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Neurosci Biobehav Rev. 2015 Oct;57:46-62. doi: 10.1016/j.neubiorev.2015.07.012. Epub 2015 Jul 29.

Transcranial direct current stimulation (tDCS) in the treatment of depression: Systematic review and meta-analysis of efficacy and tolerability.

Author information

1
Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, University Department of Psychiatry, Academic Centre, College Keep, 4-12 Terminus Terrace, Southampton SO14 3DT, United Kingdom; Avon & Wiltshire Partnership NHS Trust, Jenner House, Langley Park, Chippenham SN15 1GG, Wiltshire, United Kingdom. Electronic address: dan@soton.ac.uk.
2
Psychology, Faculty of Social, Human and Mathematical Sciences, University of Southampton, Southampton, United Kingdom. Electronic address: nick.hedger@soton.ac.uk.
3
Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, University Department of Psychiatry, Academic Centre, College Keep, 4-12 Terminus Terrace, Southampton SO14 3DT, United Kingdom; Psychology, Faculty of Social, Human and Mathematical Sciences, University of Southampton, Southampton, United Kingdom. Electronic address: M.J.GARNER@soton.ac.uk.
4
Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, University Department of Psychiatry, Academic Centre, College Keep, 4-12 Terminus Terrace, Southampton SO14 3DT, United Kingdom; University Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa. Electronic address: D.S.Baldwin@soton.ac.uk.

Abstract

BACKGROUND:

Transcranial direct current stimulation (tDCS) is a potential alternative treatment option for major depressive episodes (MDE).

OBJECTIVES:

We address the efficacy and safety of tDCS in MDE.

METHODS:

The outcome measures were Hedges' g for continuous depression ratings, and categorical response and remission rates.

RESULTS:

A random effects model indicated that tDCS was superior to sham tDCS (k=11, N=393, g=0.30, 95% CI=[0.04, 0.57], p=0.027). Adjunctive antidepressant medication and cognitive control training negatively impacted on the treatment effect. The pooled log odds ratios (LOR) for response and remission were positive, but statistically non-significant (response: k=9, LOR=0.36, 95% CI[-0.16, 0.88], p=0.176, remission: k=9, LOR=0.25, 95% CI [-0.42, 0.91], p=0.468). We estimated that for a study to detect the pooled continuous effect (g=0.30) at 80% power (alpha=0.05), a total N of at least 346 would be required (with the total N required to detect the upper and lower bound being 49 and 12,693, respectively).

CONCLUSIONS:

tDCS may be efficacious for treatment of MDE. The data do not support the use of tDCS in treatment-resistant depression, or as an add-on augmentation treatment. Larger studies over longer treatment periods are needed.

KEYWORDS:

Cognitive control training; Depression; Meta-analysis; Non-pharmacological therapies; Remission; Response; Systematic review; Transcranial direct current stimulation; tDCS

PMID:
26232699
DOI:
10.1016/j.neubiorev.2015.07.012
[Indexed for MEDLINE]

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