Effect of transcranial direct current stimulation on postoperative sleep disturbance in older patients undergoing lower limb major arthroplasty: a prospective, double-blind, pilot, randomised controlled trial
Background Postoperative sleep disturbance (PSD) is a common and serious postoperative complication and is associated with poor postoperative outcomes.Aims This study aimed to investigate the effect of transcranial direct current stimulation (tDCS) on PSD in older patients undergoing lower limb majo...
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BMJ Publishing Group
2024-04-01
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| Series: | General Psychiatry |
| Online Access: | https://gpsych.bmj.com/content/37/2/e101173.full |
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| author | Chunyan Li Jie Yang He Liu Wen Tan Song Zhang Hongxing Zhang Yuan Han Mingshu Tao Rongguang Liu Jiaxing Fang Dexian Chen Qi Wei Xingyu Xiong Wenxin Zhao Junli Cao |
| author_facet | Chunyan Li Jie Yang He Liu Wen Tan Song Zhang Hongxing Zhang Yuan Han Mingshu Tao Rongguang Liu Jiaxing Fang Dexian Chen Qi Wei Xingyu Xiong Wenxin Zhao Junli Cao |
| author_sort | Chunyan Li |
| collection | DOAJ |
| description | Background Postoperative sleep disturbance (PSD) is a common and serious postoperative complication and is associated with poor postoperative outcomes.Aims This study aimed to investigate the effect of transcranial direct current stimulation (tDCS) on PSD in older patients undergoing lower limb major arthroplasty.Methods In this prospective, double-blind, pilot, randomised, sham-controlled trial, patients 65 years and over undergoing lower limb major arthroplasty were randomly assigned to receive active tDCS (a-tDCS) or sham tDCS (s-tDCS). The primary outcomes were the objective sleep measures on postoperative nights (N) 1 and N2.Results 116 inpatients were assessed for eligibility, and a total of 92 patients were enrolled; 47 received a-tDCS and 45 received s-tDCS. tDCS improved PSD by altering the following sleep measures in the a-tDCS and s-tDCS groups; the respective comparisons were as follows: the promotion of rapid eye movement (REM) sleep time on N1 (64.5 (33.5–105.5) vs 19.0 (0.0, 45.0) min, F=20.10, p<0.001) and N2 (75.0 (36.0–120.8) vs 30.0 (1.3–59.3) min, F=12.55, p<0.001); the total sleep time on N1 (506.0 (408.0–561.0) vs 392.0 (243.0–483.5) min, F=14.13, p<0.001) and N2 (488.5 (455.5–548.5) vs 346.0 (286.5–517.5) min, F=7.36, p=0.007); the deep sleep time on N1 (130.0 (103.3–177.0) vs 42.5 (9.8–100.8) min, F=24.4, p<0.001) and N2 (103.5 (46.0–154.8) vs 57.5 (23.3–106.5) min, F=8.4, p=0.004); and the percentages of light sleep and REM sleep on N1 and N2 (p<0.05 for each). The postoperative depression and anxiety scores did not differ significantly between the two groups. No significant adverse events were reported.Conclusion In older patients undergoing lower limb major arthroplasty, a single session of anodal tDCS over the left dorsolateral prefrontal cortex showed a potentially prophylactic effect in improving postoperative short-term objective sleep measures. However, this benefit was temporary and was not maintained over time. |
| format | Article |
| id | doaj-art-fd24e5eaef0049608acb1378a14be006 |
| institution | Kabale University |
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| language | English |
| publishDate | 2024-04-01 |
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| series | General Psychiatry |
| spelling | doaj-art-fd24e5eaef0049608acb1378a14be0062025-01-29T15:55:13ZengBMJ Publishing GroupGeneral Psychiatry2517-729X2024-04-0137210.1136/gpsych-2023-101173Effect of transcranial direct current stimulation on postoperative sleep disturbance in older patients undergoing lower limb major arthroplasty: a prospective, double-blind, pilot, randomised controlled trialChunyan Li0Jie Yang1He Liu2Wen Tan3Song Zhang4Hongxing Zhang5Yuan Han6Mingshu Tao7Rongguang Liu8Jiaxing Fang9Dexian Chen10Qi Wei11Xingyu Xiong12Wenxin Zhao13Junli Cao141Shandong Provincial Hospital, Gynecology, Jinan, ChinaDepartment of Neurology, Xinqiao Hospital and the Second Affiliated Hospital of Army Medical University, Chongqing, China5 Department of Anesthesiology & Clinical Research Center for Anesthesia and Perioperative Medicine & Huzhou Key Laboratory of Basic Research and Clinical Translation for Neuromodulation, The Fifth School of Clinical Medicine of Zhejiang Chinese Medical University || Huzhou Central Hospital || The Affiliated Huzhou Hospital, Zhejiang University School of Medicine || Affiliated Central Hospital Huzhou University, Huzhou, Zhejiang, China1 Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China6 Department of Anesthesiology, Renji Hospital School of Medicine, Shanghai Jiao Tong University, Shanghai, China3 Department of Psychiatry, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan, China4 Department of Anesthesiology, Eye & ENT Hospital of Fudan University, Shanghai, China3 NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs & Jiangsu Province Key Laboratory of Anesthesiology & Jiangsu Key Laboratory of Applied Technology of Anesthesia and Analgesia, Xuzhou Medical University, Xuzhou, Jiangsu, China1 Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China1 Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China1 Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China3 NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs & Jiangsu Province Key Laboratory of Anesthesiology & Jiangsu Key Laboratory of Applied Technology of Anesthesia and Analgesia, Xuzhou Medical University, Xuzhou, Jiangsu, China1 Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China2 Shandong University of Traditional Chinese Medicine First Clinical Medical College, Jinan, Shandong, China1 Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, ChinaBackground Postoperative sleep disturbance (PSD) is a common and serious postoperative complication and is associated with poor postoperative outcomes.Aims This study aimed to investigate the effect of transcranial direct current stimulation (tDCS) on PSD in older patients undergoing lower limb major arthroplasty.Methods In this prospective, double-blind, pilot, randomised, sham-controlled trial, patients 65 years and over undergoing lower limb major arthroplasty were randomly assigned to receive active tDCS (a-tDCS) or sham tDCS (s-tDCS). The primary outcomes were the objective sleep measures on postoperative nights (N) 1 and N2.Results 116 inpatients were assessed for eligibility, and a total of 92 patients were enrolled; 47 received a-tDCS and 45 received s-tDCS. tDCS improved PSD by altering the following sleep measures in the a-tDCS and s-tDCS groups; the respective comparisons were as follows: the promotion of rapid eye movement (REM) sleep time on N1 (64.5 (33.5–105.5) vs 19.0 (0.0, 45.0) min, F=20.10, p<0.001) and N2 (75.0 (36.0–120.8) vs 30.0 (1.3–59.3) min, F=12.55, p<0.001); the total sleep time on N1 (506.0 (408.0–561.0) vs 392.0 (243.0–483.5) min, F=14.13, p<0.001) and N2 (488.5 (455.5–548.5) vs 346.0 (286.5–517.5) min, F=7.36, p=0.007); the deep sleep time on N1 (130.0 (103.3–177.0) vs 42.5 (9.8–100.8) min, F=24.4, p<0.001) and N2 (103.5 (46.0–154.8) vs 57.5 (23.3–106.5) min, F=8.4, p=0.004); and the percentages of light sleep and REM sleep on N1 and N2 (p<0.05 for each). The postoperative depression and anxiety scores did not differ significantly between the two groups. No significant adverse events were reported.Conclusion In older patients undergoing lower limb major arthroplasty, a single session of anodal tDCS over the left dorsolateral prefrontal cortex showed a potentially prophylactic effect in improving postoperative short-term objective sleep measures. However, this benefit was temporary and was not maintained over time.https://gpsych.bmj.com/content/37/2/e101173.full |
| spellingShingle | Chunyan Li Jie Yang He Liu Wen Tan Song Zhang Hongxing Zhang Yuan Han Mingshu Tao Rongguang Liu Jiaxing Fang Dexian Chen Qi Wei Xingyu Xiong Wenxin Zhao Junli Cao Effect of transcranial direct current stimulation on postoperative sleep disturbance in older patients undergoing lower limb major arthroplasty: a prospective, double-blind, pilot, randomised controlled trial General Psychiatry |
| title | Effect of transcranial direct current stimulation on postoperative sleep disturbance in older patients undergoing lower limb major arthroplasty: a prospective, double-blind, pilot, randomised controlled trial |
| title_full | Effect of transcranial direct current stimulation on postoperative sleep disturbance in older patients undergoing lower limb major arthroplasty: a prospective, double-blind, pilot, randomised controlled trial |
| title_fullStr | Effect of transcranial direct current stimulation on postoperative sleep disturbance in older patients undergoing lower limb major arthroplasty: a prospective, double-blind, pilot, randomised controlled trial |
| title_full_unstemmed | Effect of transcranial direct current stimulation on postoperative sleep disturbance in older patients undergoing lower limb major arthroplasty: a prospective, double-blind, pilot, randomised controlled trial |
| title_short | Effect of transcranial direct current stimulation on postoperative sleep disturbance in older patients undergoing lower limb major arthroplasty: a prospective, double-blind, pilot, randomised controlled trial |
| title_sort | effect of transcranial direct current stimulation on postoperative sleep disturbance in older patients undergoing lower limb major arthroplasty a prospective double blind pilot randomised controlled trial |
| url | https://gpsych.bmj.com/content/37/2/e101173.full |
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