Home-based Transcranial Direct Current Stimulation in Bipolar Depression: an Open-label Treatment Study of Clinical Outcomes, Acceptability and Adverse Events

Overview

Journal Int J Bipolar Disord

Date 2024 Aug 20

PMID 39162912

Authors

Ali-Reza Ghazi-Noori

Rachel D Woodham

Hakimeh Rezaei

Mhd Saeed Sharif

Elvira Bramon

Philipp Ritter

Michael Bauer

Allan H Young

Cynthia H Y Fu

Affiliations

Soon will be listed here.

Abstract

Background: Current treatments for bipolar depression have limited effectiveness, tolerability and acceptability. Transcranial direct current stimulation (tDCS) is a novel non-invasive brain stimulation method that has demonstrated treatment efficacy for major depressive episodes. tDCS is portable, safe, and individuals like having sessions at home. We developed a home-based protocol with real-time remote supervision. In the present study, we have examined the clinical outcomes, acceptability and feasibility of home-based tDCS treatment in bipolar depression.

Results: Participants were 44 individuals with bipolar disorder (31 women), mean age 47.27 ± 12.89 years, in current depressive episode of at least moderate severity (mean Montgomery Asberg Depression Rating Scale (MADRS) score 24.59 ± 2.64). tDCS was provided in bilateral frontal montage, F3 anode, F4 cathode, 2 mA, for 30 min, in a 6-week trial, for total 21 sessions, a follow up visit was conducted 5 months from baseline. Participants maintained their current treatment (psychotherapy, antidepressant or mood stabilising medication) or maintained being medication-free. A research team member was present by video conference at each session. 93.2% participants (n = 41) completed the 6-week treatment and 72.7% of participants (n = 32) completed the 5 month follow up. There was a significant improvement in depressive symptoms following treatment (mean MADRS 8.77 ± 5.37) which was maintained at the 5 month follow up (mean MADRS 10.86 ± 6.90), rate of clinical response was 77.3% (MADRS improvement of 50% or greater from baseline), and rate of clinical remission was 47.7% (MADRS rating of 9 or less). Acceptability was endorsed as "very acceptable" or "quite acceptable" by all participants. No participants developed mania or hypomania.

Conclusions: In summary, home-based tDCS with real-time supervision was associated with significant clinical improvements and high acceptability in bipolar depression. Due to the open-label design, efficacy findings are preliminary.

Trial Registration: ClinicalTrials.gov number NCT05436613 registered on 23 June 2022 https//www.

Clinicaltrials: gov/study/NCT05436613.

Citing Articles

Effect of home-based transcranial direct current stimulation (tDCS) on cognitive functioning in bipolar depression.

Rezaei H, Woodham R, Ghazi-Noori A, Ritter P, Bramon E, Bauer M Res Sq. 2024; .

PMID: 39711528 PMC: 11661373. DOI: 10.21203/rs.3.rs-5396838/v1.

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