Cognitive effects of transcranial direct current stimulation treatment in patients with major depressive disorder: An individual patient data meta-analysis of randomised, sham-controlled trials

Donel M Martin; Adriano Moffa; Stevan Nikolin; Djamila Bennabi; André R Brunoni; William Flannery; Emmanuel Haffen; Shawn M McClintock; Marina L Moreno; Frank Padberg; Ulrich Palm; Colleen K Loo

doi:10.1016/j.neubiorev.2018.04.008

Cognitive effects of transcranial direct current stimulation treatment in patients with major depressive disorder: An individual patient data meta-analysis of randomised, sham-controlled trials

Neurosci Biobehav Rev. 2018 Jul:90:137-145. doi: 10.1016/j.neubiorev.2018.04.008. Epub 2018 Apr 13.

Authors

Affiliations

¹ School of Psychiatry, Black Dog Institute, University of New South Wales, Hospital Rd., Randwick, Sydney NSW 2031, Australia. Electronic address: donel.martin@unsw.edu.au.
² School of Psychiatry, Black Dog Institute, University of New South Wales, Hospital Rd., Randwick, Sydney NSW 2031, Australia.
³ Department of Clinical Psychiatry, Clinical Investigation Center 1431 Inserm, EA 481 Neurosciences, University Hospital of Besancon and FondaMental Foundation, Créteil, France.
⁴ Service of Interdisciplinary Neuromodulation (SIN), Department and Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil; Laboratory of Neuroscience (LIM27) and National Institute of Biomarkers in Psychiatry (INBioN), Department and Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil; Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany.
⁵ Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA.
⁶ Department and Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil.
⁷ Department of Psychiatry and Psychotherapy, Ludwig Maximilian University Munich, Munich, Germany.

PMID: 29660416
DOI: 10.1016/j.neubiorev.2018.04.008

Abstract

Transcranial direct current stimulation (tDCS) has emerged as a promising new treatment for major depression. While recent randomised, sham-controlled studies found tDCS to have antidepressant effects, it remains to be determined whether a tDCS treatment course may also enhance cognitive function independent of mood effects in depressed patients. This systematic review and individual patient data (IPD) meta-analysis examined cognitive outcomes from randomised, sham-controlled trials of tDCS treatment for major depression. Seven randomised, sham-controlled trials (n = 478 participants, 260 in active and 218 in sham) of tDCS for major depression were included. Results showed no cognitive enhancement after active tDCS compared to sham for the 12 cognitive outcomes investigated. Active relative to sham tDCS treatment was associated with reduced performance gains on a measure of processing speed (β = -0.33, 95% CI -0.58; -0.08, p = 0.011). Active tDCS treatment for depression did not show cognitive benefits independent of mood effects. Rather, tDCS treatment relative to sham stimulation for major depression may instead be associated with a reduced practice effect for processing speed.

Keywords: Bipolar; Cognition; Depression; Transcranial direct current stimulation; Treatment.

Publication types

Meta-Analysis
Review

MeSH terms

Behavior / physiology
Clinical Trials as Topic*
Cognition / physiology*
Depression / therapy*
Depressive Disorder, Major / physiopathology
Humans
Transcranial Direct Current Stimulation* / methods