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Transcranial direct current stimulation in the treatment of major depression: a meta-analysis

Published online by Cambridge University Press:  12 January 2012

U. G. Kalu
Affiliation:
Department of Psychiatry, University of Oxford, Oxford, UK
C. E. Sexton
Affiliation:
Department of Psychiatry, University of Oxford, Oxford, UK
C. K. Loo
Affiliation:
Department of Psychiatry, University of Oxford, Oxford, UK
K. P. Ebmeier*
Affiliation:
Department of Psychiatry, University of Oxford, Oxford, UK
*
*Address for correspondence: K. P. Ebmeier, M.D., Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK. (Email: klaus.ebmeier@psych.ox.ac.uk)

Abstract

Background

So far, no comprehensive answer has emerged to the question of whether transcranial direct current stimulation (tDCS) can make a clinically useful contribution to the treatment of major depression. We aim to present a systematic review and meta-analysis of tDCS in the treatment of depression.

Method

Medline and Embase were searched for open-label and randomized controlled trials of tDCS in depression using the expressions (‘transcranial direct current stimulation’ or ‘tDCS’) and (‘depression’ or ‘depressed’). Study data were extracted with a standardized data sheet. For randomized controlled trials, effect size (Hedges' g) was calculated and the relationships between study variables and effect size explored using meta-regression.

Results

A total of 108 citations were screened and 10 studies included in the systematic review. Six randomized controlled trials were included in the meta-analysis, with a cumulative sample of 96 active and 80 sham tDCS courses. Active tDCS was found to be more effective than sham tDCS for the reduction of depression severity (Hedges' g=0.743, 95% confidence interval 0.21–1.27), although study results differed more than expected by chance (Q=15.52, df=6, p=0.017, I2=61.35). Meta-regression did not reveal any significant correlations.

Conclusions

Our study was limited by the small number of studies included, which often had small sample size. Future studies should use larger, if possible representative, health service patient samples, and optimized protocols to evaluate the efficacy of tDCS in the treatment of depression further.

Type
Review Article
Copyright
Copyright © Cambridge University Press 2012

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