TY - JOUR
T1 - Home-based transcranial direct current stimulation in bipolar depression
T2 - an open-label treatment study of clinical outcomes, acceptability and adverse events
AU - Ghazi-Noori, Ali-Reza
AU - Woodham, Rachel D
AU - Rezaei, Hakimeh
AU - Sharif, Mhd Saeed
AU - Bramon, Elvira
AU - Ritter, Philipp
AU - Bauer, Michael
AU - Young, Allan H
AU - Fu, Cynthia H Y
N1 - Publisher Copyright:
© The Author(s) 2024.
PY - 2024/8/20
Y1 - 2024/8/20
N2 - BACKGROUND: Current treatments for bipolar depression have limited effectiveness, tolerability and acceptability. Transcranial direct current stimulation (tDCS) is a novel non-invasive brain stimulation method that has demonstrated treatment efficacy for major depressive episodes. tDCS is portable, safe, and individuals like having sessions at home. We developed a home-based protocol with real-time remote supervision. In the present study, we have examined the clinical outcomes, acceptability and feasibility of home-based tDCS treatment in bipolar depression.RESULTS: Participants were 44 individuals with bipolar disorder (31 women), mean age 47.27 ± 12.89 years, in current depressive episode of at least moderate severity (mean Montgomery Asberg Depression Rating Scale (MADRS) score 24.59 ± 2.64). tDCS was provided in bilateral frontal montage, F3 anode, F4 cathode, 2 mA, for 30 min, in a 6-week trial, for total 21 sessions, a follow up visit was conducted 5 months from baseline. Participants maintained their current treatment (psychotherapy, antidepressant or mood stabilising medication) or maintained being medication-free. A research team member was present by video conference at each session. 93.2% participants (n = 41) completed the 6-week treatment and 72.7% of participants (n = 32) completed the 5 month follow up. There was a significant improvement in depressive symptoms following treatment (mean MADRS 8.77 ± 5.37) which was maintained at the 5 month follow up (mean MADRS 10.86 ± 6.90), rate of clinical response was 77.3% (MADRS improvement of 50% or greater from baseline), and rate of clinical remission was 47.7% (MADRS rating of 9 or less). Acceptability was endorsed as "very acceptable" or "quite acceptable" by all participants. No participants developed mania or hypomania.CONCLUSIONS: In summary, home-based tDCS with real-time supervision was associated with significant clinical improvements and high acceptability in bipolar depression. Due to the open-label design, efficacy findings are preliminary.TRIAL REGISTRATION: ClinicalTrials.gov number NCT05436613 registered on 23 June 2022 https//www.CLINICALTRIALS: gov/study/NCT05436613.
AB - BACKGROUND: Current treatments for bipolar depression have limited effectiveness, tolerability and acceptability. Transcranial direct current stimulation (tDCS) is a novel non-invasive brain stimulation method that has demonstrated treatment efficacy for major depressive episodes. tDCS is portable, safe, and individuals like having sessions at home. We developed a home-based protocol with real-time remote supervision. In the present study, we have examined the clinical outcomes, acceptability and feasibility of home-based tDCS treatment in bipolar depression.RESULTS: Participants were 44 individuals with bipolar disorder (31 women), mean age 47.27 ± 12.89 years, in current depressive episode of at least moderate severity (mean Montgomery Asberg Depression Rating Scale (MADRS) score 24.59 ± 2.64). tDCS was provided in bilateral frontal montage, F3 anode, F4 cathode, 2 mA, for 30 min, in a 6-week trial, for total 21 sessions, a follow up visit was conducted 5 months from baseline. Participants maintained their current treatment (psychotherapy, antidepressant or mood stabilising medication) or maintained being medication-free. A research team member was present by video conference at each session. 93.2% participants (n = 41) completed the 6-week treatment and 72.7% of participants (n = 32) completed the 5 month follow up. There was a significant improvement in depressive symptoms following treatment (mean MADRS 8.77 ± 5.37) which was maintained at the 5 month follow up (mean MADRS 10.86 ± 6.90), rate of clinical response was 77.3% (MADRS improvement of 50% or greater from baseline), and rate of clinical remission was 47.7% (MADRS rating of 9 or less). Acceptability was endorsed as "very acceptable" or "quite acceptable" by all participants. No participants developed mania or hypomania.CONCLUSIONS: In summary, home-based tDCS with real-time supervision was associated with significant clinical improvements and high acceptability in bipolar depression. Due to the open-label design, efficacy findings are preliminary.TRIAL REGISTRATION: ClinicalTrials.gov number NCT05436613 registered on 23 June 2022 https//www.CLINICALTRIALS: gov/study/NCT05436613.
UR - http://www.scopus.com/inward/record.url?scp=85201539672&partnerID=8YFLogxK
U2 - 10.1186/s40345-024-00352-9
DO - 10.1186/s40345-024-00352-9
M3 - Article
C2 - 39162912
SN - 2194-7511
VL - 12
SP - 30
JO - International Journal of Bipolar Disorders
JF - International Journal of Bipolar Disorders
IS - 1
M1 - 30
ER -