tDCS for Depression: Is Home-Based Treatment Effective with Remote Supervision?

Author Names

Rachel D. Woodham, Rachael M. Rimmer, Allan H. Young and Cynthia H.Y. Fu

Published Date: July 2022

Source: Journal of Psychiatric Research

Abstract

This study investigates the feasibility, acceptability, and long-term outcomes of home-based transcranial direct current stimulation (tDCS) for major depressive disorder (MDD) with real-time remote supervision. The study enrolled 26 participants with moderate to severe depression, delivering 21 sessions over six weeks. The results showed significant improvements in depressive symptoms, with high rates of clinical response and remission, maintained at six months follow-up. The treatment was well-tolerated and rated as highly acceptable by participants.

Key Concepts

• Transcranial Direct Current Stimulation (tDCS): A non-invasive neuromodulation technique used to treat depression by applying a weak electrical current to the scalp.

• Major Depressive Disorder (MDD): A mental health condition characterized by persistent sadness and a lack of interest or pleasure in life, often accompanied by physical symptoms.

• Remote Supervision: A method of monitoring patients during home-based treatments through real-time video calls or other remote technologies.

• Literature Review: Previous research has indicated that tDCS can be an effective treatment for MDD, particularly when used with real-time supervision to ensure safety and adherence.

Procedure Highlights - Research Methodology

1. Study Design: An open-label, single-arm feasibility study conducted over six weeks.

2. Participants: 26 adults diagnosed with MDD, 19 women and 7 men, aged 19 to 73 years.

3. tDCS Protocol: Participants received 21 sessions of 2 mA tDCS, each lasting 30 minutes, targeting the dorsolateral prefrontal cortex (DLPFC).

4. Supervision: Real-time remote supervision was provided during each session via video call to ensure safety and protocol adherence.

5. Outcome Measures: Depression severity was measured using the Hamilton Depression Rating Scale (HAMD), with follow-ups at 3 and 6 months.

Results - Findings of the Research

• Clinical Response and Remission at Week 6: At the end of the 6-week treatment, the mean HAMD score was 5.33 ± 2.33. A remarkable 91.7% of participants showed a clinical response, and 87.5% achieved clinical remission.

• 3-Month Follow-Up: At the 3-month follow-up, the mean HAMD score slightly increased to 5.65 ± 3.02. However, 87.0% of participants maintained a clinical response, and 78.2% remained in remission.

• 6-Month Follow-Up: By the 6-month follow-up, the mean HAMD score was 5.43 ± 2.73. Clinical response was sustained in 91.3% of participants, with 73.9% continuing in remission.

• Early Response: Notably, 16.7% of participants showed an early response after just 2 weeks (10 tDCS sessions), and 12.5% were already in remission at this point.

• Symptom Maintenance: Significant clinical improvements from baseline were maintained at both the 3-month and 6-month follow-ups.

• Acceptability: The treatment was highly acceptable, with participants rating the sessions as “very acceptable” or “quite acceptable.”

Discussion and Conclusion of the Research

The study demonstrates that home-based tDCS with real-time remote supervision is a feasible, effective, and acceptable treatment for patients with MDD.

The high rates of clinical response and remission suggest that this approach can be an alternative to in-clinic treatments, providing flexibility and maintaining safety through remote supervision.

The study supports the integration of home-based tDCS into clinical practice, particularly for patients who may have difficulty accessing traditional treatment settings.

Link to the Original Paper

Adjunctive home-based transcranial direct current stimulation treatment for major depression with real-time remote supervision: An open-label, single-arm feasibility study with long-term outcomes

Author Information

• Rachel D. Woodham: School of Psychology, University of East London, United Kingdom

• Rachael M. Rimmer: School of Psychology, University of East London, United Kingdom

• Allan H. Young: Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, United Kingdom

• Cynthia H.Y. Fu: School of Psychology, University of East London, United Kingdom; Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, United Kingdom

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