Follow-up effects of transcranial direct current stimulation (tDCS) for the major depressive episode: A systematic review and meta-analysis

Author(s)

Razza, Lais B. ^[1] ; De Smet, Stefanie ^{[2, 3]} ; Moffa, Adriano ^{[4, 5]} ; Sudbrack-Oliveira, Pedro ^[1] ; Vanderhasselt, Marie-Anne ^{[6, 2, 3]} ; Brunoni, Andre R. ^{[1, 7]}

Affiliation

^[1] Univ Sao Paulo, Fac Med, Serv Interdisciplinar Neuromodulacao, Clin Hosp, Lab Neurociencias LIM27, Dept & Inst Psiquiatria, Sao Paulo - Brazil

^[2] Ghent Expt Psychiat GHEP Lab, Ghent - Belgium

^[3] Univ Ghent, Ghent Univ Hosp, Dept Head & Skin Psychiat & Med Psychol, Ghent - Belgium

^[4] Black Dog Inst, Sydney, NSW - Australia

^[5] Univ New South Wales, Sch Psychiat, Sydney, NSW - Australia

^[6] Univ Ghent, Dept Expt Clin & Hlth Psychol, Ghent - Belgium

^[7] Univ Sao Paulo, Univ Sao Paulo & Hosp Univ, Dept Med Interna, Fac Med, Av Prof Lineu Prestes 2565, BR-05508000 Sao Paulo - Brazil

• Document type: Review article
• Source: PSYCHIATRY RESEARCH; v. 302, AUG 2021.
• Web of Science Citations: 0

Abstract

Transcranial Direct Current Stimulation (tDCS) is an effective treatment during the acute phase of a major depressive episode (MDE), although the evidence for its follow-up efficacy is mixed. A systematic review and meta-analysis were performed. MEDLINE/PubMed, Scopus (EMBASE), Web of Science, Cochrane Library and additional sources were searched from inception to April 29, 2021. Studies that followed up adults treated with tDCS during an MDE - using (interventional) and/or not using (observational) tDCS in the follow-up period were included. The primary outcome was the Hedges' g for the follow-up depression scores. Small study effects and sources of heterogeneity were explored. 427 studies were retrieved and 11 trials (13 datasets, n = 311) were included, most presenting moderate bias. Results showed a follow-up depression improvement (k = 13, g = -0.81, 95% confidence interval {[}CI]: -1.28; -0.34, I-2 = 84.0%), which was probably driven by the interventional studies (k = 7, g = -1.12, 95% CI: -1.84; -0.40, I-2 = 87.1%). No predictor of response was associated with the outcome. No risk of publication bias was found. Significant between-study heterogeneity may have influenced the overall results. Our findings suggest that tDCS produces effects beyond the intervention period during MDEs. Maintenance sessions are advised in future research. (AU)

• FAPESP's process: 19/06009-6 - Non-implantable neuromodulation therapies: a perspective for the depressed brain
• Grantee: Geraldo Busatto Filho
• Support Opportunities: Research Projects - Thematic Grants
• FAPESP's process: 19/10760-9 - Circadian variability of motor cortex excitability in patients with Mesial Temporal Lobe Epilepsy: a Transcranial Magnetic Stimulation (TMS) study
• Grantee: Pedro Sudbrack Oliveira
• Support Opportunities: Scholarships in Brazil - Doctorate
• FAPESP's process: 19/07256-7 - Cerebral alteration perfusion induced by transcranial stimulation of the prefrontal cortex: a randomized, placebo-controlled study, using 99mTc SPECT
• Grantee: Lais Boralli Razza
• Support Opportunities: Scholarships in Brazil - Doctorate (Direct)
• FAPESP's process: 18/10861-7 - A Phase-I bilateral project using a sham-controlled, factorial design of transcranial direct current stimulation and theta-burst stimulation to investigate the effects on multimodal assessments of prefrontal cortex functioning
• Grantee: Andre Russowsky Brunoni
• Support Opportunities: Regular Research Grants