The Effects of Transcranial Direct Current Stimulation on Mental Health of Veterans with Psychiatric Disorders

IntroductionDepression is among the most widespread psychiatric disorders in France. Psychiatric disorders are associated with considerable social costs, amounting to €22.6 billion for treatment and psychotropic medication in 2011. Treatment as usual (TAU), mainly consisting of pharmacotherapy and psychotherapy, is effective for only a third of patients and in most cases fails to prevent treatment resistance and chronicity. Transcranial direct current stimulation (tDCS) consists in a non-invasive and painless application of low-intensity electric current to the cerebral cortex through the scalp. Having proved effective in depressed patients, it could be used in combination with TAU to great advantage. The objective is to compare, for the first time ever, the cost-utility of tDCS-TAU and of TAU alone for the treatment of a depressive episode that has been refractory to one or two drug treatments.Methods and analysisThis paper, based on the DISCO study protocol, focuses on the design of a prospective, randomised, controlled, open-label multicentre economic study to be conducted in France. It will include 214 patients with unipolar or bipolar depression, assigning them to two parallel arms: group A (tDCS-TAU) and group B (TAU alone). The primary outcome is the incremental cost-effectiveness ratio, that is, the ratio of the difference in cost between each strategy to the difference in their effects. Their effects will be expressed as numbers of quality-adjusted life-years, determined through administration of the EuroQol Five-Dimension questionnaire over a 12-month period to patients (EQ-5D-5L). Expected benefits are the reduction of treatment resistance and suicidal ideation as well as social and professional costs of depression. Should depression-related costs fall significantly, tDCS might be considered an efficient treatment for depression.Ethics and disseminationThis protocol has been approved by a French ethics committee, the CPP-–Est IV (Comité de Protection des Personnes–Strasbourg). Data are to be published in peer-reviewed medical journals.Trial registration numberRCB 2018-A00474-51;NCT03758105

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Transcranial direct current stimulation – possible therapeutic applications in psychiatric disorders in adults and children

Family Medicine & Primary Care Review ◽

10.5114/fmpcr/60386 ◽

2015 ◽

Vol 4 ◽

pp. 341-346

Author(s):

Anna Poleszczyk ◽

Anna Zofia Antosik-Wójcińska

Keyword(s):

Psychiatric Disorders ◽

Direct Current ◽

Transcranial Direct Current Stimulation ◽

Direct Current Stimulation ◽

Therapeutic Applications ◽

Adults And Children

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Neurobiological Mechanisms of Transcranial Direct Current Stimulation for Psychiatric Disorders; Neurophysiological, Chemical, and Anatomical Considerations

Frontiers in Human Neuroscience ◽

10.3389/fnhum.2021.631838 ◽

2021 ◽

Vol 15 ◽

Author(s):

Yuji Yamada ◽

Tomiki Sumiyoshi

Keyword(s):

Psychiatric Disorders ◽

Direct Current ◽

Transcranial Direct Current Stimulation ◽

Cortical Excitability ◽

Long Term Potentiation ◽

Brain Network ◽

Therapeutic Effects ◽

Gamma Aminobutyric Acid ◽

Processing Efficiency ◽

Direct Current Stimulation

Backgrounds: Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique for the treatment of several psychiatric disorders, e.g., mood disorders and schizophrenia. Therapeutic effects of tDCS are suggested to be produced by bi-directional changes in cortical activities, i.e., increased/decreased cortical excitability via anodal/cathodal stimulation. Although tDCS provides a promising approach for the treatment of psychiatric disorders, its neurobiological mechanisms remain to be explored.Objectives: To review recent findings from neurophysiological, chemical, and brain-network studies, and consider how tDCS ameliorates psychiatric conditions.Findings: Enhancement of excitatory synaptic transmissions through anodal tDCS stimulation is likely to facilitate glutamate transmission and suppress gamma-aminobutyric acid transmission in the cortex. On the other hand, it positively or negatively modulates the activities of dopamine, serotonin, and acetylcholine transmissions in the central nervous system. These neural events by tDCS may change the balance between excitatory and inhibitory inputs. Specifically, multi-session tDCS is thought to promote/regulate information processing efficiency in the cerebral cortical circuit, which induces long-term potentiation (LTP) by synthesizing various proteins.Conclusions: This review will help understand putative mechanisms underlying the clinical benefits of tDCS from the perspective of neurotransmitters, network dynamics, intracellular events, and related modalities of the brain function.

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Enhancing Reappraisal of Negative Emotional Memories With Transcranial Direct Current Stimulation

10.21203/rs.3.rs-140343/v1 ◽

2021 ◽

Author(s):

Nadja Doerig ◽

Rosa Bohlender ◽

Marius Moisa ◽

Erich Seifritz ◽

Christian Ruff ◽

...

Keyword(s):

Psychiatric Disorders ◽

Direct Current ◽

Transcranial Direct Current Stimulation ◽

Well Being ◽

Current Treatment ◽

Direct Current Stimulation ◽

Negative Valence ◽

Emotional Memories ◽

Dorsolateral Prefrontal ◽

The Right

Abstract Reappraisal of negative memories and experiences is central for mental health and well-being. Deficiency of reappraisal lies at the core of many psychiatric disorders and is a key target for treatment. Here we apply transcranial direct current stimulation (tDCS) to enhance reappraisal of negative emotional memories. In a randomized, sham-controlled, 2x2 between-subject and double-blinded study, we applied single sessions of anodal and sham tDCS over the right dorsolateral prefrontal cortex (DLPFC) of 101 healthy participants while reappraising a personal negative memory or engaging in a control task. We hypothesized that (i) reappraisal decreases negative valence, arousal and evaluations of the memory and leads to improved decision making, and (ii) tDCS leads to additional changes in these reappraisal outcomes. In line with these hypotheses, participants’ personal memories were rated as less negative and less arousing following reappraisal. Anodal tDCS stimulation during reappraisal was associated with significant additional reductions in negative valence compared to sham stimulation. Our results indicate that tDCS may enhance some of the effects of reappraisal. If replicated, our findings suggest potential benefits elicited by tDCS stimulation that may help to optimize current treatment approaches for psychiatric disorders.

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