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Transcranial direct current stimulation for the outpatient treatment of poor-responder depressed patients

Published online by Cambridge University Press:  15 April 2020

B. Dell’Osso ,
S. Zanoni ,
R. Ferrucci ,
M. Vergari ,
F. Castellano ,
N. D’Urso ,
C. Dobrea ,
B. Benatti ,
C. Arici  and
A. Priori
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B. Dell’Osso*
Affiliation:
Dipartimento di Neuroscienze, Università degli Studi di Milano, Dipartimento di Salute Mentale Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122Milano, Italy
S. Zanoni
Affiliation:
Dipartimento di Neuroscienze, Università degli Studi di Milano, Dipartimento di Salute Mentale Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122Milano, Italy
R. Ferrucci
Affiliation:
Centro Clinico per le Neuronanotecnologie e la Neurostimolazione, Università degli Studi di Milano, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milano, Italy U.O. Neurofisiopatologia, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milano, Italy
M. Vergari
Affiliation:
Centro Clinico per le Neuronanotecnologie e la Neurostimolazione, Università degli Studi di Milano, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milano, Italy U.O. Neurofisiopatologia, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milano, Italy
F. Castellano
Affiliation:
Dipartimento di Neuroscienze, Università degli Studi di Milano, Dipartimento di Salute Mentale Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122Milano, Italy
N. D’Urso
Affiliation:
Dipartimento di Neuroscienze, Università degli Studi di Milano, Dipartimento di Salute Mentale Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122Milano, Italy
C. Dobrea
Affiliation:
Dipartimento di Neuroscienze, Università degli Studi di Milano, Dipartimento di Salute Mentale Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122Milano, Italy
B. Benatti
Affiliation:
Dipartimento di Neuroscienze, Università degli Studi di Milano, Dipartimento di Salute Mentale Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122Milano, Italy
C. Arici
Affiliation:
Dipartimento di Neuroscienze, Università degli Studi di Milano, Dipartimento di Salute Mentale Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122Milano, Italy
A. Priori
Affiliation:
Centro Clinico per le Neuronanotecnologie e la Neurostimolazione, Università degli Studi di Milano, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milano, Italy U.O. Neurofisiopatologia, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milano, Italy
A.C. Altamura
Affiliation:
Dipartimento di Neuroscienze, Università degli Studi di Milano, Dipartimento di Salute Mentale Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122Milano, Italy
*
*Corresponding author. Tel.: +02 5503 5994; fax: +02 5032 0310. E-mail address:bernardo.dellosso@unimi.it
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Abstract

Transcranial direct current stimulation (tDCS) is a selective, painless, brain stimulation technique that allows the electric stimulation of specific cortical regions. TDCS has been recently used as investigational intervention for major depression and treatment resistant depression (TRD) with encouraging results. The present study was aimed to investigate the efficacy and tolerability of tDCS in major depressives with poor response to pharmacological treatment. Twenty-three depressed patients, with a diagnosis of major depressive disorder or bipolar disorder, were treated with augmentative tDCS for 5 days, two sessions per day in a blind-rater trial. The course of depressive symptoms was analyzed using repeated measures ANOVA for HAM-D and MADRS total scores. A qualitative analysis on the basis of the HAM-D response was performed as well. Both analyses were conducted at three time-points: T0 (baseline), T1 (endpoint tDCS) and T2 (end of the first week of follow-up). All patients completed the trial without relevant side-effects. A significant reduction of HAM-D and MADRS total scores was observed during the study (P<0.0001). Treatment response (endpoint HAM-D reduction ≥50%) was obtained by four patients (17.4%) at T1 and by seven patients (30.4%) at T2 and remission (endpoint HAM-D<8) by three patients (13.0%) at T1 and by four subjects (17.4%) at T2. Present findings support the efficacy and good tolerability of tDCS in the acute treatment of patients with TRD with clinical benefit being progressive and extended to the first week of follow-up. Further sham-controlled trials with longer follow-up are needed to confirm present results.

Keywords

Brain stimulationTranscranial direct current stimulation (tDCS)Treatment-resistant depression (TRD)Augmentation
Type
Original articles
Information
European Psychiatry , Volume 27 , Issue 7 , October 2012 , pp. 513 - 517
Copyright
Copyright © European Psychiatric Association 2012

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