BACKGROUND: Transcranial direct current stimulation (tDCS) is a non-invasive, neuromodulatory technique with an emerging role for treating major depression. OBJECTIVE: To investigate the interactions between tDCS and drug therapy in unipolar and bipolar depressed patients who were refractory for at least one pharmacological treatment. METHODS: This was a naturalistic study using data from 54 female and 28 male patients (mean age of 54 years) that consecutively visited our psychiatric unit. They received active tDCS (five consecutive days, 2mA, anodal stimulation over the left and cathodal over the right dorsolateral prefrontal cortex, twice a day, 20minutes). The outcome variable (mood) was evaluated using the Beck Depression Inventory (BDI) and the Hamilton Depression Rating Scale (HDRS). Predictor variables were age, gender, disorder and pharmacological treatment (seven dummy variables). We performed univariate and multivariate analyses as to identify predictors associated to the outcome. RESULTS: After 5 days of treatment, BDI and HDRS scores decreased significantly (29%±36%, 18%±9%, respectively, P<0.01 for both). Benzodiazepine use was independently associated with a worse outcome in both univariate (β=4.92, P<0.01) and multivariate (β=5.8, P<0.01) analyses; whereas use of dual-reuptake inhibitors positively changed tDCS effects in the multivariate model (β=-4.7, P=0.02). A similar trend was observed for tricyclics (β=-4, P=0.06) but not for antipsychotics, non-benzodiazepine anticonvulsants and other drugs. CONCLUSION: tDCS over the DLPFC acutely improved depressive symptoms. Besides the inherent limitations of our naturalistic design, our results suggest that tDCS effects might vary according to prior pharmacological treatment, notably benzodiazepines and some antidepressant classes. This issue should be further explored in controlled studies.
BACKGROUND: Transcranial direct current stimulation (tDCS) is a non-invasive, neuromodulatory technique with an emerging role for treating major depression. OBJECTIVE: To investigate the interactions between tDCS and drug therapy in unipolar and bipolar depressedpatients who were refractory for at least one pharmacological treatment. METHODS: This was a naturalistic study using data from 54 female and 28 male patients (mean age of 54 years) that consecutively visited our psychiatric unit. They received active tDCS (five consecutive days, 2mA, anodal stimulation over the left and cathodal over the right dorsolateral prefrontal cortex, twice a day, 20minutes). The outcome variable (mood) was evaluated using the Beck Depression Inventory (BDI) and the Hamilton Depression Rating Scale (HDRS). Predictor variables were age, gender, disorder and pharmacological treatment (seven dummy variables). We performed univariate and multivariate analyses as to identify predictors associated to the outcome. RESULTS: After 5 days of treatment, BDI and HDRS scores decreased significantly (29%±36%, 18%±9%, respectively, P<0.01 for both). Benzodiazepine use was independently associated with a worse outcome in both univariate (β=4.92, P<0.01) and multivariate (β=5.8, P<0.01) analyses; whereas use of dual-reuptake inhibitors positively changed tDCS effects in the multivariate model (β=-4.7, P=0.02). A similar trend was observed for tricyclics (β=-4, P=0.06) but not for antipsychotics, non-benzodiazepine anticonvulsants and other drugs. CONCLUSION: tDCS over the DLPFC acutely improved depressive symptoms. Besides the inherent limitations of our naturalistic design, our results suggest that tDCS effects might vary according to prior pharmacological treatment, notably benzodiazepines and some antidepressant classes. This issue should be further explored in controlled studies.
Authors: André R Brunoni; Adriano H Moffa; Felipe Fregni; Ulrich Palm; Frank Padberg; Daniel M Blumberger; Zafiris J Daskalakis; Djamila Bennabi; Emmanuel Haffen; Angelo Alonzo; Colleen K Loo Journal: Br J Psychiatry Date: 2016-04-07 Impact factor: 9.319
Authors: A Antal; I Alekseichuk; M Bikson; J Brockmöller; A R Brunoni; R Chen; L G Cohen; G Dowthwaite; J Ellrich; A Flöel; F Fregni; M S George; R Hamilton; J Haueisen; C S Herrmann; F C Hummel; J P Lefaucheur; D Liebetanz; C K Loo; C D McCaig; C Miniussi; P C Miranda; V Moliadze; M A Nitsche; R Nowak; F Padberg; A Pascual-Leone; W Poppendieck; A Priori; S Rossi; P M Rossini; J Rothwell; M A Rueger; G Ruffini; K Schellhorn; H R Siebner; Y Ugawa; A Wexler; U Ziemann; M Hallett; W Paulus Journal: Clin Neurophysiol Date: 2017-06-19 Impact factor: 3.708
Authors: Bernardo Sampaio-Junior; Gabriel Tortella; Lucas Borrione; Adriano H Moffa; Rodrigo Machado-Vieira; Eric Cretaz; Adriano Fernandes da Silva; Renério Fraguas; Luana V Aparício; Izio Klein; Beny Lafer; Stephan Goerigk; Isabela Martins Benseñor; Paulo Andrade Lotufo; Wagner F Gattaz; André Russowsky Brunoni Journal: JAMA Psychiatry Date: 2018-02-01 Impact factor: 21.596
Authors: André R Brunoni; Rodrigo Machado-Vieira; Carlos A Zarate; Leandro Valiengo; Erica Lm Vieira; Isabela M Benseñor; Paulo A Lotufo; Wagner F Gattaz; Antonio L Teixeira Journal: Psychopharmacology (Berl) Date: 2013-10-23 Impact factor: 4.530
Authors: A J Woods; A Antal; M Bikson; P S Boggio; A R Brunoni; P Celnik; L G Cohen; F Fregni; C S Herrmann; E S Kappenman; H Knotkova; D Liebetanz; C Miniussi; P C Miranda; W Paulus; A Priori; D Reato; C Stagg; N Wenderoth; M A Nitsche Journal: Clin Neurophysiol Date: 2015-11-22 Impact factor: 3.708
Authors: André R Brunoni; Rodrigo Machado-Vieira; Carlos A Zarate; Erica L M Vieira; Leandro Valiengo; Isabela M Benseñor; Paulo A Lotufo; Wagner F Gattaz; Antonio L Teixeira Journal: Prog Neuropsychopharmacol Biol Psychiatry Date: 2014-08-27 Impact factor: 5.067