title: A pilot study of alternative transcranial direct current stimulation electrode montages for the treatment of major depression.
abstract: BACKGROUND
  Typically, transcranial direct current stimulation (tDCS) treatments for depression have used bifrontal montages with anodal (excitatory) stimulation targeting the left dorsolateral prefrontal cortex (DLPFC). There is limited research examining the effects of alternative electrode montages.
  
  
  OBJECTIVE
  This pilot study aimed to examine the feasibility, tolerability and safety of two alternative electrode montages and provide preliminary data on efficacy. The montages, Fronto-Occipital (F-O) and Fronto-Cerebellar (F-C), were designed respectively to target midline brain structures and the cerebellum.
  
  
  METHODS
  The anode was placed over the left supraorbital region and the cathode over the occipital and cerebellar region for the F-O and F-C montages respectively. Computational modelling was used to determine the electric fields produced in the brain regions of interest compared to a standard bifrontal montage. The two montages were evaluated in an open label study of depressed participants (N=14). Mood and neuropsychological functioning were assessed at baseline and after four weeks of tDCS.
  
  
  RESULTS
  Computational modelling revealed that the novel montages resulted in greater activation in the anterior cingulate cortices and cerebellum than the bifrontal montage, while activation of the DLPFCs was higher for the bifrontal montage. After four weeks of tDCS, overall mood improvement rates of 43.8% and 15.9% were observed under the F-O and F-C conditions, respectively. No significant neuropsychological changes were found.
  
  
  CONCLUSIONS
  The clinical pilot was open-label, without a control condition and computational modelling was based on one healthy participant.
  
  
  CONCLUSIONS
  Results found both montages safe and feasible. The F-O montage showed promising antidepressant potential.
authors.affiliation: School of Psychiatry, University of New South Wales, Black Dog Institute, Sydney, NSW 2031, Australia.
authors.forename: Kerrie-Anne
authors.initials: KA
authors.lastname: Ho
authors.affiliation: Graduate School of Biomedical Engineering, University of New South Wales, Sydney, Australia.
authors.forename: Siwei
authors.initials: S
authors.lastname: Bai
authors.affiliation: School of Psychiatry, University of New South Wales, Black Dog Institute, Sydney, NSW 2031, Australia.
authors.forename: Donel
authors.initials: D
authors.lastname: Martin
authors.affiliation: School of Psychiatry, University of New South Wales, Black Dog Institute, Sydney, NSW 2031, Australia.
authors.forename: Angelo
authors.initials: A
authors.lastname: Alonzo
authors.affiliation: Graduate School of Biomedical Engineering, University of New South Wales, Sydney, Australia.
authors.forename: Socrates
authors.initials: S
authors.lastname: Dokos
authors.affiliation: Department of Psychiatry, Hospital Universitario de Getafe, Getafe, Madrid, Spain; School of Psychiatry, University of New South Wales, Black Dog Institute, Sydney, NSW 2031, Australia.
authors.forename: Pablo
authors.initials: P
authors.lastname: Puras
authors.affiliation: School of Psychiatry, University of New South Wales, Black Dog Institute, Sydney, NSW 2031, Australia; Department of Psychiatry, St George Hospital, Sydney, Australia. Electronic address: colleen.loo@unsw.edu.au.
authors.forename: Colleen K
authors.initials: CK
authors.lastname: Loo
mesh_terms: D000328:Adult; D000339:Affect; D000928:Antidepressive Agents / Q000627:therapeutic use; D002531:Cerebellum; D003198:Computer Simulation; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*; D004567:Electrodes, Implanted / Q000009:adverse effects; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D009778:Occipital Lobe; D010865:Pilot Projects; D017397:Prefrontal Cortex; D065908:Transcranial Direct Current Stimulation / Q000295:instrumentation / Q000379:methods; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents
keywords: Computer simulation; Depression; Direct current; Stimulation; Therapy