Home-Based tDCS for Anxiety and Depression: Case Series Analysis

Author Names

Mónica Sobral, Raquel Guiomar, Vera Martins, Ana Ganho-Ávila

Published Date: October 2022

Journal Name: Frontiers in Psychiatry

Abstract

This case series explores the application of home-based transcranial direct current stimulation (tDCS) combined with behavioral therapy and/or pharmacotherapy in treating depression and anxiety. Seven patients with various psychiatric conditions, including major depressive disorder (MDD), dysthymia, illness anxiety disorder, obsessive-compulsive disorder (OCD), and anxiety disorders, were included in the study. The results indicate significant improvements in depressive and anxiety symptoms for most patients, highlighting the potential of tDCS as a complementary treatment option.

Key Concepts

• Transcranial Direct Current Stimulation (tDCS): A non-invasive brain stimulation technique used to modulate neuronal activity, potentially alleviating symptoms of depression and anxiety.

• Home-Based Treatment: The use of tDCS at home, providing patients with a convenient and accessible treatment option.

• Dual Active Treatment: The combination of tDCS with behavioral therapy or pharmacotherapy to enhance therapeutic outcomes.

• Literature Review: Previous studies have shown varying results with tDCS, but recent research suggests potential benefits when combined with other therapies, particularly in treating psychiatric disorders.

Procedure Highlights - Research Methodology

1. Study Design: A case series involving seven patients diagnosed with depression, anxiety, or OCD, who received home-based tDCS in combination with psychotherapy and/or medication.

2. Participants: Seven patients aged 26-51 years, with different psychiatric diagnoses, were selected for the study. Five patients were medication-free, while two were on stable doses of antidepressants and benzodiazepines.

3. tDCS Intervention: Patients received 18 to 39 sessions of tDCS over 6 to 10 weeks, using the Flow tDCS device. The stimulation targeted the dorsolateral prefrontal cortex, with sessions paired with behavioural therapy via the Flow app.

4. Outcome Measures: Depression and anxiety symptoms were measured using the Montgomery-Åsberg Depression Rating Scale (MADRS-S), Beck Depression Inventory-II (BDI-II), and State-Trait Anxiety Inventory (STAI-Y2). Treatment acceptability was assessed with the ACCEPT-tDCS questionnaire.

Results - Findings of the Research

• Depression Improvement: Five patients showed clinically significant improvement in depressive symptoms. The percentage change in MADRS-S scores ranged from 37.9% to 66.7%, and in BDI-II scores from 57.1% to 100%.

• Anxiety Improvement: Five patients also experienced significant reductions in anxiety symptoms, with STAI-Y2 percentage changes ranging from 12.3% to 46.4%.

• Treatment Adherence: Overall adherence to the tDCS treatment was high, with patients reporting minimal side effects, primarily mild tingling or scalp discomfort.

Discussion and Conclusion of the Research

The study concludes that home-based tDCS, combined with behavioural therapy and/or pharmacotherapy, can be an effective treatment for depression and anxiety, especially when integrated into a dual active treatment plan. The convenience of home-based treatment, coupled with high patient adherence and significant symptom improvement, supports the use of tDCS as a complementary option in clinical practice. However, further research with larger sample sizes is needed to confirm these findings and optimize treatment protocols.

Link to the Original Paper

Home-based transcranial direct current stimulation in dual active treatments for symptoms of depression and anxiety: A case series

Author Information

• Mónica Sobral: Faculty of Psychology and Educational Sciences, Center for Research in Neuropsychology and Cognitive Behavioral Intervention, University of Coimbra, Coimbra, Portugal

• Raquel Guiomar: Faculty of Psychology and Educational Sciences, Center for Research in Neuropsychology and Cognitive Behavioral Intervention, University of Coimbra, Coimbra, Portugal

• Vera Martins: Neuroncircuit—e.Stim Clínica de Saúde Mental, Coimbra, Portugal; Coimbra Hospital and University Centre, Coimbra, Portugal

• Ana Ganho-Ávila: Faculty of Psychology and Educational Sciences, Center for Research in Neuropsychology and Cognitive Behavioral Intervention, University of Coimbra, Coimbra, Portugal

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