Luana V M Aparicio1,2, Vivianne Rosa1,2, Lais M Razza1,2, Bernardo Sampaio-Junior1,2, Lucas Borrione1,2, Leandro Valiengo2, Paulo A Lotufo1, Isabela M Benseñor1, Renerio Fraguas1,3, Adriano H Moffa1,4, Wagner F Gattaz5, André Russowsky Brunoni1,2,5,6. 1. University Hospital, University of São Paulo, São Paulo, Brazil. 2. Service of Interdisciplinary Neuromodulation (SIN), Department and Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil. 3. Laboratory of Psychiatric Neuroimaging (LIM-21), Department and Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil. 4. School of Psychiatry, Black Dog Institute, University of New South Wales, Sydney, Australia. 5. Laboratory of Neuroscience (LIM27) and National Institute of Biomarkers in Neuropsychiatry (INBioN), Department and Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil. 6. Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany.
Abstract
BACKGROUND: The efficacy of transcranial direct current stimulation (tDCS) as a continuation therapy for the maintenance phase of the depressive episode is low and insufficiently investigated in literature. We investigated whether it could be enhanced by using a more intensive treatment regimen compared to previous reports. METHODS: Twenty-four patients (16 with unipolar depression and eight with bipolar depression) who presented acute tDCS response (≥50% depression improvement in the Hamilton Depression Rating Scale [HDRS]) after receiving 15 tDCS sessions were followed for up to 6 months or until relapse, defined as clinical worsening and/or HDRS > 15. Sessions were performed twice a week (maximum of 48 sessions) over 24 weeks. The anode and the cathode were positioned over the left and right dorsolateral prefrontal cortex (2 mA current, 30 min sessions were delivered). We performed Kaplan-Meier survival analysis and Cox proportional hazards ratios to evaluate predictors of relapse. RESULTS: Out of 24 patients, 18 completed the follow-up period. tDCS treatment was well tolerated. The mean survival duration was 17.5 weeks (122 days). The survival rate at the end of follow-up was 73.5% (95% confidence interval, 50-87). A trend (P = 0.09) was observed for lower relapse rates in nontreatment- vs. antidepressant treatment-resistant patients (7.7% vs. 45.5%, respectively). No differences in efficacy between unipolar and bipolar depression were observed. CONCLUSION: An intensive tDCS treatment regimen consisting of sessions twice a week achieved relatively low relapse rates after a 6-month follow up of tDCS responders, particularly for nontreatment-resistant patients.
BACKGROUND: The efficacy of transcranial direct current stimulation (tDCS) as a continuation therapy for the maintenance phase of the depressive episode is low and insufficiently investigated in literature. We investigated whether it could be enhanced by using a more intensive treatment regimen compared to previous reports. METHODS: Twenty-four patients (16 with unipolar depression and eight with bipolar depression) who presented acute tDCS response (≥50% depression improvement in the Hamilton Depression Rating Scale [HDRS]) after receiving 15 tDCS sessions were followed for up to 6 months or until relapse, defined as clinical worsening and/or HDRS > 15. Sessions were performed twice a week (maximum of 48 sessions) over 24 weeks. The anode and the cathode were positioned over the left and right dorsolateral prefrontal cortex (2 mA current, 30 min sessions were delivered). We performed Kaplan-Meier survival analysis and Cox proportional hazards ratios to evaluate predictors of relapse. RESULTS: Out of 24 patients, 18 completed the follow-up period. tDCS treatment was well tolerated. The mean survival duration was 17.5 weeks (122 days). The survival rate at the end of follow-up was 73.5% (95% confidence interval, 50-87). A trend (P = 0.09) was observed for lower relapse rates in nontreatment- vs. antidepressant treatment-resistant patients (7.7% vs. 45.5%, respectively). No differences in efficacy between unipolar and bipolar depression were observed. CONCLUSION: An intensive tDCS treatment regimen consisting of sessions twice a week achieved relatively low relapse rates after a 6-month follow up of tDCS responders, particularly for nontreatment-resistant patients.
Authors: Hyein Cho; Lais B Razza; Lucas Borrione; Marom Bikson; Leigh Charvet; Tracy A Dennis-Tiwary; Andre R Brunoni; Pedro Sudbrack-Oliveira Journal: Focus (Am Psychiatr Publ) Date: 2022-01-25
Authors: Jasmina Paneva; Inge Leunissen; Teresa Schuhmann; Tom A de Graaf; Morten Gørtz Jønsson; Balder Onarheim; Alexander T Sack Journal: Front Hum Neurosci Date: 2022-06-09 Impact factor: 3.473
Authors: Lucas Borrione; Helena Bellini; Lais Boralli Razza; Ana G Avila; Chris Baeken; Anna-Katharine Brem; Geraldo Busatto; Andre F Carvalho; Adam Chekroud; Zafiris J Daskalakis; Zhi-De Deng; Jonathan Downar; Wagner Gattaz; Colleen Loo; Paulo A Lotufo; Maria da Graça M Martin; Shawn M McClintock; Jacinta O'Shea; Frank Padberg; Ives C Passos; Giovanni A Salum; Marie-Anne Vanderhasselt; Renerio Fraguas; Isabela Benseñor; Leandro Valiengo; Andre R Brunoni Journal: Braz J Psychiatry Date: 2020-03-16 Impact factor: 2.697