An electric field modeling study with meta-analysis to understand the antidepressant effects of transcranial direct current stimulation (tDCS)
Braz. J. Psychiatry (São Paulo, 1999, Impr.)
; Braz. J. Psychiatry (São Paulo, 1999, Impr.);45(6): 518-529, Nov.-Dec. 2023. tab, graf
Article
em En
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LILACS-Express
| LILACS
| ID: biblio-1534003
Biblioteca responsável:
BR1.1
ABSTRACT
Objective:
Transcranial direct current stimulation (tDCS) has mixed effects for major depressive disorder (MDD) symptoms, partially owing to large inter-experimental variability in tDCS protocols and their correlated induced electric fields (E-fields). We investigated whether the E-field strength of distinct tDCS parameters was associated with antidepressant effect.Methods:
A meta-analysis was performed with placebo-controlled clinical trials of tDCS enrolling MDD patients. PubMed, EMBASE, and Web of Science were searched from inception to March 10, 2023. Effect sizes of tDCS protocols were correlated with E-field simulations (SimNIBS) of brain regions of interest (bilateral dorsolateral prefrontal cortex [DLPFC] and bilateral subgenual anterior cingulate cortex [sgACC]). Moderators of tDCS responses were also investigated.Results:
A total of 20 studies were included (21 datasets, 1,008 patients), using 11 distinct tDCS protocols. Results revealed a moderate effect for MDD (g = 0.41, 95%CI 0.18-0.64), while cathode position and treatment strategy were found to be moderators of response. A negative association between effect size and tDCS-induced E-field magnitude was seen, with stronger E-fields in the right frontal and medial parts of the DLPFC (targeted by the cathode) leading to smaller effects. No association was found for the left DLPFC and the bilateral sgACC. An optimized tDCS protocol is proposed.Conclusions:
Our results highlight the need for a standardized tDCS protocol in MDD clinical trials. Registration number PROSPERO CRD42022296246.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
LILACS
Idioma:
En
Revista:
Braz. J. Psychiatry (São Paulo, 1999, Impr.)
/
Brazilian Journal of Psychiatry (São Paulo. 1999. Impresso)
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Brazilian Journal of Psychiatry (São Paulo. 1999. Online)
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Rev Bras Psiquiatr
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Revista Brasileira de Psiquiatria
Assunto da revista:
PSIQUIATRIA
Ano de publicação:
2023
Tipo de documento:
Article
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Project document
País de afiliação:
Bélgica
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Brasil
/
Estados Unidos
País de publicação:
Brasil