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. 2024 Mar 8;37(2):e101338.
doi: 10.1136/gpsych-2023-101338. eCollection 2024.

Brain-wide activation involved in 15 mA transcranial alternating current stimulation in patients with first-episode major depressive disorder

Jie Wang  1   2 , Wenfeng Zhao  3 , Huang Wang  3 , Haixia Leng  3 , Qing Xue  3 , Mao Peng  3 , Baoquan Min  3 , Xiukun Jin  3 , Liucen Tan  3 , Keming Gao  4   5 , Hongxing Wang  3   6   7
Affiliations

Brain-wide activation involved in 15 mA transcranial alternating current stimulation in patients with first-episode major depressive disorder

Jie Wang et al. Gen Psychiatr. .

Abstract

Background: Although 15 mA transcranial alternating current stimulation (tACS) has a therapeutic effect on depression, the activations of brain structures in humans accounting for this tACS configuration remain largely unknown.

Aims: To investigate which intracranial brain structures are engaged in the tACS at 77.5 Hz and 15 mA, delivered via the forehead and the mastoid electrodes in the human brain.

Methods: Actual human head models were built using the magnetic resonance imagings of eight outpatient volunteers with drug-naïve, first-episode major depressive disorder and then used to perform the electric field distributions with SimNIBS software.

Results: The electric field distributions of the sagittal, coronal and axial planes showed that the bilateral frontal lobes, bilateral temporal lobes, hippocampus, cingulate, hypothalamus, thalamus, amygdala, cerebellum and brainstem were visibly stimulated by the 15 mA tACS procedure.

Conclusions: Brain-wide activation, including the cortex, subcortical structures, cerebellum and brainstem, is involved in the 15 mA tACS intervention for first-episode major depressive disorder. Our results indicate that the simultaneous involvement of multiple brain regions is a possible mechanism for its effectiveness in reducing depressive symptoms.

Keywords: Cerebellum; Depression.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Schematic view of the transcranial alternating current stimulation (tACS) protocol. (A) Stimulation configuration. Three electrodes were used: one was connected to the electrode over the forehead (15 mA, Fp1, Fpz, Fp2) and two were connected to the electrodes over the left and right mastoids (7.5 mA for each side). At a specific moment, the red electrode was the anode, and the blue return electrodes were the cathode (vice versa). (B) Active stimulation paradigm. Ramp-in and ramp-out were 180 and 12 s, respectively, with 2400 s of active stimulation for 77.5 Hz tACS. The forehead and both mastoid areas were at opposite phase at any given point during stimulation.
Figure 2
Figure 2
Procedure of the depression diagnosis and clinical treatment in our study. tACS, transcranial alternating current stimulation. MRI, magnetic resonance imaging.
Figure 3
Figure 3
Electric field distributions in the average brain. (A) The electric field distribution on the surface of brain tissue from five angles. (B–D) The electric field distributions were illustrated in different directions, such as the sagittal plane (B), the coronal plane (C) and the axial plane (D), respectively. All sections were through the brainstem. The colour scale was ranged from 0 V/m (blue) to 4 V/m (red).
Figure 4
Figure 4
The one-circle intracranial electrical activity (energy density: J/m3) induced by 77.5 Hz, 15 mA transcranial alternating current stimulation.
See this image and copyright information in PMC

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