A pilot study on effect of adjunctive transcranial direct current stimulation on symptom domains of depression in patients with depressive disorder
- PMID: 35017816
- PMCID: PMC8709522
- DOI: 10.4103/ipj.ipj_38_20
A pilot study on effect of adjunctive transcranial direct current stimulation on symptom domains of depression in patients with depressive disorder
Abstract
Background: Depression is a highly prevalent condition and includes clusters of symptoms, namely, depressive cognition, anxiety, and visceral symptoms. Depressive symptoms often respond sub-optimally to pharmacotherapy. Adjunctive transcranial direct current stimulation (tDCS), a noninvasive brain stimulation modality, may improve depressive symptomatology.
Aim: The aim of this study was to study the effect of tDCS as an augmentation strategy in depression and its various symptom domains.
Materials and methods: It is a prospective interventional study. Patients diagnosed with depressive disorder (based on International Classification of Disease- 10 criteria, diagnosed by treating psychiatrist), aged 18-70 years, who showed inadequate improvement on antidepressant selective serotonin reuptake inhibitors, were recruited after informed consent. Each participant was administered 20 sessions of tDCS over 2 weeks, each session of 20 min, with anode placement at left dorsolateral prefrontal cortex and cathode at right supraorbital region. Hamilton Rating Scale for Depression (HAM-D) was administered pre- and post-intervention to assess the change in symptoms.
Results: Of a total of 35 participants, the mean score on HAM-D prior to and postintervention was 19.97 (standard deviation [SD] = 3.519) and 13.17 (SD = 3.365), respectively. The difference was statistically highly significant (P = 0.000) on paired t-test. All symptom domains of HAM-D, identified using the Cole and Motivala model (Cole et al., 2004), also showed significant reduction from pre-tDCS to post-tDCS scores (P = 0.000).
Conclusion: Positive effect of tDCS on depressive symptoms, its tolerability and safety profile, and affordability makes it an effective therapeutic strategy in augmenting antidepressants in patients with depression. However, longer period studies with larger sample size may yield more generalizable results.
Keywords: Adjunctive; Hamilton Rating Scale for Depression; depression; transcranial direct current stimulation.
Copyright: © 2021 Industrial Psychiatry Journal.
Conflict of interest statement
There are no conflicts of interest.
Similar articles
-
Bifrontal-transcranial direct current stimulation as an early augmentation strategy in major depressive disorder: A single-blind randomised controlled trial.Asian J Psychiatr. 2023 Aug;86:103637. doi: 10.1016/j.ajp.2023.103637. Epub 2023 May 22. Asian J Psychiatr. 2023. PMID: 37270874 Clinical Trial.
-
PsychotherapyPlus: augmentation of cognitive behavioral therapy (CBT) with prefrontal transcranial direct current stimulation (tDCS) in major depressive disorder-study design and methodology of a multicenter double-blind randomized placebo-controlled trial.Eur Arch Psychiatry Clin Neurosci. 2018 Dec;268(8):797-808. doi: 10.1007/s00406-017-0859-x. Epub 2017 Dec 6. Eur Arch Psychiatry Clin Neurosci. 2018. PMID: 29214483
-
The Neurostimulation of the Brain in Depression Trial: Protocol for a Randomized Controlled Trial of Transcranial Direct Current Stimulation in Treatment-Resistant Depression.JMIR Res Protoc. 2021 Mar 17;10(3):e22805. doi: 10.2196/22805. JMIR Res Protoc. 2021. PMID: 33729165 Free PMC article.
-
Novel Augmentation Strategies in Major Depression.Dan Med J. 2017 Apr;64(4):B5338. Dan Med J. 2017. PMID: 28385173 Review.
-
Is transcranial direct current stimulation, alone or in combination with antidepressant medications or psychotherapies, effective in treating major depressive disorder? A systematic review and meta-analysis.BMC Med. 2021 Dec 17;19(1):319. doi: 10.1186/s12916-021-02181-4. BMC Med. 2021. PMID: 34915885 Free PMC article.
Cited by
-
Effectiveness and tolerability of adjunctive transcranial direct current stimulation (tDCS) in management of treatment-resistant depression: A retrospective chart review.Indian J Psychiatry. 2024 Jun;66(6):538-544. doi: 10.4103/indianjpsychiatry.indianjpsychiatry_243_24. Epub 2024 Jun 19. Indian J Psychiatry. 2024. PMID: 39100375 Free PMC article.
References
-
- World Health Organization. Depression and Other Common Mental Disorders: Global Health Estimates. Geneva: World Health Organization; 2017.
-
- Gururaj G, Varghese M, Benegal V, Rao GN, Pathak K, Singh LK, et al. National Mental Health Survey of India, 2015- 16: Prevalence, patterns and outcomes. Bengaluru, National Institute of Mental Health and Neuro Sciences, NIMHANS Publication No. 129. 2016
-
- Rush AJ, Trivedi MH, Wisniewski SR, Nierenberg AA, Stewart JW, Warden D, et al. Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps: A STAR*D report. Am J Psychiatry. 2006;163:1905–17. - PubMed
-
- Rush AJ, Warden D, Wisniewski SR, Fava M, Trivedi MH, Gaynes BN, et al. STAR*D: Revising conventional wisdom. CNS Drugs. 2009;23:627–47. - PubMed
-
- Culpepper L. Functional impairment and improvement in depression. J Clin Psychiatry. 2016;77:e35. - PubMed
LinkOut - more resources
Full Text Sources