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Augmentative transcranial direct current stimulation (tDCS) in poor responder depressed patients: a follow-up study

Published online by Cambridge University Press:  20 August 2013

Bernardo Dell'Osso ,
Cristina Dobrea ,
Chiara Arici ,
Beatrice Benatti ,
Roberta Ferrucci ,
Maurizio Vergari ,
Alberto Priori  and
A. Carlo Altamura
Bernardo Dell'Osso*
Affiliation:
Department of Psychiatry, University of Milan, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
Cristina Dobrea
Affiliation:
Department of Psychiatry, University of Milan, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
Chiara Arici
Affiliation:
Department of Psychiatry, University of Milan, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
Beatrice Benatti
Affiliation:
Department of Psychiatry, University of Milan, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
Roberta Ferrucci
Affiliation:
Center of Neurostimulation, University of Milan, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
Maurizio Vergari
Affiliation:
Center of Neurostimulation, University of Milan, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
Alberto Priori
Affiliation:
Center of Neurostimulation, University of Milan, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
A. Carlo Altamura
Affiliation:
Department of Psychiatry, University of Milan, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
*
*Address for correspondence: Dr. Bernardo Dell'Osso, MD, Assistant Professor of Psychiatry, Department of Psychiatry, University of Milan; Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milano, Italy. (Email bernardo.dellosso@unimi.it)
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Abstract

Objectives

Transcranial direct current stimulation (tDCS) is a non-invasive neurostimulation technique that has received increasing interest in the area of mood disorders over the last several years. While acute, double-blind, sham-controlled studies have already reported positive findings in terms of efficacy and safety for tDCS, follow-up data are lacking. This need prompted the present follow-up study, which assesses post-acute effects of tDCS (no maintenance stimulation was performed), in the mid-term, in a sample of major depressives.

Methods

After completing an acute, open trial of tDCS, 23 outpatients with either major depressive disorder or bipolar disorder entered a naturalistic follow-up (T1) with clinical evaluations at one week (T2), 1 month (T3), and 3 months (T4). A quantitative analysis of Hamilton Depression Rating Scale (HAM-D), Montgomery–Asberg Depression Rating Scale (MADRS), and Young Mania Rating Scale (YMRS) total scores, through repeated measures analysis of variance (ANOVA) (T1–T4) and paired t-test for comparing specific time points (T1–T2, T2–T3, and T3–T4), was performed. In addition, a qualitative analysis on the basis of treatment response and remission (HAM-D) was performed.

Results

Even though a progressive reduction of follow-up completers was observed from T2 to T4 (95.6% at T2, 65.2% at T3, and 47.8% at T4), the antidepressant effects of acute tDCS persisted over 3 months in almost half of the sample. Of note, no post-acute side effects emerged during the follow-up observation. The most frequent causes of drop-out from this study included major modifications in therapeutic regimen (30%) and poor adherence to follow-up visits (17%).

Conclusions

In this mid-term, open, follow-up study, tDCS showed mixed results. Further controlled studies are urgently needed to assess its effects beyond the acute phase.

Keywords

Bipolar disorderfollow-up observationmajor depressive disorderpoor responsetranscranial direct current stimulation (tDCS)
Type
Original Research
Information
CNS Spectrums , Volume 19 , Issue 4 , August 2014 , pp. 347 - 354
Copyright
Copyright © Cambridge University Press 2013 

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Footnotes

The authors thank Dr. Filippo Castellano, MD, and Dr. Massimiliano Buoli, MD, for their support.

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