Personalized High-Definition Transcranial Direct Current Stimulation Shows Benefit in Depression Patients
Personalized high-definition transcranial direct current stimulation (HD-tDCS) induced a significantly greater improvement in mood in patients with depression compared to those who underwent sham treatment, according to trial results published in JAMA Network Open.
With the goal of creating a more personalized, precise treatment approach, HD-tDCS is a newer form of tDCS that uses a combination of smaller electrodes and neuroimaging to locate patients’ optimal brain targets.
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“By honing in on the precise brain regions affected by depression, we've shown that stimulation can significantly improve mood and daily functioning,” said first author Mayank A. Jog, PhD, Department of Neurology, UCLA, Los Angeles, in a news release.
The trial included 71 participants with moderate to severe depression who were randomly assigned to receive 20 minutes of active (n=40) or sham (n=31) personalized HD-tDCS therapy for 12 consecutive working days. Researchers assessed the therapies’ effect on mood by measuring change in Hamilton Depression Rating Scale (HAMD) scores at baseline, midtreatment (visit 6), and posttreatment (visit 12).
The study found that the mean pretreatment to posttreatment change in HAMD score differed significantly between the active and sham treatment groups (group difference, −2.2 [4.3]; P = .04; Cohen d, −0.50 [95% CI, −0.99 to −0.01]). The active HD-tDCS therapy was associated with significantly greater decreases in HAMD score (active HD-tDCS group, −7.8 [4.2]; sham HD-tDCS group, −5.6 [4.4]) and was well-tolerated.
Additional analyses indicated that the active HD-tDCS therapy was also associated with a significant improvement in the anxiety dimension of the primary outcome measure (group difference, −0.68 [1.42]; P = .049; Cohen d, −0.48 [95% CI, −0.96 to −0.004]). “These observations provide preliminary evidence for investigating left dorsolateral prefrontal cortex (DLPFC) HD-tDCS therapy for anxiety,” the researchers wrote.
To address limitations of the study, the authors recommended that future research investigate the interactions between HD-tDCS and psychotropic medications and examine whether mood improvements can be sustained throughout a longer treatment period.
