Efficacy of optimized multichannel vs conventional tDCS for major depression treatment: A randomized controlled trial
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Introduction
Transcranial direct current stimulation (tDCS) has been proposed for treating depression. While it has advantages such as affordability, home-use application and fewer side effects its clinical efficacy is not yet established. This randomized, sham-controlled trial ( NCT06165445 ) compares efficacy of an optimized multichannel protocol vs conventional and sham tDCS for depression treatment.
Methods and Materials
Sixty patients with major depression received 30 sessions of conventional, optimized multichannel, or sham tDCS in parallel groups. In the multichannel optimized tDCS, electrical current was delivered via 7 small electrodes (1.65 mA max current per electrode, 4.0 mA total injected current per polarity) while in the conventional (2 mA max current per electrode, 2.0 mA total injected current per polarity) and sham tDCS large anodal and cathodal electrodes were used. Intervention efficacy and treatment response were evaluated before treatment and after the 10th, 20th, and 30th sessions, 1- and 3-months post-intervention. Cognitive functions and brain connectivity were also assessed.
Results
Both active tDCS groups showed a significant reduction in depressive symptoms compared to the sham group, with the multichannel protocol demonstrating effects as early as the 10th session and achieving greater symptom alleviation than conventional tDCS. A response rate of 72.7% is observed, based on at least a 50% improvement in depressive scores from baseline at 1 month (Hedge’s g=2.80) and 3 months (Hedge’s g=2.31) post-treatment. Furthermore, the multichannel protocol improved cognitive functions and enhanced cerebral functional connectivity markers of depression pathophysiology.
Discussion
The optimized multichannel tDCS showed high efficacy for treating depression.
