title: Clinical Pilot Study and Computational Modeling of Bitemporal Transcranial Direct Current Stimulation, and Safety of Repeated Courses of Treatment, in Major Depression.
abstract: OBJECTIVE
  This study aimed to examine a bitemporal (BT) transcranial direct current stimulation (tDCS) electrode montage for the treatment of depression through a clinical pilot study and computational modeling. The safety of repeated courses of stimulation was also examined.
  
  
  METHODS
  Four participants with depression who had previously received multiple courses of tDCS received a 4-week course of BT tDCS. Mood and neuropsychological function were assessed. The results were compared with previous courses of tDCS given to the same participants using different electrode montages. Computational modeling examined the electric field maps produced by the different montages.
  
  
  RESULTS
  Three participants showed clinical improvement with BT tDCS (mean [SD] improvement, 49.6% [33.7%]). There were no adverse neuropsychological effects. Computational modeling showed that the BT montage activates the anterior cingulate cortices and brainstem, which are deep brain regions that are important for depression. However, a fronto-extracephalic montage stimulated these areas more effectively. No adverse effects were found in participants receiving up to 6 courses of tDCS.
  
  
  CONCLUSIONS
  Bitemporal tDCS was safe and led to clinically meaningful efficacy in 3 of 4 participants. However, computational modeling suggests that the BT montage may not activate key brain regions in depression more effectively than another novel montage--fronto-extracephalic tDCS. There is also preliminary evidence to support the safety of up to 6 repeated courses of tDCS.
authors: From the *School of Psychiatry, University of New South Wales, Black Dog Institute; †Graduate School of Biomedical Engineering, University of New South Wales and ‡Department of Psychiatry, St George Hospital, Sydney, New South Wales, Australia.
authors: Kerrie-Anne
authors: KA
authors: Ho
authors: Siwei
authors: S
authors: Bai
authors: Donel
authors: D
authors: Martin
authors: Angelo
authors: A
authors: Alonzo
authors: Socrates
authors: S
authors: Dokos
authors: Colleen K
authors: CK
authors: Loo
mesh_terms: D000328:Adult; D000339:Affect; D001933:Brain Stem; D003071:Cognition; D003198:Computer Simulation; D003865:Major Depressive Disorder / Q000523:psychology / Q000628:therapy*; D004574:Electromagnetic Fields; D005260:Female; D005625:Frontal Lobe; D006179:Gyrus Cinguli; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D061214:Patient Safety; D010865:Pilot Projects; D011569:Psychiatric Status Rating Scales; D065908:Transcranial Direct Current Stimulation / Q000009:adverse effects* / Q000379:methods*; D016896:Treatment Outcome