Transcranial direct current stimulation in severe, drug-resistant major depression

Ferrucci, Roberta; Bortolomasi, Marco; Vergari, Maurizio; Tadini, L.; Salvoro, B.; Giacopuzzi, M.; Barbieri, S.

doi:10.1016/j.jad.2009.02.015

Cited by 202 publications

(119 citation statements)

References 22 publications

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“…For the left anodal stimulation, the anode was at F3 and the cathode at F4; for the left cathodal stimulation, the cathode was at F3 and the anode at F4. This montage has been used in several studies (Ferrucci et al, 2009, Brunoni et al, 2011b. For the verum tDCS we used a 1.5 mA current, for the sham condition the device was turned off after 30 seconds of stimulation, a sham method proved to be reliable for blinding purposes (Gandiga et al, 2006).…”

Section: Designmentioning

confidence: 99%

Polarity- and valence-dependent effects of prefrontal transcranial direct current stimulation on heart rate variability and salivary cortisol

Brunoni

Vanderhasselt

Boggio

et al. 2013

Psychoneuroendocrinology

125

115

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Recent evidence has supported the notion that the hypothalamic-pituitary-adrenal (HPA) and the sympatho-adreno-medullary (SAM) systems are modulated by cortical structures such as the prefrontal cortex. This top-down modulation may play a major role in the neuroendocrine changes associated with stressful events. We aimed to investigate further this hypothesis by modulating directly prefrontal cortex excitability using transcranial direct current stimulation (tDCS) -a non-invasive, neuromodulatory tool that induces polaritydependent changes in cortical excitability -and measuring effects on salivary cortisol and heart rate variability as proxies of the HPA and SAM systems. Twenty healthy participants with no clinical and neuropsychiatric conditions were randomized to receive bifrontal tDCS (left anodal/right cathodal or left cathodal/right anodal) or sham stimulation, in a withinsubject design. During each stimulation session, after a resting period, subjects were shown images with neutral or negative valence. Our findings showed that excitability enhancing left anodal tDCS induced a decrease in cortisol levels. This effect is more pronounced during emotional negative stimuli. Moreover, vagal activity was higher during left anodal tDCS and emotional negative stimuli, as compared to sham stimulation and neutral images. We also observed an association between higher mood scores, higher vagal activation and lower cortisol levels for anodal stimulation. Subjective mood and anxiety evaluation revealed no specific changes after stimulation. Our findings suggest that tDCS induced transient, polarity specific modulatory top-down effects with anodal tDCS leading to a down-regulation of HPA and SAM systems. Further research using tDCS and neuroendocrine markers should explore the mechanisms of stress regulation in healthy and clinical samples.3

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Section: Designmentioning

confidence: 99%

Polarity- and valence-dependent effects of prefrontal transcranial direct current stimulation on heart rate variability and salivary cortisol

Brunoni

Vanderhasselt

Boggio

et al. 2013

Psychoneuroendocrinology

125

115

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“…Anodal tDCS of the dorsolateral prefrontal cortex (DLPFC) with the cathode placed over the contralateral supraorbital region has been found to improve performance in several cognitive domains, including executive functions, verbal skills, and memory performance in healthy subjects (Iyer et al, 2005;Wassermann and Grafman, 2005;Cerruti and Schlaug, 2009;Sparing et al, 2008;Dockery et al, 2009;Fiori et al, 2011), as well as in patients with Parkinson's disease and stroke Jo et al, 2009). Promising pilot data suggest a positive therapeutic effect in patients with major depression Boggio et al, 2008;Rigonatti et al, 2008;Ferrucci et al, 2009). Moreover, prefrontal tDCS could influence the emotional-affective domain of the self (Boggio et al, 2009;Karim et al, 2010;Mameli et al, 2010).…”

Section: Introductionmentioning

confidence: 99%

Prefrontal Transcranial Direct Current Stimulation Changes Connectivity of Resting-State Networks during fMRI

Keeser¹,

Meindl²,

Bor³

et al. 2011

J. Neurosci.

526

363

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Transcranial direct current stimulation (tDCS) has been proposed for experimental and therapeutic modulation of regional brain function. Specifically, anodal tDCS of the dorsolateral prefrontal cortex (DLPFC) together with cathodal tDCS of the supraorbital region have been associated with improvement of cognition and mood, and have been suggested for the treatment of several neurological and psychiatric disorders. Although modeled mathematically, the distribution, direction, and extent of tDCSmediated effects on brain physiology are not well understood. The current study investigates whether tDCS of the human prefrontal cortex modulates resting-state network (RSN) connectivity measured by functional magnetic resonance imaging (fMRI). Thirteen healthy subjects underwent real and sham tDCS in random order on separate days. tDCS was applied for 20 min at 2 mA with the anode positioned over the left DLPFC and the cathode over the right supraorbital region. Patterns of resting-state brain connectivity were assessed before and after tDCS with 3 T fMRI, and changes were analyzed for relevant networks related to the stimulation-electrode localizations. At baseline, four RSNs were detected, corresponding to the default mode network (DMN), the left and right frontal-parietal networks (FPNs) and the self-referential network. After real tDCS and compared with sham tDCS, significant changes of regional brain connectivity were found for the DMN and the FPNs both close to the primary stimulation site and in connected brain regions. These findings show that prefrontal tDCS modulates resting-state functional connectivity in distinct functional networks of the human brain.

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“…It has been shown that the induced excitability changes and the length of the lasting effect depend on two parameters of direct currents: intensity and duration of application 26, 27. The effects of modifications of these parameters have been tested in a few clinical applications 28, 29, 30…”

Section: Discussionmentioning

confidence: 99%

Cathodal transcranial direct‐current stimulation for treatment of drug‐resistant temporal lobe epilepsy: A pilot randomized controlled trial

et al. 2016

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SummaryObjectiveTo investigate the effect of cathodal transcranial direct‐current stimulation (c‐tDCS) on seizure frequency in patients with drug‐resistant temporal lobe epilepsy (TLE).MethodTwenty‐nine patients with drug‐resistant TLE participated in this study. They were randomized to experimental or sham group. Twenty participants (experimental group) received within‐session repeated c‐tDCS intervention over the affected temporal lobe, and nine (sham group) received sham tDCS. Paired‐pulse transcranial magnetic stimulation was used to assess short interval intracortical inhibition (SICI) in primary motor cortex ipsilateral to the affected temporal lobe. SICI was measured from motor evoked potentials recorded from the contralateral first dorsal interosseous muscle. Adverse effects were monitored during and after each intervention in both groups. A seizure diary was given to each participant to complete for 4 weeks following the tDCS intervention. The mean response ratio was calculated from their seizure rates before and after the tDCS intervention.ResultsThe experimental group showed a significant increase in SICI compared to the sham group (F = 10.3, p = 0.005). None of the participants reported side effects of moderate or severe degree. The mean response ratio in seizure frequency was −42.14% (standard deviation [SD] 35.93) for the experimental group and −16.98% (SD 52.41) for the sham group.SignificanceResults from this pilot study suggest that tDCS may be a safe and efficacious nonpharmacologic intervention for patients with drug‐resistant TLE. Further evaluation in larger double‐blind randomized controlled trials is warranted.

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Transcranial direct current stimulation in severe, drug-resistant major depression

Cited by 202 publications

References 22 publications

Polarity- and valence-dependent effects of prefrontal transcranial direct current stimulation on heart rate variability and salivary cortisol

Polarity- and valence-dependent effects of prefrontal transcranial direct current stimulation on heart rate variability and salivary cortisol

Prefrontal Transcranial Direct Current Stimulation Changes Connectivity of Resting-State Networks during fMRI

Cathodal transcranial direct‐current stimulation for treatment of drug‐resistant temporal lobe epilepsy: A pilot randomized controlled trial

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