Home-Based Transcranial Direct Current Stimulation (tDCS) for Bipolar Depression: Effects on Quality of Life and Functioning: an open-label study

Purpose Individuals with bipolar disorder often experience reduced quality of life (QoL). Transcranial direct current stimulation (tDCS) is a promising non-invasive treatment for bipolar depression that is portable, safe, and suitable for use at home. We developed a home-based tDCS protocol with real-time remote supervision and examined its effect on QoL in bipolar depression. Methods In an open-label design, 44 participants (31 women) with bipolar depression of at least a moderate severity received 21 sessions of home‐based tDCS (2 mA, 30 min, F3 anode/F4 cathode) over 6 weeks, with a follow up visit conducted 5 months from baseline. QoL was assessed using the Quality of Life Enjoyment and Satisfaction Questionnaire at baseline, week 2, end of treatment, and follow up session. Baseline and post treatment scores were compared with healthy control participants (28 adults; 17 women). Results At baseline and at the end of treatment, bipolar participants showed a significantly lower Q-LES-Q score than healthy controls ( p  < .001). Within the bipolar group, there was a significant improvement in total Q-LES-Q scores ( p  < .001) and across multiple domains by week 6 and remained elevated at follow-up. Changes in Q-LES-Q were no longer significant after adjustment for depressive symptoms. Conclusion A 6-week course of supervised home-based tDCS was associated with significant QoL improvements in bipolar depression, which appeared to be closely linked to reduction in depressive symptoms. Randomized, sham-controlled trials are warranted to clarify the specific contribution of tDCS to improve QoL in bipolar depression.