title: Transcranial direct current stimulation in a patient with therapy-resistant major depression.
abstract: Transcranial direct current stimulation (tDCS) of the prefrontal cortex (PFC) has been reported to exert significant antidepressant effects in patients with major depression. Several recent studies found an improvement of depressive symptoms in drug-free patients. Here we report the case of a 66-year-old female patient suffering from recurrent major depressive episodes who underwent anodal tDCS of the left dorsolateral PFC over 4 weeks as an add-on treatment to a stable antidepressant medication. Only a modest improvement of depressive symptoms was observed after tDCS, i.e. reduction of the baseline scores in the Hamilton Depression Rating Scale from 23 to 19 and in the Beck Depression Inventory from 27 to 20. However, there was an increase from 52 to 90% in the Regensburg Verbal Fluency Test. In addition, EEG was used to assess the acute effects of tDCS. Low resolution brain electromagnetic tomography (LORETA) showed a left unilateral focal effect (25-40% reduced power) in the delta, theta and alpha frequency bands. The same effect appeared in the surface analysis of the EEG. The absolute, as well as the relative power decreased significantly in the delta, theta and alpha bands after a comparison of the spectral analysis. Though tDCS over 4 weeks did not exert clinically meaningful antidepressant effects in this case of therapy-resistant depression, the findings for cognitive measures and EEG suggest that beneficial effects may occur in depressed subjects and future studies need to further explore this approach also in therapy-resistant major depression.
authors.affiliation: Department of Psychiatry and Psychotherapy, Ludwig-Maximilians University, Munich, Germany. Ulrich.Palm@med.uni-muenchen.de
authors.forename: Ulrich
authors.initials: U
authors.lastname: Palm
authors.forename: Daniel
authors.initials: D
authors.lastname: Keeser
authors.forename: Christina
authors.initials: C
authors.lastname: Schiller
authors.forename: Zoe
authors.initials: Z
authors.lastname: Fintescu
authors.forename: Eva
authors.initials: E
authors.lastname: Reisinger
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Baghai
authors.forename: Christoph
authors.initials: C
authors.lastname: Mulert
authors.forename: Frank
authors.initials: F
authors.lastname: Padberg
mesh_terms: D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D004292:Dominance, Cerebral / Q000502:physiology; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D010555:Personality Inventory / Q000706:statistics & numerical data; D017397:Prefrontal Cortex / Q000503:physiopathology*; D011594:Psychometrics; D012008:Recurrence
chemical_list: D000928:Antidepressive Agents