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Brain Stimul. 2019 Jun 19. pii: S1935-861X(19)30273-6. doi: 10.1016/j.brs.2019.06.019. [Epub ahead of print]

Transcranial direct current stimulation (tDCS) for depression in pregnancy: A pilot randomized controlled trial.

Author information

1
University of Toronto, Toronto, Ontario, Canada; Women's College Hospital and Research Institute, Toronto, Ontario, Canada. Electronic address: simone.vigod@wchospital.ca.
2
University of Toronto, Toronto, Ontario, Canada; Sinai Health System, Toronto, Ontario, Canada.
3
University of Toronto, Toronto, Ontario, Canada; St. Michael's Hospital, Li Ka Shing Knowledge Translation Institute, Toronto, Ontario, Canada.
4
BC Children's Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada.
5
University of Toronto, Toronto, Ontario, Canada; Temerty Centre for Therapeutic Brain Intervention and Campbell Family Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.

Abstract

BACKGROUND:

Depression in pregnancy negatively affects maternal-child health. Transcranial direct current stimulation (tDCS), a non-invasive brain stimulation treatment for depression, has not been evaluated in pregnancy.

OBJECTIVE:

To conduct a pilot randomized controlled trial (RCT) to evaluate tDCS for antenatal depression.

METHODS:

In this pilot RCT in Toronto, Ontario (October 2014 to December 2016), adult pregnant women 14-32 weeks gestation with major depressive disorder who had declined antidepressant medication were considered for inclusion. Participants were randomly assigned 1:1 to tDCS or sham-control. Active tDCS comprised 30-min sessions of 2 mAmp direct current delivered over the dorsolateral prefrontal cortex, 5 days per week, for 3 weeks. Sham was administered similarly, but with current turned off after 30 s. Main outcomes were feasibility, acceptability, and protocol adherence. Maternal Montgomery Asperg Depression Rating Scale (MADRS) was measured post-treatment and at 4 and 12 weeks postpartum.

RESULTS:

Of 20 women randomized, 16 completed treatment and provided data (124 tDCS, 122 sham sessions). Views of treatment were positive with no serious adverse events. Post-treatment estimated marginal mean MADRS scores were 11.8 (standard error, SE 2.66) for tDCS and 15.4 (SE 2.51) for sham (p = 0.34). At 4 weeks postpartum, 75.0% of tDCS women were remitted versus 12.5% sham-control (p = 0.04).

CONCLUSIONS:

Results support proceeding to a definitive RCT to evaluate tDCS for antenatal depression. The preliminary efficacy estimates immediately post-treatment and in the postpartum, are encouraging with respect to the potential use of tDCS to improve treatment rates in this population. The trial was registered at: clinical trials.gov (NCT02116127).

KEYWORDS:

Antenatal depression; Antidepressive agents; Brain stimulation; Pregnancy; Transcranial direct current stimulation; tDCS

PMID:
31257092
DOI:
10.1016/j.brs.2019.06.019

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