Transcranial direct current stimulation (tDCS) in the treatment of depression: Systematic review and meta-analysis of efficacy and tolerability.

Journal: Neuroscience and biobehavioral reviews

Volume: 57

Issue: 

Year of Publication: 2016

Affiliated Institutions:  Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, University Department of Psychiatry, Academic Centre, College Keep, - Terminus Terrace, Southampton SO DT, United Kingdom; Avon & Wiltshire Partnership NHS Trust, Jenner House, Langley Park, Chippenham SN GG, Wiltshire, United Kingdom. Electronic address: dan@soton.ac.uk. Psychology, Faculty of Social, Human and Mathematical Sciences, University of Southampton, Southampton, United Kingdom. Electronic address: nick.hedger@soton.ac.uk. Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, University Department of Psychiatry, Academic Centre, College Keep, - Terminus Terrace, Southampton SO DT, United Kingdom; Psychology, Faculty of Social, Human and Mathematical Sciences, University of Southampton, Southampton, United Kingdom. Electronic address: M.J.GARNER@soton.ac.uk. Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, University Department of Psychiatry, Academic Centre, College Keep, - Terminus Terrace, Southampton SO DT, United Kingdom; University Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa. Electronic address: D.S.Baldwin@soton.ac.uk.

Abstract summary 

Transcranial direct current stimulation (tDCS) is a potential alternative treatment option for major depressive episodes (MDE).We address the efficacy and safety of tDCS in MDE.The outcome measures were Hedges' g for continuous depression ratings, and categorical response and remission rates.A random effects model indicated that tDCS was superior to sham tDCS (k=11, N=393, g=0.30, 95% CI=[0.04, 0.57], p=0.027). Adjunctive antidepressant medication and cognitive control training negatively impacted on the treatment effect. The pooled log odds ratios (LOR) for response and remission were positive, but statistically non-significant (response: k=9, LOR=0.36, 95% CI[-0.16, 0.88], p=0.176, remission: k=9, LOR=0.25, 95% CI [-0.42, 0.91], p=0.468). We estimated that for a study to detect the pooled continuous effect (g=0.30) at 80% power (alpha=0.05), a total N of at least 346 would be required (with the total N required to detect the upper and lower bound being 49 and 12,693, respectively).tDCS may be efficacious for treatment of MDE. The data do not support the use of tDCS in treatment-resistant depression, or as an add-on augmentation treatment. Larger studies over longer treatment periods are needed.

Authors & Co-authors:  Meron Daniel D Hedger Nicholas N Garner Matthew M Baldwin David S DS

Study Outcome 

Source Link: Visit source

Statistics
Citations : 
Authors :  4
Identifiers
Doi : 10.1016/j.neubiorev.2015.07.012
SSN : 1873-7528
Study Population
Male,Female
Mesh Terms
Depressive Disorder, Major
Other Terms
Cognitive control training;Depression;Meta-analysis;Non-pharmacological therapies;Remission;Response;Systematic review;Transcranial direct current stimulation;tDCS
Study Design
Case Control Trial,Cross Sectional Study
Study Approach
Systemic Review
Country of Study
Publication Country
United States