Home-Based Transcranial Direct Current Stimulation for the Treatment of Symptoms of Depression and Anxiety in Temporal Lobe Epilepsy: A Randomized, Double-Blind, Sham-Controlled Clinical Trial

Abstract

We conducted a double-blind randomized clinical trial in order to examine the effects and the safety of home-based transcranial direct current stimulation (tDCS) on depressive and anxious symptoms of patients with temporal lobe epilepsy (TLE). We evaluated 26 adults with TLE and depressive symptoms randomized into two different groups: active tDCS (tDCSa) and Sham (tDCSs). The patients were first submitted to 20 sessions of tDCS for 20 min daily, 5 days a week for 4 weeks and then received a maintenance tDCS application in the research laboratory once a week for 3 weeks. The intensity of the current was 2 mA, applied bilaterally over the dorsolateral prefrontal cortex, with the anode positioned on the left side and the cathode on the right side. Participants were evaluated on days 1, 15, 30, and 60 of the study using the Beck Depression Inventory II (BDI). A follow-up evaluation was performed 1 year after the end of treatment. They were also evaluated for quality of life and for anxious symptoms as secondary outcomes. The groups did not differ in clinical, socioeconomic or psychometric characteristics at the initial assessment. There was no statistically significant difference between groups regarding reported adverse effects, seizure frequency or dropouts. On average, between the 1st and 60th day, the BDI score decreased by 43.93% in the active group and by 44.67% in the Sham group (ΔBDIfinal – initial = −12.54 vs. −12.20, p = 0.68). The similar improvement in depressive symptoms observed in both groups was attributed to placebo effect and interaction between participants and research group and not to tDCS intervention per se. In our study, tDCS was safe and well tolerated, but it was not effective in reducing depressive or anxiety symptoms in patients with temporal lobe epilepsy.Clinical Trial Registration: [ClinicalTrials.gov], identifier [NCT03871842].

Transcranial direct current stimulation in the treatment of anxiety and depression in patients with oral cancer during perioperative period

“…[15][16][17][18] It applies low-intensity direct current using scalp electrodes overlying targeted cerebral cortical areas through the scalp. [15][16][17] Although a variety of studies have reported tDCS for anxiety and depression relief, [19][20][21][22][23][24][25] there are still insufficient data to investigate the efficacy of tDCS in the treatment of anxiety and depression in patients with OC during PPP. Therefore, this retrospective study explored the efficacy of tDCS for anxiety and depression in patients with OC during PPP.…”

TDCS at home for depressive disorders: an updated systematic review and lessons learned from a prematurely terminated randomized controlled pilot study

“…MADRS decreased in all 3 completers (average decrease: 59% baseline to 1-month follow-up), same trend for the other scores S: new training programme, electrode montage multichannel. W: only 3 patients completed, ratings via phone, no control group A = yes Q = yes S = yes T = no V = no Mota et al [ 31 ] Randomized, double-blind, sham-controlled clinical trial for home-based tDCS in depression in temporal lobe epilepsy N = 26 13 active, 12 female 53.38 ± 14.45 years, 12 sham, 10 female 55.76 ± 7.68 years Active and sham condition, prefrontal: anode left, cathode right, 2 mA, sham: no current, 20 min, 20 sessions in 4 weeks home-based, then 3 sessions in 3 weeks in-clinic Self-administered after training by a clinician and with instructional video 7 moderate or severe AEs in active, 3 in sham group: headache, most common side effects were tingling, itching, burning, headache, somnolence, moodswings. Drop-out: 1 (active): pain, burning discomfort.…”

Transcranial Direct Current Stimulation as Treatment for Major Depression in a Home Treatment Setting (HomeDC Trial): Study Design and Methodology of a Double-blind, Placebo-controlled Pilotstudy

“…Thus, while the home-based treatment with tDCS has been widely applied and studied in neurological and in speci c psychiatric disorders, there are few published studies examining the home use of tDCS in the treatment of depression: In a placebo-controlled study, the home-based application of 20 sessions of 20 minute 2 mA prefrontal tDCS in 26 patients with temporal lobe epilepsy and depressive symptoms was investigated. Results showed good feasibility, but no difference between the groups with regard to the reduction of depressive symptoms equally signi cant in both groups (22). In another tDCS home-application case series, 12 patients with treatment-resistant and chronic depression were treated with tDCS, partly as maintenance therapy after electroconvulsive therapy (ECT) or rTMS.…”