Transcranial direct current stimulation (tDCS) for preventing major depressive disorder relapse: Results of a 6-month follow-up

Author(s):Show less -

Aparicio, Luana V. M. ^{[1, 2]} ; Rosa, Vivianne ^{[1, 2]} ; Razza, Lais M. ^{[1, 2]} ; Sampaio-Junior, Bernardo ^{[1, 2]} ; Borrione, Lucas ^{[1, 2]} ; Valiengo, Leandro ^[2] ; Lotufo, Paulo A. ^[1] ; Bensenor, Isabela M. ^[1] ; Fraguas, Renerio ^{[1, 3]} ; Moffa, Adriano H. ^{[1, 4]} ; Gattaz, Wagner F. ^{[5, 6]} ; Brunoni, Andre Russowsky ^{[1, 5, 6, 2, 7]}

Affiliation

^[1] Univ Sao Paulo, Univ Hosp, Sao Paulo - Brazil

^[2] Univ Sao Paulo, Med Sch, Dept & Inst Psychiat, SIN, Sao Paulo - Brazil

^[3] Univ Sao Paulo, Med Sch, Dept & Inst Psychiat, Lab Psychiat Neuroimaging LIM 21, Sao Paulo - Brazil

^[4] Univ New South Wales, Black Dog Inst, Sch Psychiat, Sydney, NSW - Australia

^[5] Univ Sao Paulo, Med Sch, Dept & Inst Psychiat, Lab Neurosci LIM27, Sao Paulo - Brazil

^[6] Univ Sao Paulo, Med Sch, Dept & Inst Psychiat, Natl Inst Biomarkers Neuropsychiat INBioN, Sao Paulo - Brazil

^[7] Ludwig Maximilians Univ Munchen, Univ Hosp, Dept Psychiat & Psychotherapy, Munich - Germany

• Document type: Journal article
• Source: DEPRESSION AND ANXIETY; v. 36, n. 3, p. 262-268, MAR 2019.
• Web of Science Citations: 1

Abstract

BackgroundThe efficacy of transcranial direct current stimulation (tDCS) as a continuation therapy for the maintenance phase of the depressive episode is low and insufficiently investigated in literature. We investigated whether it could be enhanced by using a more intensive treatment regimen compared to previous reports. MethodsTwenty-four patients (16 with unipolar depression and eight with bipolar depression) who presented acute tDCS response (50% depression improvement in the Hamilton Depression Rating Scale {[}HDRS]) after receiving 15 tDCS sessions were followed for up to 6 months or until relapse, defined as clinical worsening and/or HDRS>15. Sessions were performed twice a week (maximum of 48 sessions) over 24weeks. The anode and the cathode were positioned over the left and right dorsolateral prefrontal cortex (2mA current, 30 min sessions were delivered). We performed Kaplan-Meier survival analysis and Cox proportional hazards ratios to evaluate predictors of relapse. ResultsOut of 24 patients, 18 completed the follow-up period. tDCS treatment was well tolerated. The mean survival duration was 17.5weeks (122 days). The survival rate at the end of follow-up was 73.5% (95% confidence interval, 50-87). A trend (P=0.09) was observed for lower relapse rates in nontreatment- vs. antidepressant treatment-resistant patients (7.7%vs. 45.5%, respectively). No differences in efficacy between unipolar and bipolar depression were observed. ConclusionAn intensive tDCS treatment regimen consisting of sessions twice a week achieved relatively low relapse rates after a 6-month follow up of tDCS responders, particularly for nontreatment-resistant patients. (AU)

• FAPESP's process: 12/20911-5 - Escitalopram and transcranial direct current stimulation in major depressive disorder: a double blind, placebo-controlled, randomized, non-inferiority trial
• Grantee: Andre Russowsky Brunoni
• Support Opportunities: Research Grants - Young Investigators Grants