Follow-up effects of transcranial direct current stimulation (tDCS) for the major depressive episode: A systematic review and meta-analysis. (August 2021)

• Record Type: Journal Article
• Authors: Razza, Laís B.; De Smet, Stefanie; Moffa, Adriano; Sudbrack-Oliveira, Pedro; Vanderhasselt, Marie-Anne; Brunoni, André R.
• Is Part Of: Psychiatry research. Volume 302(2021)
• Publication Date: 2021-08
• Subjects: Depression -- Transcranial direct current stimulation -- Meta-analysis -- Follow-up -- Long-term effects; Psychiatry -- Periodicals; Psychiatry -- periodicals; Psychiatrie -- Périodiques; 616.89
• DOI: 10.1016/j.psychres.2021.114024
• Languages: English
• ISSNs: 0165-1781

Abstract

Highlights: We investigated the follow-up effects of tDCS for depression. We searched for studies with a follow-up period after tDCS treatment for an acute major depressive episodes. A moderate-to-large improvement of the antidepressant tDCS effects in the follow-up phase was found. Primary outcome may be driven by the effect size of the interventional studies (with active tDCS). No predictor of response was significantly associated with the outcome. Abstract: Transcranial Direct Current Stimulation (tDCS) is an effective treatment during the acute phase of a major depressive episode (MDE), although the evidence for its follow-up efficacy is mixed. A systematic review and meta-analysis were performed. MEDLINE/PubMed, Scopus (EMBASE), Web of Science, Cochrane Library and additional sources were searched from inception to April 29, 2021. Studies that followed up adults treated with tDCS during an MDE - using ( interventional ) and/or not using ( observational ) tDCS in the follow-up period were included. The primary outcome was the Hedges' g for the follow-up depression scores. Small study effects and sources of heterogeneity were explored. 427 studies were retrieved and 11 trials (13 datasets, n = 311) were included, most presenting moderate bias. Results showed a follow-up depression improvement ( k = 13, g = -0.81, 95% confidence interval [CI]: -1.28; -0.34, I² = 84.0%), which was probably driven by the interventional studies (k = 7, g = -1.12, 95% CI: -1.84; -0.40, I² = 87.1%). No predictor of response was associated with the outcome. No risk of publication bias was found. Significant between-study heterogeneity may have influenced the overall results. Our findings suggest that tDCS produces effects beyond the intervention period during MDEs. Maintenance sessions are advised in future research.