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

Transcranial direct current stimulation (tDCS) in the treatment of depression: systematic review and meta-analysis of efficacy and tolerability
Transcranial direct current stimulation (tDCS) in the treatment of depression: systematic review and meta-analysis of efficacy and tolerability
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.
cognitive control training, depression, meta-analysis, non-pharmacological therapies, remission, response, systematic review, transcranial direct current stimulation, tDCS
0097-0549
46-62
Meron, D.
65e463bd-1283-445f-ac48-dbde36e85415
Hedger, N.
26a456a8-1f18-4c41-a29e-1ddd2218ea9b
Garner, M.
3221c5b3-b951-4fec-b456-ec449e4ce072
Baldwin, D.S.
1beaa192-0ef1-4914-897a-3a49fc2ed15e
Meron, D.
65e463bd-1283-445f-ac48-dbde36e85415
Hedger, N.
26a456a8-1f18-4c41-a29e-1ddd2218ea9b
Garner, M.
3221c5b3-b951-4fec-b456-ec449e4ce072
Baldwin, D.S.
1beaa192-0ef1-4914-897a-3a49fc2ed15e

Meron, D., Hedger, N., Garner, M. and Baldwin, D.S. (2015) Transcranial direct current stimulation (tDCS) in the treatment of depression: systematic review and meta-analysis of efficacy and tolerability. Neuroscience and Behavioral Reviews, 57, 46-62. (doi:10.1016/j.neubiorev.2015.07.012). (PMID:26232699)

Record type: Article

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.

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Accepted/In Press date: 26 July 2015
e-pub ahead of print date: 29 July 2015
Published date: October 2015
Keywords: cognitive control training, depression, meta-analysis, non-pharmacological therapies, remission, response, systematic review, transcranial direct current stimulation, tDCS
Organisations: Clinical & Experimental Sciences

Identifiers

Local EPrints ID: 379931
URI: https://eprints.soton.ac.uk/id/eprint/379931
ISSN: 0097-0549
PURE UUID: 6b3b36c9-adb2-41a4-8314-4a7aca272079

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Date deposited: 01 Sep 2015 08:34
Last modified: 17 Jul 2017 20:39

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