Giordano D'Urso1, Bernardo Dell'Osso2, Rodolfo Rossi3, Andre Russowsky Brunoni4, Marco Bortolomasi5, Roberta Ferrucci6, Alberto Priori7, Andrea de Bartolomeis1, Alfredo Carlo Altamura8. 1. Unit of Psychiatry, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy. 2. Department of Psychiatry, University of Milan, Milan, Italy; Fondazione IRCCS Ca' Granda, Policlinico, Milan, Italy; Department of Psychiatry and Behavioral Sciences, Stanford University, CA, USA. 3. Unit of Psychiatry, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy. Electronic address: rudy86.rossi@gmail.com. 4. Service of Interdisciplinary Neuromodulation, Department and Institute of Psychiatry, Laboratory of Neurosciences (LIM-27), University of São Paulo, São Paulo, Brazil; Interdisciplinary Center for Applied Neuromodulation, University Hospital of São Paulo, São Paulo, Brazil. 5. Casa di cura Villa Santa Chiara, Quinto di Valpantena, Verona, Italy. 6. Fondazione IRCCS Ca' Granda, Policlinico, Milan, Italy; Department of Health Sciences, University of Milan, Italy. 7. Department of Health Sciences, University of Milan, Italy; III Clinica Neurologica, Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milan, Italy. 8. Department of Psychiatry, University of Milan, Milan, Italy; Fondazione IRCCS Ca' Granda, Policlinico, Milan, Italy.
Abstract
BACKGROUND: Transcranial direct current stimulation (tDCS) is a promising neuromodulation intervention for poor-responding or refractory depressed patients. However, little is known about predictors of response to this therapy. The present study aimed to analyze clinical predictors of response to tDCS in depressed patients. METHODS: Clinical data from 3 independent tDCS trials on 171 depressed patients (including unipolar and bipolar depression), were pooled and analyzed to assess predictors of response. Depression severity and the underlying clinical dimensions were measured using the Hamilton Depression Rating Scale (HDRS) at baseline and after the tDCS treatment. Age, gender and diagnosis (bipolar/unipolar depression) were also investigated as predictors of response. Linear mixed models were fitted in order to ascertain which HDRS factors were associated with response to tDCS. RESULTS: Age, gender and diagnosis did not show any association with response to treatment. The reduction in HDRS scores after tDCS was strongly associated with the baseline values of "Cognitive Disturbances" and "Retardation" factors, whilst the "Anxiety/Somatization" factor showed a mild association with the response. LIMITATIONS: Open-label design, the lack of control group, and minor differences in stimulation protocols. CONCLUSIONS: No differences in response to tDCS were found between unipolar and bipolar patients, suggesting that tDCS is effective for both conditions. "Cognitive disturbance", "Retardation", and "Anxiety/Somatization", were identified as potential clinical predictors of response to tDCS. These findings point to the pre-selection of the potential responders to tDCS, therefore optimizing the clinical use of this technique and the overall cost-effectiveness of the psychiatric intervention for depressed patients.
BACKGROUND: Transcranial direct current stimulation (tDCS) is a promising neuromodulation intervention for poor-responding or refractory depressedpatients. However, little is known about predictors of response to this therapy. The present study aimed to analyze clinical predictors of response to tDCS in depressedpatients. METHODS: Clinical data from 3 independent tDCS trials on 171 depressedpatients (including unipolar and bipolar depression), were pooled and analyzed to assess predictors of response. Depression severity and the underlying clinical dimensions were measured using the Hamilton Depression Rating Scale (HDRS) at baseline and after the tDCS treatment. Age, gender and diagnosis (bipolar/unipolar depression) were also investigated as predictors of response. Linear mixed models were fitted in order to ascertain which HDRS factors were associated with response to tDCS. RESULTS: Age, gender and diagnosis did not show any association with response to treatment. The reduction in HDRS scores after tDCS was strongly associated with the baseline values of "Cognitive Disturbances" and "Retardation" factors, whilst the "Anxiety/Somatization" factor showed a mild association with the response. LIMITATIONS: Open-label design, the lack of control group, and minor differences in stimulation protocols. CONCLUSIONS: No differences in response to tDCS were found between unipolar and bipolarpatients, suggesting that tDCS is effective for both conditions. "Cognitive disturbance", "Retardation", and "Anxiety/Somatization", were identified as potential clinical predictors of response to tDCS. These findings point to the pre-selection of the potential responders to tDCS, therefore optimizing the clinical use of this technique and the overall cost-effectiveness of the psychiatric intervention for depressedpatients.
Keywords:
Brain stimulation; Major depression; Mood disorders; Pooled analysis; Predictors of response; Transcranial direct current stimulation (tDCS); Transcranial magnetic stimulation (TMS)
Authors: Emanuela Zappulo; Maria Pia Riccio; Sandro Binda; Laura Pellegrinelli; Fabrizio Pregliasco; Antonio Riccardo Buonomo; Biagio Pinchera; Giordano D'Urso; Carmela Bravaccio; Guglielmo Borgia; Ivan Gentile Journal: In Vivo Date: 2018 Sep-Oct Impact factor: 2.155
Authors: Paulo J C Suen; Sarah Doll; Marcelo C Batistuzzo; Geraldo Busatto; Lais B Razza; Frank Padberg; Eva Mezger; Lucia Bulubas; Daniel Keeser; Zhi-De Deng; Andre R Brunoni Journal: Eur Arch Psychiatry Clin Neurosci Date: 2020-04-11 Impact factor: 5.270
Authors: Roberta Ferrucci; Simona Mrakic-Sposta; Simona Gardini; Fabiana Ruggiero; Maurizio Vergari; Francesca Mameli; Andrea Arighi; Marco Spallazzi; Federica Barocco; Giovanni Michelini; Anna Margherita Pietroboni; Laura Ghezzi; Giorgio Giulio Fumagalli; Giordano D'Urso; Paolo Caffarra; Elio Scarpini; Alberto Priori; Sara Marceglia Journal: Front Behav Neurosci Date: 2018-10-29 Impact factor: 3.558
Authors: Nemanja Rancic; Katarina Mladenovic; Nela V Ilic; Viktorija Dragojevic-Simic; Menelaos Karanikolas; Tihomir V Ilic; Dusica M Stamenkovic Journal: Int J Environ Res Public Health Date: 2020-01-28 Impact factor: 3.390