title: Augmentative transcranial direct current stimulation (tDCS) in poor responder depressed patients: a follow-up study.
abstract: OBJECTIVE
  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.
authors: 1Department of Psychiatry,University of Milan,Fondazione IRCCS Ca' Granda,Ospedale Maggiore Policlinico,Milan,Italy.
authors: Bernardo
authors: B
authors: Dell'Osso
authors: 1Department of Psychiatry,University of Milan,Fondazione IRCCS Ca' Granda,Ospedale Maggiore Policlinico,Milan,Italy.
authors: Cristina
authors: C
authors: Dobrea
authors: 1Department of Psychiatry,University of Milan,Fondazione IRCCS Ca' Granda,Ospedale Maggiore Policlinico,Milan,Italy.
authors: Chiara
authors: C
authors: Arici
authors: 1Department of Psychiatry,University of Milan,Fondazione IRCCS Ca' Granda,Ospedale Maggiore Policlinico,Milan,Italy.
authors: Beatrice
authors: B
authors: Benatti
authors: 2Center of Neurostimulation,University of Milan,Fondazione IRCCS Ca' Granda,Ospedale Maggiore Policlinico,Milan,Italy.
authors: Roberta
authors: R
authors: Ferrucci
authors: 2Center of Neurostimulation,University of Milan,Fondazione IRCCS Ca' Granda,Ospedale Maggiore Policlinico,Milan,Italy.
authors: Maurizio
authors: M
authors: Vergari
authors: 2Center of Neurostimulation,University of Milan,Fondazione IRCCS Ca' Granda,Ospedale Maggiore Policlinico,Milan,Italy.
authors: Alberto
authors: A
authors: Priori
authors: 1Department of Psychiatry,University of Milan,Fondazione IRCCS Ca' Granda,Ospedale Maggiore Policlinico,Milan,Italy.
authors: A Carlo
authors: AC
authors: Altamura
mesh_terms: D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000628:therapy*; D003131:Combined Modality Therapy; D003865:Major Depressive Disorder / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D065908:Transcranial Direct Current Stimulation / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents