title: A randomized, double-blind clinical trial on the efficacy of cortical direct current stimulation for the treatment of major depression.
abstract: Preliminary findings suggest that transcranial direct current stimulation (tDCS) can have antidepressant effects. We sought to test this further in a parallel-group, double-blind clinical trial with 40 patients with major depression, medication-free randomized into three groups of treatment: anodal tDCS of the left dorsolateral prefrontal cortex (active group - 'DLPFC'); anodal tDCS of the occipital cortex (active control group - 'occipital') and sham tDCS (placebo control group - 'sham'). tDCS was applied for 10 sessions during a 2-wk period. Mood was evaluated by a blinded rater using the Hamilton Depression Rating Scale (HDRS) and Beck Depression Inventory (BDI). The treatment was well tolerated with minimal side-effects that were distributed equally across all treatment groups. We found significantly larger reductions in depression scores after DLPFC tDCS [HDRS reduction of 40.4% (+/-25.8%)] compared to occipital [HDRS reduction of 21.3% (+/-12.9%)] and sham tDCS [HDRS reduction of 10.4% (+/-36.6%)]. The beneficial effects of tDCS in the DLPFC group persisted for 1 month after the end of treatment. Our findings support further investigation on the effects of this novel potential therapeutic approach - tDCS - for the treatment of major depression.
authors.affiliation: Núcleo de Neurociências, Centro de Ciências Biológicas e da Saúde, Universidade Presbiteriana Mackenzie, Sao Paulo, Brazil. boggio@usp.br
authors.forename: Paulo S
authors.initials: PS
authors.lastname: Boggio
authors.forename: Sergio P
authors.initials: SP
authors.lastname: Rigonatti
authors.forename: Rafael B
authors.initials: RB
authors.lastname: Ribeiro
authors.forename: Martin L
authors.initials: ML
authors.lastname: Myczkowski
authors.forename: Michael A
authors.initials: MA
authors.lastname: Nitsche
authors.forename: Alvaro
authors.initials: A
authors.lastname: Pascual-Leone
authors.forename: Felipe
authors.initials: F
authors.lastname: Fregni
mesh_terms: D000328:Adult; D000339:Affect; D003865:Major Depressive Disorder / Q000503:physiopathology / Q000628:therapy*; D004311:Double-Blind Method; D004599:Electric Stimulation Therapy / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009778:Occipital Lobe / Q000503:physiopathology; D017397:Prefrontal Cortex / Q000503:physiopathology*; D011569:Psychiatric Status Rating Scales; D013997:Time Factors; D016896:Treatment Outcome