Lucia Bulubas1, Frank Padberg2, Priscila V Bueno3, Fabio Duran4, Geraldo Busatto4, Edson Amaro5, Isabela M Benseñor6, Paulo A Lotufo6, Stephan Goerigk7, Wagner Gattaz3, Daniel Keeser8, Andre R Brunoni9. 1. Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany; International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany. 2. Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany. 3. Service of Interdisciplinary Neuromodulation, Department of Psychiatry, Laboratory of Neurosciences (LIM-27) and National Institute of Biomarkers in Neuropsychiatry (INBioN), Institute of Psychiatry, University of Sao Paulo, Sao Paulo, Brazil. 4. Center for Interdisciplinary Research on Applied Neurosciences (NAPNA) and Laboratory of Psychiatric Neuroimaging, Department and Institute of Psychiatry, University of Sao Paulo, Sao Paulo, Brazil. 5. Department of Radiology, Clinics Hospital, University of Sao Paulo Medical School, Sao Paulo, Brazil. 6. Hospital Universitario, Departamento de Clínica Médica, Faculdade de Medicina da USP, São Paulo, Brazil. 7. Department of Psychological Methodology and Assessment, LMU Munich, Munich, Germany; Hochschule Fresenius, University of Applied Sciences, Munich, Germany. 8. Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany; Department of Clinical Radiology, University Hospital, LMU Munich, Munich, Germany. 9. Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany; Service of Interdisciplinary Neuromodulation, Department of Psychiatry, Laboratory of Neurosciences (LIM-27) and National Institute of Biomarkers in Neuropsychiatry (INBioN), Institute of Psychiatry, University of Sao Paulo, Sao Paulo, Brazil; Hospital Universitario, Departamento de Clínica Médica, Faculdade de Medicina da USP, São Paulo, Brazil. Electronic address: brunowsky@gmail.com.
Abstract
BACKGROUND:Transcranial direct current stimulation (tDCS) is a promising intervention for major depression. However, its clinical effects are heterogeneous. We investigated, in a subsample of the randomized, clinical trial Escitalopram versus Electrical Direct Current Therapy for Depression Study (ELECT-TDCS), whether the volumes of left and right prefrontal cortex (PFC) and anterior cingulate cortex (ACC) were associated with prefrontal tDCS response. METHODS:Baseline structural T1 weighted MRI data were analyzed from 52 patients (15 males). Patients were randomized to the following conditions: escitalopram 20 mg/day, bifrontal tDCS (2 mA, 30min, 22 sessions), or placebo. Antidepressant outcomes were assessed over a treatment period of 10 weeks. Voxel-based gray matter volumes of PFC and ACC were determined using state-of-the-art parcellation approaches. RESULTS: According to our a priori hypothesis, in the left dorsal PFC, larger gray matter volumes were associated with depression improvement in the tDCS group (n = 15) compared to sham (n = 21) (Cohen's d = 0.3, 95% confidence interval [0.01; 0.6], p = 0.04). Neither right PFC nor ACC volumes were associated with depression improvement. Exploratory analyses of distinct PFC subregions were performed, but no area was associated with tDCS response after correction for multiple comparisons. CONCLUSION:Left PFC baseline gray matter volume was associated with tDCS antidepressant effects. This brain region and its subdivisions should be investigated further as a potential neurobiological predictor for prefrontal tDCS treatment in depression and might be correlated with tDCS antidepressant mechanisms of action.
RCT Entities:
BACKGROUND: Transcranial direct current stimulation (tDCS) is a promising intervention for major depression. However, its clinical effects are heterogeneous. We investigated, in a subsample of the randomized, clinical trial Escitalopram versus Electrical Direct Current Therapy for Depression Study (ELECT-TDCS), whether the volumes of left and right prefrontal cortex (PFC) and anterior cingulate cortex (ACC) were associated with prefrontal tDCS response. METHODS: Baseline structural T1 weighted MRI data were analyzed from 52 patients (15 males). Patients were randomized to the following conditions: escitalopram 20 mg/day, bifrontal tDCS (2 mA, 30min, 22 sessions), or placebo. Antidepressant outcomes were assessed over a treatment period of 10 weeks. Voxel-based gray matter volumes of PFC and ACC were determined using state-of-the-art parcellation approaches. RESULTS: According to our a priori hypothesis, in the left dorsal PFC, larger gray matter volumes were associated with depression improvement in the tDCS group (n = 15) compared to sham (n = 21) (Cohen's d = 0.3, 95% confidence interval [0.01; 0.6], p = 0.04). Neither right PFC nor ACC volumes were associated with depression improvement. Exploratory analyses of distinct PFC subregions were performed, but no area was associated with tDCS response after correction for multiple comparisons. CONCLUSION: Left PFC baseline gray matter volume was associated with tDCS antidepressant effects. This brain region and its subdivisions should be investigated further as a potential neurobiological predictor for prefrontal tDCS treatment in depression and might be correlated with tDCS antidepressant mechanisms of action.
Keywords:
Antidepressant response; Magnetic resonance imaging; Major depressive disorder; Noninvasive brain stimulation; Structural neuroanatomy; Transcranial direct current stimulation
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: Geraldo Busatto Filho; Pedro G Rosa; Mauricio H Serpa; Paula Squarzoni; Fabio L Duran Journal: Braz J Psychiatry Date: 2020-06-08 Impact factor: 2.697
Authors: Daniel Keeser; Lucia Bulubas; Frank Padberg; Eva Mezger; Paulo Suen; Priscila V Bueno; Fabio Duran; Geraldo Busatto; Edson Amaro; Isabela M Benseñor; Paulo A Lotufo; Stephan Goerigk; Wagner Gattaz; Andre R Brunoni Journal: Eur Arch Psychiatry Clin Neurosci Date: 2020-09-02 Impact factor: 5.270
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