Cognitive changes after tDCS and escitalopram treatment in major depressive disorder: Results from the placebo-controlled ELECT-TDCS trial

Author(s):Show less -

Moreno, Marina L. ^{[1, 2, 3, 4, 5]} ; Goerigk, Stephan A. ^{[6, 7, 8]} ; Bertola, Laiss ^{[1, 5]} ; Suemoto, Claudia K. ^{[1, 5]} ; Razza, Lais B. ^{[2, 3, 4]} ; Moffa, Adriano H. ^{[2, 3, 4, 9]} ; Veronezi, Beatriz P. ^{[1, 5]} ; Tort, Luara ^{[1, 2, 3, 4, 5]} ; Nogueira, Barbara S. ^{[1, 5]} ; Gattaz, Wagner F. ^{[2, 3, 4]} ; Fraguas, Renerio ^{[2, 3, 4]} ; Padberg, Frank ^[6] ; Lotufo, Paulo A. ^{[1, 5]} ; Bensenor, Isabela M. ^{[1, 5]} ; Brunoni, Andre R. ^{[1, 2, 3, 4, 5]}

Affiliation

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

^[2] Univ Sao Paulo, Fac Med, Dept & Inst Psiquiatria, Sao Paulo - Brazil

^[3] Univ Sao Paulo, Lab Neurosci LIM27, Sao Paulo - Brazil

^[4] Univ Sao Paulo, Natl Inst Biomarkers Neuropsychiat, Sao Paulo - Brazil

^[5] Univ Sao Paulo, Dept Clin Med, Fac Med, Sao Paulo - Brazil

^[6] Ludwig Maximilians Univ Munchen, Dept Psychiat & Psychotherapy, Munich - Germany

^[7] Ludwig Maximilians Univ Munchen, Dept Psychol Methodol & Assessment, Leopoldstr 13, D-80802 Munich - Germany

^[8] Univ Appl Sci, Hsch Fresenius, Infanteriestr 11A, D-80797 Munich - Germany

^[9] Univ New South Wales, Sch Psychiat, Black Dog Inst, Sydney, NSW - Australia

• Document type: Journal article
• Source: Journal of Affective Disorders; v. 263, p. 344-352, FEB 15 2020.
• Web of Science Citations: 0

Abstract

Background: Cognitive deficits in major depressive disorder (MDD) are associated with low quality of life and higher suicide risk. Antidepressant drugs have modest to null effects in improving such deficits. Therefore, we investigated the cognitive effects of transcranial direct current stimulation (tDCS), which is a promising antidepressant non-pharmacological intervention, in MDD. Methods: An exploratory analysis on cognitive performance was conducted in 243 depressed patients from the Escitalopram vs. Electric Current Therapy for Treating Depression Clinical Study (ELECT-TDCS), a sham-controlled study comparing the efficacy of tDCS vs. escitalopram. A neuropsychological battery was applied at baseline and endpoint (10 weeks of treatment) to create composite cognitive scores (processing speed, working memory, and verbal fluency). Linear mixed regression models were used to evaluate changes according to intervention groups, adjusted for confounding variables (age, years of schooling, gender, and benzodiazepine use) and depression improvement. Results: No cognitive deterioration was observed in any group. Patients receiving tDCS presented reduced practice gains compared to placebo in processing speed. In patients receiving escitalopram vs. placebo and in the subgroup of clinical responders ( > 50% depression improvement from baseline), those receiving tDCS vs. placebo presented increased performance in verbal fluency. No significant differences between tDCS and escitalopram groups were detected. Limitations: Absence of healthy controls. Conclusion: Prefrontal tDCS did not lead to cognitive deficits in depressed patients, although it reduced practice effects in processing speed. tDCS responders presented increased performance in verbal fluency. Further investigation of tDCS cognitive effects in depression is warranted. (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