Is tDCS a potential first line treatment for major depression?
Woodham, R., Rimmer, R., Mutz, J. and Fu, C. 2021. Is tDCS a potential first line treatment for major depression? International Review of Psychiatry. 33 (3), pp. 250-265. https://doi.org/10.1080/09540261.2021.1879030
|Woodham, R., Rimmer, R., Mutz, J. and Fu, C.
Transcranial direct current stimulation (tDCS) is a novel treatment option for major depression which could be provided as a first-line treatment. tDCS is a non-invasive form of transcranial stimulation which changes cortical tissue excitability by applying a weak (0.5-2 mA) direct current via scalp electrodes. Anodal and cathodal stimulation leads to depolarisation and hyperpolarisation, respectively, and cumulative effects are observed with repeated sessions. The montage in depression most often involves anodal stimulation to the left dorsolateral prefrontal cortex. Rates of clinical response, remission, and improvements in depressive symptoms following a course of active tDCS are greater in comparison to a course of placebo sham-controlled tDCS. In particular, the largest treatment effects are evident in first episode and recurrent major depression, while minimal effects have been observed in treatment-resistant depression. The proposed mechanism is neuroplasticity at the cellular and molecular level. Alterations in neural responses have been found at the stimulation site as well as subcortically in prefrontal-amygdala connectivity. A possible mediating effect could be cognitive control in emotion dysregulation. Additional beneficial effects on cognitive impairments have been reported, which would address an important unmet need. The tDCS device is portable and can be used at home. Clinical trials are required to establish the efficacy, feasibility and acceptability of home-based tDCS treatment and mechanisms.
|International Review of Psychiatry
|33 (3), pp. 250-265
|Taylor & Francis
|Accepted author manuscript
File Access Level
|Digital Object Identifier (DOI)
|11 Mar 2021
|Publication process dates
|15 Jan 2021
|22 Mar 2021
|© 2021 Taylor & Francis
This is an Accepted Manuscript of an article published by Taylor & Francis in International Review of Psychiatry on 11/03/2021, available online: http://www.tandfonline.com/10.1080/09540261.2021.1879030.
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