com/cjcnn/EN/Y2026/V26/I1/92

Figures/Tables 4

References 50

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神经调控技术	技术特点	核心作用机制	起效速度	不良反应	适用性及成本
tACS	非侵入性^[5]	调节内源性神经振荡和神经节律^[7]	较慢：需多次治疗累积效果	仅轻微刺痛或瘙痒感，安全性高^[12]，几乎无严重不良反应	设备便携、成本较低，未来可能实现家庭化治疗，极具推广潜力
ECT	非侵入性（需全身麻醉）	调节神经递质重新分布和突触可塑性^[8]	最快：通常数次治疗即可产生显著效果	短期记忆丧失和意识混乱^[4]	需在手术室内完成，设备和人力成本较高
tDCS	非侵入性	调节神经元膜静息电位^[9]	较慢：需多次治疗累积效果	刺激部位刺痛、瘙痒感，偶有轻微头晕、恶心^[9]	设备便携、成本较低，已开始探索家庭化应用^[14]
TMS	非侵入性	改变神经元兴奋性^[10]	中等：通常2~4周	治疗期间有头部叩击感，总体安全^[13]	设备昂贵，需在专业临床机构由医师操作
DBS	侵入性^[6]	持续高频电脉冲刺激特定脑结构和神经回路^[11]	缓慢且可变：起效慢，需数月精细程控	伴感染、出血等风险，还可能存在硬件并发症和刺激相关不良反应	仅用于难治性病例，手术和设备费用昂贵

神经调控技术	技术特点	核心作用机制	起效速度	不良反应	适用性及成本
tACS	非侵入性^[5]	调节内源性神经振荡和神经节律^[7]	较慢：需多次治疗累积效果	仅轻微刺痛或瘙痒感，安全性高^[12]，几乎无严重不良反应	设备便携、成本较低，未来可能实现家庭化治疗，极具推广潜力
ECT	非侵入性（需全身麻醉）	调节神经递质重新分布和突触可塑性^[8]	最快：通常数次治疗即可产生显著效果	短期记忆丧失和意识混乱^[4]	需在手术室内完成，设备和人力成本较高
tDCS	非侵入性	调节神经元膜静息电位^[9]	较慢：需多次治疗累积效果	刺激部位刺痛、瘙痒感，偶有轻微头晕、恶心^[9]	设备便携、成本较低，已开始探索家庭化应用^[14]
TMS	非侵入性	改变神经元兴奋性^[10]	中等：通常2~4周	治疗期间有头部叩击感，总体安全^[13]	设备昂贵，需在专业临床机构由医师操作
DBS	侵入性^[6]	持续高频电脉冲刺激特定脑结构和神经回路^[11]	缓慢且可变：起效慢，需数月精细程控	伴感染、出血等风险，还可能存在硬件并发症和刺激相关不良反应	仅用于难治性病例，手术和设备费用昂贵

文献来源	刺激频段	刺激频率（Hz）	刺激强度（mA）	刺激靶点	治疗效果
Alexander等^[25]（2019）	α频段	10	2	双侧DLPFC	左侧额叶α频段功率显著降低，具有治疗重度抑郁症的潜力
Gehrman等^[26]（2024）	α频段	15	2	颞叶皮质、双侧颞上回	与假刺激组相比，治疗第1周抑郁症状改善幅度更显著，治疗后4周抑郁症状改善的应答率更显著；女性患者较男性获益更多
Zhang等^[27]（2022）	α频段	10	1	双侧DLPFC、颞顶交界区	增加目标区域α频段功率，降低左侧与右侧额叶功能连接，证实改善抑郁症状的潜力
Riddle等^[24]（2022）	个性化α频段	8~13	1	左侧DLPFC	减少左侧DLPFC的α频段功率，可作为治疗重度抑郁症的方法
Riddle等^[28]（2020）	α频段	10	2	左侧DLPFC	每日抑郁自我报告曲线图可见症状逐步缓解且改善效果极佳
Haller等^[29]（2020）	γ频段	40	2	双侧DLPFC	抑郁症状减轻，认知功能改善
Sánchez-Garrido Campos等^[33]（2025）	γ频段	40	2	颞区	情景记忆和认知功能改善，海马灌注增加
Sprugnoli等^[30]（2021）	γ频段	40	2	双侧额叶、颞叶	增加快速脑振荡活动，增加刺激脑区灌注，外显记忆明显改善

文献来源	刺激频段	刺激频率（Hz）	刺激强度（mA）	刺激靶点	治疗效果
Alexander等^[25]（2019）	α频段	10	2	双侧DLPFC	左侧额叶α频段功率显著降低，具有治疗重度抑郁症的潜力
Gehrman等^[26]（2024）	α频段	15	2	颞叶皮质、双侧颞上回	与假刺激组相比，治疗第1周抑郁症状改善幅度更显著，治疗后4周抑郁症状改善的应答率更显著；女性患者较男性获益更多
Zhang等^[27]（2022）	α频段	10	1	双侧DLPFC、颞顶交界区	增加目标区域α频段功率，降低左侧与右侧额叶功能连接，证实改善抑郁症状的潜力
Riddle等^[24]（2022）	个性化α频段	8~13	1	左侧DLPFC	减少左侧DLPFC的α频段功率，可作为治疗重度抑郁症的方法
Riddle等^[28]（2020）	α频段	10	2	左侧DLPFC	每日抑郁自我报告曲线图可见症状逐步缓解且改善效果极佳
Haller等^[29]（2020）	γ频段	40	2	双侧DLPFC	抑郁症状减轻，认知功能改善
Sánchez-Garrido Campos等^[33]（2025）	γ频段	40	2	颞区	情景记忆和认知功能改善，海马灌注增加
Sprugnoli等^[30]（2021）	γ频段	40	2	双侧额叶、颞叶	增加快速脑振荡活动，增加刺激脑区灌注，外显记忆明显改善

文献来源	刺激频段	刺激频率（Hz）	刺激强度（mA）	刺激靶点	治疗效果
Li等^[40]（2024）	γ频段	77.50	15	额极区	纠正重度抑郁症患者的认知偏差并改善认知功能
Zhou等^[15]（2024）	γ频段	77.50	15	左侧DLPFC	联合抗抑郁药可减轻重度抑郁症患者抑郁症状
Wang等^[35]（2022）	γ频段	77.50	15	前额区、双侧乳突	明显减轻药物治疗无效的重度抑郁症患者的抑郁症状
罗炯等^[39]（2022）	γ频段	77.50	15	前额区、双侧乳突	抑郁症状减轻、认知功能改善，治疗过程未发生不良事件

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