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A randomized, double-blind clinical trial on the efficacy of cortical direct current stimulation for the treatment of major depression

Paulo S. Boggio, Sergio P. Rigonatti, Rafael B. Ribeiro, Martin L. Myczkowski, Michael A. Nitsche, Alvaro Pascual-Leone, Felipe Fregni
DOI: http://dx.doi.org/10.1017/S1461145707007833 249-254 First published online: 1 March 2008

Abstract

Preliminary findings suggest that transcranial direct current stimulation (tDCS) can have antidepressant effects. We sought to test this further in a parallel-group, double-blind clinical trial with 40 patients with major depression, medication-free randomized into three groups of treatment: anodal tDCS of the left dorsolateral prefrontal cortex (active group – ‘DLPFC’); anodal tDCS of the occipital cortex (active control group – ‘occipital’) and sham tDCS (placebo control group – ‘sham’). tDCS was applied for 10 sessions during a 2-wk period. Mood was evaluated by a blinded rater using the Hamilton Depression Rating Scale (HDRS) and Beck Depression Inventory (BDI). The treatment was well tolerated with minimal side-effects that were distributed equally across all treatment groups. We found significantly larger reductions in depression scores after DLPFC tDCS [HDRS reduction of 40.4% (±25.8%)] compared to occipital [HDRS reduction of 21.3% (±12.9%)] and sham tDCS [HDRS reduction of 10.4% (±36.6%)]. The beneficial effects of tDCS in the DLPFC group persisted for 1 month after the end of treatment. Our findings support further investigation on the effects of this novel potential therapeutic approach – tDCS – for the treatment of major depression.

Key words
  • Brain stimulation
  • electrical stimulation
  • major depression
  • prefrontal cortex
  • transcranial direct current stimulation
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