| Texto completo | |
| Autor(es): Mostrar menos - |
Aparicio, Luana V. M.
;
Luethi, Matthias S.
;
Borrione, Lucas
;
Moran, Natasha K. S.
;
Cavendish, Beatriz A.
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Silva, Valquiria A.
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Valiengo, Leandro
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Goerigk, Stephan
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Padberg, Frank
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Razza, Lais B.
;
Vidal, Kallene S. M.
;
Brunoni, Andre R.
Número total de Autores: 12
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| Tipo de documento: | Artigo Científico |
| Fonte: | Journal of Affective Disorders; v. 394, p. 8-pg., 2025-11-03. |
| Resumo | |
Background: Transcranial direct current stimulation (tDCS) has demonstrated antidepressant efficacy, but optimal strategies for long-term maintenance remain unexplored. While clinic-based maintenance tDCS poses adherence and logistical challenges, home-based protocols may improve accessibility and prevent attrition. Objective: To evaluate the efficacy and safety of home-based tDCS for relapse prevention in patients with major depressive disorder (MDD) during the maintenance phase of the PSYLECT trial. Methods: Following the randomized controlled trial (Phase I, n = 210) and open-label crossover (Phase II), responders (>= 50 % improvement in Hamilton Depression Rating Scale scores) were enrolled in Phase III: a 6month, open-label continuation protocol involving twice-weekly home-based tDCS sessions (2 mA, 30 min, F3-F4 montage) with or without digital behavioral therapy (BT). The primary outcome was time to relapse, analyzed using Kaplan-Meier survival curves. Cox regression assessed predictors of relapse. Results: Seventy-one patients (mean age 37.9 +/- 9.0 years; 89 % female) were included in Phase III. At 24 weeks, 75 % (95 % CI, 64.2-82.8) remained without relapse or discontinuation, while survival without relapse alone was 82 %. Six participants (8.5 %) relapsed, and 11 (15.5 %) discontinued. No significant predictors of relapse were identified, nor did BT significantly enhance survivability. Adverse events were predominantly mild; most common were transient scalp itching (21 %) and headaches (18 %), while 40 % of participants reported no adverse events by month 6. Conclusion: Home-based maintenance tDCS was safe, feasible, and led to clinically meaningful relapse prevention comparable to clinic-based protocols. Its advantages in terms of scalability, cost-effectiveness and accessibility support its potential as a maintenance strategy for MDD. (AU) | |
| Processo FAPESP: | 19/06009-6 - Terapias de neuromodulação não-implantáveis: uma perspectiva para o cérebro deprimido |
| Beneficiário: | Geraldo Busatto Filho |
| Modalidade de apoio: | Auxílio à Pesquisa - Temático |
| Processo FAPESP: | 21/10574-0 - Aumento de acurácia prognóstica em pacientes deprimidos utilizando diferentes intervenções de neuromodulação não-implantáveis |
| Beneficiário: | Matthias Stephan Luthi |
| Modalidade de apoio: | Bolsas no Brasil - Pós-Doutorado |