Transcranial direct current stimulation for the outpatient treatment of poor-responder depressed patients

2012 ◽  
Vol 27 (7) ◽  
pp. 513-517 ◽  
Author(s):  
B. Dell’Osso ◽  
S. Zanoni ◽  
R. Ferrucci ◽  
M. Vergari ◽  
F. Castellano ◽  
...  

AbstractTranscranial direct current stimulation (tDCS) is a selective, painless, brain stimulation technique that allows the electric stimulation of specific cortical regions. TDCS has been recently used as investigational intervention for major depression and treatment resistant depression (TRD) with encouraging results. The present study was aimed to investigate the efficacy and tolerability of tDCS in major depressives with poor response to pharmacological treatment. Twenty-three depressed patients, with a diagnosis of major depressive disorder or bipolar disorder, were treated with augmentative tDCS for 5 days, two sessions per day in a blind-rater trial. The course of depressive symptoms was analyzed using repeated measures ANOVA for HAM-D and MADRS total scores. A qualitative analysis on the basis of the HAM-D response was performed as well. Both analyses were conducted at three time-points: T0 (baseline), T1 (endpoint tDCS) and T2 (end of the first week of follow-up). All patients completed the trial without relevant side-effects. A significant reduction of HAM-D and MADRS total scores was observed during the study (P<0.0001). Treatment response (endpoint HAM-D reduction ≥50%) was obtained by four patients (17.4%) at T1 and by seven patients (30.4%) at T2 and remission (endpoint HAM-D<8) by three patients (13.0%) at T1 and by four subjects (17.4%) at T2. Present findings support the efficacy and good tolerability of tDCS in the acute treatment of patients with TRD with clinical benefit being progressive and extended to the first week of follow-up. Further sham-controlled trials with longer follow-up are needed to confirm present results.

CNS Spectrums ◽  
2013 ◽  
Vol 19 (4) ◽  
pp. 347-354 ◽  
Author(s):  
Bernardo Dell'Osso ◽  
Cristina Dobrea ◽  
Chiara Arici ◽  
Beatrice Benatti ◽  
Roberta Ferrucci ◽  
...  

ObjectivesTranscranial direct current stimulation (tDCS) is a non-invasive neurostimulation technique that has received increasing interest in the area of mood disorders over the last several years. While acute, double-blind, sham-controlled studies have already reported positive findings in terms of efficacy and safety for tDCS, follow-up data are lacking. This need prompted the present follow-up study, which assesses post-acute effects of tDCS (no maintenance stimulation was performed), in the mid-term, in a sample of major depressives.MethodsAfter completing an acute, open trial of tDCS, 23 outpatients with either major depressive disorder or bipolar disorder entered a naturalistic follow-up (T1) with clinical evaluations at one week (T2), 1 month (T3), and 3 months (T4). A quantitative analysis of Hamilton Depression Rating Scale (HAM-D), Montgomery–Asberg Depression Rating Scale (MADRS), and Young Mania Rating Scale (YMRS) total scores, through repeated measures analysis of variance (ANOVA) (T1–T4) and paired t-test for comparing specific time points (T1–T2, T2–T3, and T3–T4), was performed. In addition, a qualitative analysis on the basis of treatment response and remission (HAM-D) was performed.ResultsEven though a progressive reduction of follow-up completers was observed from T2 to T4 (95.6% at T2, 65.2% at T3, and 47.8% at T4), the antidepressant effects of acute tDCS persisted over 3 months in almost half of the sample. Of note, no post-acute side effects emerged during the follow-up observation. The most frequent causes of drop-out from this study included major modifications in therapeutic regimen (30%) and poor adherence to follow-up visits (17%).ConclusionsIn this mid-term, open, follow-up study, tDCS showed mixed results. Further controlled studies are urgently needed to assess its effects beyond the acute phase.


2020 ◽  
pp. 1-13
Author(s):  
Raed A. Alharbi ◽  
Saleh A. Aloyuni ◽  
Faizan Kashoo ◽  
Mohamed I. Waly ◽  
Harpreet Singh ◽  
...  

Abstract Objective: Infantile hemiplegia due to brain injury is associated with poor attention span, which critically affects the learning and acquisition of new skills, especially among children with left-sided infantile hemiplegia (LSIH). This study aimed to improve the selective visual attention (SVA) of children with LSIH through transcranial direct current stimulation (tDCS). Methods: A total of 15 children participated in this randomized, double-blinded, pilot study; of them, 10 experienced LSIH, and the remaining 5 were healthy age-matched controls. All the children performed the Computerized Stroop Color-Word Test (CSCWT) at baseline, during the 5th and 10th treatment sessions, and at follow-up. The experimental (n = 5) and control groups (n = 5) received tDCS, while the sham group (n = 5) received placebo tDCS. All three groups received cognitive training on alternate days, for 3 weeks, with the aim to improve SVA. Results: Two-way repeated measures analysis of variance (ANOVA) showed a statistically significant change in the mean scores of CSCWT between time points (baseline, 5th and 10th sessions, and follow-up) within-subject factor, group (experimental, sham) between-subject factor and interaction (time points X group) (p < 0.005). Furthermore, a one-way repeated measures ANOVA showed significant differences between time point (p < 0.005) for the experimental and control group but not the sham group. Conclusion: These pilot results suggest that future research should be conducted with adequate samples to enable conclusions to be drawn.


2021 ◽  
pp. 003151252110212
Author(s):  
Alexandre Moreira ◽  
Daniel Gomes da Silva Machado ◽  
Marom Bikson ◽  
Gozde Unal ◽  
Paul S. Bradley ◽  
...  

This study investigated the effect of transcranial direct current stimulation (tDCS) combined with a recovery training session on the well-being and self-perceived recovery of professional female soccer players after official matches. Data from 13 world-class players were analyzed after participating in four official soccer matches of the first division of the Brazilian Women’s Soccer Championship (7-, 10-, and 13-day intervals). We applied anodal tDCS (a-tDCS) over the left dorsolateral prefrontal cortex with 2 mA for 20 minutes (+F3/−F4 montage) the day after each match. Participants underwent two randomly ordered sessions of a-tDCS or sham. Players completed the Well-Being Questionnaire (WBQ) and the Total Quality Recovery (TQR) scale before each experimental condition and again the following morning. A two-way repeated-measures ANOVA showed a significant time x condition interaction on the WBQ (F(1,11)=5.21; p=0.043; ηp2=0.32), but not on the TQR (F(1,12) = 0.552; p = 0.47; ηp2 = 0.044). There was a large effect size (ES) for a-tDCS for the WBQ score (ES = 1.02; 95%CI = 0.17;1.88), and there was a moderate WBQ score increase (ES = 0.53; 95%CI = −0.29;1.34) for the sham condition. We found similar increases in the TQR score for a-tDCS (ES = 1.50; 95%CI = 0.63–2.37) and the sham condition (ES = 1.36; 95%CI = 0.51–2.22). These results suggest that a-tDCS (+F3/−F4 montage) combined with a recovery training session may slightly improve perceived well-being beyond the level of improvement after only the recovery training session among world-class female soccer players. Prior to widely adopting this recovery approach, further study is needed with larger and more diverse samples, including for female teams of different performance levels.


Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Suzanne Babyar ◽  
Taiza Santos-Pontelli ◽  
Tenysson Will-Lemos ◽  
Suleimy Mazin ◽  
Dylan Edwards ◽  
...  

Objective: To assess the effects of 2mA transcranial Direct Current Stimulation (tDCS) over the affected Parietal-Insular-Vestibular Cortex (PIVC) on seated posture of patients with lateropulsion following stroke. We hypothesized that bilateral electrode placement over PIVC (vs active control) would produce a change in seated posture. Background: Lateropulsion following stroke (Pusher Syndrome) is characterized by lateral displacement of subjective postural vertical toward the weak side. It is caused by lesions affecting vestibular projections to the Ventral Lateral Thalamus (VLT) or projections from the VLT to the Parietal-Insular-Vestibular Cortex (PIVC). Methods: Seventeen subjects with Burke Lateropulsion Scale scores ≥ 2 within 30 days of an ischemic stroke signed an IRB-approved consent. They received 2mA tDCS delivered using 25cm 2 saline soaked sponge electrodes via one of two montages: Test (anode over the affected PIVC and cathode opposite PIVC) versus Active Control (anode over the affected PIVC and cathode over the opposite supra-orbital region). PIVC was defined using EEG 10/20 coordinates. Seated medial-lateral center of pressure (COP-X) was measured using a custom-designed chair mounted on an AMTI™ analog-to-digital forceplate. An inclinometer strapped to the chest and aligned with the sternum measured lateral trunk tilt. Data were collected prior to, then at 5, 10, and 15 minutes during tDCS and 5 min following tDCS. Results: Repeated Measures Analysis of Variance rejected the hypothesis of an interaction between Montage and Time for: mean COP-X displacement (in) (Wilks’ λ F = 0.647 df =(4, 13), P = 0.639); mean speed of COP-X (in/s) (Wilks’ λ F = 0.740 df =(4, 13), P =0.581); mean inclinometer tilt (degrees) (Wilks’ λ F = 0.740 df =(4, 13), P =0.581). Conclusion: Neither tDCS montage showed improvement in COP-X displacement, COP-X movement velocity or inclinometer readings. These negative results are important to encourage the development of alternative tDCS stimulation parameters or identification of alternative cortical or vestibular tDCS targets for the treatment of Lateropulsion Following Stroke.


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