An Educational Program for Remote Training and Supervision of Home-Based Transcranial Electrical Stimulation: Feasibility and Preliminary Effectiveness

Cappon, Davide; Boer, Tim den; Yu, Wanting; LaGanke, Nicole; Fox, Robert; Brozgol, Marina; Hausdorff, Jeffrey M.; Manor, Brad; Pascual‐Leone, Álvaro

doi:10.1016/j.neurom.2023.04.477

Cited by 6 publications

(2 citation statements)

References 45 publications

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“…This highlights the need for corresponding training of the instructing staff. A recent investigation concerning another NIBS, home-based tES (transcranial electrical stimulation), showed that an educational program for remote training and supervision at home could facilitate further research ( 32 ).…”

Section: Discussionmentioning

confidence: 99%

Treating depression at home with transcranial direct current stimulation: a feasibility study

Dragon,

Abdelnaim,

Weber

et al. 2024

Front. Psychiatry

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IntroductionTreating major depressive disorder (MDD) with transcranial direct current stimulation (tDCS) devices at home has various logistic advantages compared to tDCS treatment in the clinic. However, preliminary (controlled) studies showed side effects such as skin lesions and difficulties in the implementation of home-based tDCS. Thus, more data are needed regarding the feasibility and possible disadvantages of home-based tDCS.MethodsTen outpatients (23–69 years) with an acute depressive episode were included for this one-arm feasibility study testing home-based tDCS. All patients self-administered prefrontal tDCS (2 mA, 20 min, anodal left, cathodal right) at home on 30 consecutive working days supported by video consultations. Correct implementation of the home-based treatment was analyzed with tDCS recordings. Feasibility was examined by treatment compliance. For additional analyses of effectiveness, three depression scores were used: Hamilton depression rating scale (HDRS-21), Major Depression Inventory (MDI), and the subscale depression of the Depression-Anxiety-Stress Scale (DASS). Furthermore, usability was measured with the user experience questionnaire (UEQ). Tolerability was analyzed by the number of reported adverse events (AEs).ResultsEight patients did not stick to the protocol. AEs were minimal. Four patients responded to the home treatment according to the MDI. Usability was judged positive by the patients.ConclusionsRegular video consultations or other safety concepts are recommended regardless of the number of video sessions actually conducted. Home-based tDCS seems to be safe and handy in our feasibility study, warranting further investigation.

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Section: Discussionmentioning

confidence: 99%

Treating depression at home with transcranial direct current stimulation: a feasibility study

Dragon,

Abdelnaim,

Weber

et al. 2024

Front. Psychiatry

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“…Recent attention has been drawn to home-based tDCS (a pre-configured device designed for independent use in the home setting) and its feasibility and effectiveness since it allows for more extended periods of intervention. 41 However, there is no evidence of the feasibility or effectiveness of home-based neuromodulatory interventions for an extended period in neurodegenerative diseases. In the present case study, we describe the longest (10 weeks) home-based tDCS treatment with computerized cognitive training (CCT), to our knowledge, reported in FTD.…”

Section: Introductionmentioning

confidence: 99%

Long-term, home-based transcranial direct current stimulation coupled with computerized cognitive training in frontotemporal dementia: A case report

Tippett,

Neophytou,

Tao

et al. 2024

J Cent Nerv Syst Dis

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We present the case of a 62-year-old woman with probable behavioral variant of frontotemporal dementia (bvFTD) with cognitive/language deficits who demonstrated improved performance on cognitive/language testing and in functional tasks following long-term, home-based transcranial direct current stimulation (tDCS) coupled with computerized cognitive training (CCT). The patient underwent home-based tDCS (anode on the left prefrontal cortex and cathode on the right homologue) for 46 sessions over 10 weeks along with CCT. On post-treatment testing, the patient improved by 3 points on the Mini-Mental State Exam (MMSE) (23 to 26). She also showed improvement on several cognitive/language tasks, such as immediate recall of single words and word pairs, total accurate words in sentence repetition, delayed recall, semantic processing, and sentence level comprehension. There was no decline in several other cognitive and language tasks. Family members reported subjective improvements in expressiveness, communication, and interaction with others as well as increased attention to grooming and style which contrasted with her pre-treatment condition. This report suggests that home-based tDCS combined with CCT for an extended period may slow decline, and improve cognitive/language performance and everyday function in FTD.

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Multichannel tDCS with Advanced Targeting for Major Depressive Disorder: A Tele-Supervised At-Home Pilot Study

Ruffini,

Salvador,

Castaldo

et al. 2024

Preprint

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PurposeProof-of-principle human studies suggest that transcranial direct current stimulation (tDCS) over the left dorsolateral prefrontal cortex (L-DLPFC) may improve the clinical symptoms of depression. This multicenter study (N=35) tested remotely supervised and repeated daily multichannel tDCS delivered at home designed to target the L-DLPFC in a group of patients with major depressive disorder (MDD). The main objectives of the study were to assess the feasibility and safety of home-based, remotely-supervised tDCS for patients with MDD. As an exploratory aim, we also aimed to evaluate the efficacy. The primary efficacy measure for this study was the median percent change from baseline to the end of the 4-week post-treatment follow-up period in the observer-rated Montgomery-Asberg Depression Mood Rating Scale (MADRS).MethodsFor each study participant, this open-label feasibility telemedicine pilot study involved 37 at-home stimulation sessions (30 minutes each) of multichannel tDCS targeting L-DLPFC administered over eight weeks, with a follow-up period of 4 weeks following the final stimulation session. The stimulation montage (electrode positions and currents) was optimized by employing computational models using available structural data from a similar population (group optimization). Conducted entirely remotely, the study employed the MADRS for assessment at baseline, at weeks 4 and 8 during treatment, and at 4-week follow-up visits.ResultsThe population who completed all study visits consisted of 34 patients (85.3% women and 14.7% men) with a mean age of 59 years, a diagnosis of MDD according to DSM-V criteria, and a MADRS score ≥20 at the time of study enrolment. At baseline, the mean time since MDD diagnosis was 24.0 (SD 19.1) months. Nearly 90% of the participants (n=29) completed the full course of 37 stimulation sessions at home, covering both the acute and taper phases. No detrimental effects were observed, and no participants had suicidal ideation and/or behavior, whether at baseline during treatment or during the four weeks post-treatment. The study observed a Median percentage MADRS score reduction of 64.5% (48.6, 72.4). Over 70% of participants (n=24) showed a ≥ 50% improvement in MADRS scores from baseline to the last visit (4 weeks post-treatment), with a response rate (RR) of 72.7%. Secondary measures, including the Quick Inventory of Depressive Symptomatology-Self Report (QUIDS-SR) and the Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF), reflected similar improvements. The mean (SD) and the median difference between the final visit and baseline for the Q-LES-Q-SF score were 27.9 (13.8) and 26.8 (17.9, 35.7), respectively.ConclusionsThese results suggest that remotely supervised and supported home-based tDCS is safe and feasible, and antidepressant efficacy motivates further appropriately controlled clinical studies.

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An Educational Program for Remote Training and Supervision of Home-Based Transcranial Electrical Stimulation: Feasibility and Preliminary Effectiveness

Cited by 6 publications

References 45 publications

Treating depression at home with transcranial direct current stimulation: a feasibility study

Treating depression at home with transcranial direct current stimulation: a feasibility study

Long-term, home-based transcranial direct current stimulation coupled with computerized cognitive training in frontotemporal dementia: A case report

Multichannel tDCS with Advanced Targeting for Major Depressive Disorder: A Tele-Supervised At-Home Pilot Study

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