Lais B Razza1,2, Priscila Palumbo1,2, Adriano H Moffa3, Andre F Carvalho4,5, Marco Solmi6,7, Colleen K Loo3, Andre Russowsky Brunoni1,2,8. 1. Laboratory of Neurosciences (LIM-27), Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBioN), Department and Institute of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil. 2. Department of Internal Medicine, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil. 3. Black Dog Institute, School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia. 4. Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada. 5. Centre for Addiction and Mental Health, Toronto, Ontario, Canada. 6. Department of Neurosciences, University of Padova, Padova, Italy. 7. Padova Neuroscience Center, University of Padova, Padova, Italy. 8. Hospital Universitário, Universidade de São Paulo, São Paulo, Brazil.
Abstract
BACKGROUND: Transcranial direct current stimulation (tDCS) has shown mixed results for depression treatment. OBJECTIVE: To perform a systematic review and meta-analysis of trials using tDCS to improve depressive symptoms. METHODS: A systematic review was performed from the first date available to January 06, 2020 in PubMed, EMBASE, Cochrane Library, and additional sources. We included randomized, sham-controlled clinical trials (RCTs) enrolling participants with an acute depressive episode and compared the efficacy of active versus sham tDCS, including association with other interventions. The primary outcome was the Hedges' g for continuous depression scores; secondary outcomes included odds ratios (ORs) and number needed to treat (NNT) for response, remission, and acceptability. Random effects models were employed. Sources of heterogeneity were explored via metaregression, sensitivity analyses, subgroup analyses, and bias assessment. RESULTS: We included 23 RCTs (25 datasets, 1,092 participants), most (57%) presenting a low risk of bias. Active tDCS was superior to sham regarding endpoint depression scores (k = 25, g = 0.46, 95% confidence interval [CI]: 0.22-0.70), and also achieved superior response (k = 18, 33.3% vs. 16.56%, OR = 2.28 [1.52-3.42], NNT = 6) and remission (k = 18, 19.12% vs. 9.78%, OR = 2.12 [1.42-3.16], NNT = 10.7) rates. Moreover, active tDCS was as acceptable as sham. No risk of publication bias was identified. Cumulative meta-analysis showed that effect sizes are basically unchanged since total sample reached 439 participants. CONCLUSIONS: TDCS is modestly effective in treating depressive episodes. Further well-designed, large-scale RCTs are warranted.
BACKGROUND: Transcranial direct current stimulation (tDCS) has shown mixed results for depression treatment. OBJECTIVE: To perform a systematic review and meta-analysis of trials using tDCS to improve depressive symptoms. METHODS: A systematic review was performed from the first date available to January 06, 2020 in PubMed, EMBASE, Cochrane Library, and additional sources. We included randomized, sham-controlled clinical trials (RCTs) enrolling participants with an acute depressive episode and compared the efficacy of active versus sham tDCS, including association with other interventions. The primary outcome was the Hedges' g for continuous depression scores; secondary outcomes included odds ratios (ORs) and number needed to treat (NNT) for response, remission, and acceptability. Random effects models were employed. Sources of heterogeneity were explored via metaregression, sensitivity analyses, subgroup analyses, and bias assessment. RESULTS: We included 23 RCTs (25 datasets, 1,092 participants), most (57%) presenting a low risk of bias. Active tDCS was superior to sham regarding endpoint depression scores (k = 25, g = 0.46, 95% confidence interval [CI]: 0.22-0.70), and also achieved superior response (k = 18, 33.3% vs. 16.56%, OR = 2.28 [1.52-3.42], NNT = 6) and remission (k = 18, 19.12% vs. 9.78%, OR = 2.12 [1.42-3.16], NNT = 10.7) rates. Moreover, active tDCS was as acceptable as sham. No risk of publication bias was identified. Cumulative meta-analysis showed that effect sizes are basically unchanged since total sample reached 439 participants. CONCLUSIONS: TDCS is modestly effective in treating depressive episodes. Further well-designed, large-scale RCTs are warranted.
Authors: James J Mahoney; Colleen A Hanlon; Patrick J Marshalek; Ali R Rezai; Lothar Krinke Journal: J Neurol Sci Date: 2020-09-20 Impact factor: 3.181
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: Gay Florian; Allison Singier; Bruno Aouizerate; Francesco Salvo; Thomas C M Bienvenu Journal: Front Psychiatry Date: 2022-07-01 Impact factor: 5.435
Authors: Marom Bikson; Colleen A Hanlon; Adam J Woods; Bernadette T Gillick; Leigh Charvet; Claus Lamm; Graziella Madeo; Adrienn Holczer; Jorge Almeida; Andrea Antal; Mohammad Reza Ay; Chris Baeken; Daniel M Blumberger; Salvatore Campanella; Joan A Camprodon; Lasse Christiansen; Colleen Loo; Jennifer T Crinion; Paul Fitzgerald; Luigi Gallimberti; Peyman Ghobadi-Azbari; Iman Ghodratitoostani; Roland H Grabner; Gesa Hartwigsen; Akimasa Hirata; Adam Kirton; Helena Knotkova; Evgeny Krupitsky; Paola Marangolo; Ester M Nakamura-Palacios; Weronika Potok; Samir K Praharaj; Christian C Ruff; Gottfried Schlaug; Hartwig R Siebner; Charlotte J Stagg; Axel Thielscher; Nicole Wenderoth; Ti-Fei Yuan; Xiaochu Zhang; Hamed Ekhtiari Journal: Brain Stimul Date: 2020-05-12 Impact factor: 8.955