BACKGROUND:Post-stroke depression is a disabling condition occurring in about one-third of patients with stroke. Pharmacological treatments have limited efficacy and important side effects. Recently, transcranial direct current stimulation (tDCS) has shown efficacy in treating depression. This study aimed to assess the efficacy and safety of tDCS for post-stroke depression. METHODS:48 antidepressant-free patients with post-stroke depression were randomised into two groups (active and sham tDCS). 1230 min sessions of 2 mA anodal left/cathodal right dorsolateral prefrontal tDCS were administered over 6 weeks (once daily on weekdays for 2 weeks, then 1 session every other week). The primary outcome was the change in the Hamilton Depression Rating Scale (17-items) at 6 weeks. We employed a repeated-measures analysis of variance; the depression score was the dependent variable, and time and group were independent variables. In this intention-to-treat analysis, missing data were addressed according to the last observation carried forward and the mixed-model repeated-measures analysis methods. RESULTS: 5 patients dropped out (two in the active group). Active tDCS was significantly superior to sham at end point (mean difference, 4.7 points; SD=9.21; p<0.001). Response and remission rates were significantly higher in the active (37.5% and 20.8%, respectively) versus the sham (4.1% and 0%, respectively) group, with a number-needed-to-treat of 3 and 5, respectively. CONCLUSIONS: This was the first controlled study to demonstrate that tDCS was safe and effective for post-stroke depression. Therefore, tDCS might be a favourable option for treating these patients. TRIAL REGISTRATION NUMBER: NCT01525524; Results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
RCT Entities:
BACKGROUND: Post-stroke depression is a disabling condition occurring in about one-third of patients with stroke. Pharmacological treatments have limited efficacy and important side effects. Recently, transcranial direct current stimulation (tDCS) has shown efficacy in treating depression. This study aimed to assess the efficacy and safety of tDCS for post-stroke depression. METHODS: 48 antidepressant-free patients with post-stroke depression were randomised into two groups (active and sham tDCS). 12 30 min sessions of 2 mA anodal left/cathodal right dorsolateral prefrontal tDCS were administered over 6 weeks (once daily on weekdays for 2 weeks, then 1 session every other week). The primary outcome was the change in the Hamilton Depression Rating Scale (17-items) at 6 weeks. We employed a repeated-measures analysis of variance; the depression score was the dependent variable, and time and group were independent variables. In this intention-to-treat analysis, missing data were addressed according to the last observation carried forward and the mixed-model repeated-measures analysis methods. RESULTS: 5 patients dropped out (two in the active group). Active tDCS was significantly superior to sham at end point (mean difference, 4.7 points; SD=9.21; p<0.001). Response and remission rates were significantly higher in the active (37.5% and 20.8%, respectively) versus the sham (4.1% and 0%, respectively) group, with a number-needed-to-treat of 3 and 5, respectively. CONCLUSIONS: This was the first controlled study to demonstrate that tDCS was safe and effective for post-stroke depression. Therefore, tDCS might be a favourable option for treating these patients. TRIAL REGISTRATION NUMBER: NCT01525524; Results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Authors: Leandro da Costa Lane Valiengo; Stephan Goerigk; Pedro Caldana Gordon; Frank Padberg; Mauricio Henriques Serpa; Stephanie Koebe; Leonardo Afonso Dos Santos; Roger Alberto Marcos Lovera; Juliana Barbosa de Carvalho; Martinus van de Bilt; Acioly L T Lacerda; Helio Elkis; Wagner Farid Gattaz; Andre R Brunoni Journal: JAMA Psychiatry Date: 2020-02-01 Impact factor: 21.596
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: Yejin Lee; Brian Chen; Mandy W M Fong; Jin-Moo Lee; Ginger E Nicol; Eric J Lenze; Lisa T Connor; Carolyn Baum; Alex W K Wong Journal: Top Stroke Rehabil Date: 2020-08-12 Impact factor: 2.119
Authors: Marom Bikson; Andre R Brunoni; Leigh E Charvet; Vincent P Clark; Leonardo G Cohen; Zhi-De Deng; Jacek Dmochowski; Dylan J Edwards; Flavio Frohlich; Emily S Kappenman; Kelvin O Lim; Colleen Loo; Antonio Mantovani; David P McMullen; Lucas C Parra; Michele Pearson; Jessica D Richardson; Judith M Rumsey; Pejman Sehatpour; David Sommers; Gozde Unal; Eric M Wassermann; Adam J Woods; Sarah H Lisanby Journal: Brain Stimul Date: 2017-12-29 Impact factor: 8.955