High-definition transcranial direct current stimulation (HD-tDCS) in major depressive disorder with anxious distress-a study protocol for a double-blinded randomized sham-controlled trial

Trials. 2024 May 15;25(1):320. doi: 10.1186/s13063-024-08157-y.

Abstract

Background: Comorbid anxiety disorders and anxious distress are highly prevalent among individuals with major depressive disorder (MDD). The presence of the DSM-5 anxious distress specifier (ADS) has been associated with worse treatment outcomes and chronic disease course. Few studies have evaluated the therapeutic effects of High-definition transcranial direct current stimulation (HD-tDCS) on depressive and anxiety symptoms among MDD patients with ADS. The current randomized controlled trial aims to assess the efficacy of HD-tDCS as an augmentation therapy with antidepressants compared to sham-control in subjects of MDD with ADS.

Methods: MDD patients with ADS will be recruited and randomly assigned to the active HD-tDCS or sham HD-tDCS group. In both groups, patients will receive the active or sham intervention in addition to their pre-existing antidepressant therapy, for 2 weeks with 5 sessions per week, each lasting 30 min. The primary outcome measures will be the change of depressive symptoms, clinical response, and the remission rate as measured with the 17-item Hamilton Depression Rating Scale (HDRS-17) before and after the intervention and at the 2nd and 6th week after the completed intervention. Secondary outcome measures include anxiety symptoms, cognitive symptoms, disability assessment, and adverse effects.

Discussion: The HD-tDCS applied in this trial may have treatment effects on MDD with ADS and have minimal side effects.

Trial registration: The trial protocol is registered with www.chictr.org.cn under protocol registration number ChiCTR2300071726. Registered 23 May 2023.

Keywords: Anxious distress specifier; Augmentation therapy; High-definition transcranial direct current stimulation; Major depressive disorder.

Publication types

  • Clinical Trial Protocol

MeSH terms

  • Adolescent
  • Adult
  • Antidepressive Agents / therapeutic use
  • Anxiety / diagnosis
  • Anxiety / psychology
  • Anxiety / therapy
  • Anxiety Disorders / psychology
  • Anxiety Disorders / therapy
  • Combined Modality Therapy
  • Depressive Disorder, Major* / diagnosis
  • Depressive Disorder, Major* / psychology
  • Depressive Disorder, Major* / therapy
  • Double-Blind Method
  • Female
  • Humans
  • Male
  • Middle Aged
  • Randomized Controlled Trials as Topic*
  • Transcranial Direct Current Stimulation* / methods
  • Treatment Outcome
  • Young Adult