Transcranial direct current stimulation for the treatment of post-stroke depression: A systematic review

Abstract

BackgroundPost-stroke depression (PSD) is not only a frequent neuropsychiatric manifestation secondary to stroke but is also associated with disability, poor rehabilitation outcomes, sleep disorders, cognitive impairment, and increased mortality. Transcranial direct current stimulation (tDCS), a primary modality of non-invasive brain stimulation (NIBS), has shown promising clinical results in the rehabilitation of patients with PSD recently. The primary aim of this systematic review is to assess the effects of tDCS on PSD.MethodsPubMed and Cochrane databases were used for paper identification up to May 2022. Only English language studies and published data were taken into consideration. The methodological quality of selected studies was assessed according to the modified Sackett Scale, based on Physiotherapy Evidence Database (PEDro) scores.ResultsSix experimental studies were included for the PSD treatment of tDCS and all of them reported that, following the intervention of tDCS, the experimental group shows a statistically significant decrease in the depression level in accordance with different assessment scales.ConclusionThis article simply aims at providing a comprehensive overview of the raw data reported in this field to date. Based on the current evidence, tDCS presents promising results for the treatment of PSD. Moreover, tDCS is also effective in PSD patients with aphasia or CPSP. However, an optimal stimulation protocol is needed to formulate. Thus, the development of robustly controlled, randomized, and high-quality clinical trials to further assess the utility of tDCS as a therapeutic tool for the treatment of PSD survivors is encouraged.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023322076, identifier: CRD42023322076.

Visões Contemporâneas sobre Tratamentos para a Depressão: Uma Análise da Literatura Recente

“…De acordo com Gao et al (2023), o potencial terapêutico dos probióticos na depressão é uma área emergente de pesquisa, especialmente para pacientes resistentes aos tratamentos convencionais. Estudos recentes têm revelado uma forte conexão entre a microbiota intestinal e a depressão, destacando os probióticos como uma opção viável de tratamento adjuvante.…”

A comprehensive overview of post-stroke depression treatment options

“…Extended durations of effect can occur with rTMS when repeated daily, as post-stimulation effects can be observed up to 1 month later (Sparing and Mottaghy, 2008). A recent overview on this topic concluded that patients with PSD may benefit from rTMS but noted a high level of bias and the inability to quantitatively analyze the effect of this technique (Gao et al, 2023). In more structured studies, the stimulation of the left dorsolateral prefrontal cortex with high-frequency rTMS, compared with sham stimulation, was well tolerated and associated with a significant reduction in depression in stroke survivors (Jorge et al, 2004;Qiu et al, 2023).…”