TOPLINE:

Personalized high-definition transcranial direct current stimulation (HD-tDCS) administered over 12 days was associated with a greater improvement in depression and anxiety symptoms in patients with moderate-to-severe depression compared to sham therapy, a new trial showed.

METHODOLOGY:

• Researchers conducted a randomized, double-blind, sham-controlled clinical trial from 2020 to 2024 that included 71 US adults (mean age, 34.3 years; 62% women) with moderate-to-severe depressive symptoms. All were either treatment naive or receiving standard antidepressant treatment.
• Participants were randomly assigned to receive either active (n = 40) or sham (n = 31) HD-tDCS for 20 minutes daily for 12 consecutive working days.
• The HD-tDCS configuration was personalized to target a specific location in the left dorsolateral prefrontal cortex.
• The primary outcome was the mean change between pretreatment and posttreatment scores on the Hamilton Depression Rating Scale (HAMD). Secondary outcomes included changes in HAMD scores and response and remission rates; exploratory outcomes were changes in symptom dimensions of the HAMD, including anxiety.

TAKEAWAY:

• The active HD-tDCS group had a significantly greater improvement in HAMD scores compared to the sham group (mean group difference, -2.2; P = .04).
• The active group also had significantly greater pretreatment to posttreatment percentage changes in HAMD scores (mean group difference, -13.4%; P = .02) and posttreatment remission rates (39.5% vs 13.3%; P = .02). There were no significant between-group differences for response rates.
• Exploratory analyses showed significant improvements in anxiety symptoms in the active treatment group compared with the sham group (mean group difference, -0.68; P = .049).
• HD-tDCS was well tolerated with mild or no adverse effects (AEs) reported. AEs that differed between the groups included rash or itching (P = .02) and skin redness (P =  .006).

IN PRACTICE:

“Our findings demonstrate the clinical potential of personalized HD-tDCS as a safe and fast-acting antidepressant therapy for moderate-to-severe depression,” the investigators wrote.

“Future studies incorporating appropriate maintenance treatments are needed to clarify the persistence of mood improvement, as well as whether antidepressant effects could be further improved by optimizing therapy parameters,” they added.

SOURCE:

This study was led by Mayank A. Jog, PhD, University of California Los Angeles. It was published online on September 11 in JAMA Network Open.

LIMITATIONS:

This study was not designed to investigate interactions between HD-tDCS and psychotropic medications or to empirically validate personalization. The sham HD-tDCS current of 0.065 mA may not have been physiologically inert. Additionally, the protocol did not include maintenance treatment sessions during follow-up, which may have contributed to nonsignificant findings at 2- and 4-week posttreatment timepoints.

DISCLOSURES:

This study was funded by the National Institute of Mental Health. The investigators reported having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.