Skip to main content
×
Home
    • Aa
    • Aa
  • Get access
    Check if you have access via personal or institutional login
  • Cited by 79
  • Cited by
    This article has been cited by the following publications. This list is generated based on data provided by CrossRef.

    Cook, Ian A. Espinoza, Randall and Leuchter, Andrew F. 2014. Neuromodulation for Depression. Neurosurgery Clinics of North America, Vol. 25, Issue. 1, p. 103.


    Chaturvedi, Santosh K. and Parameshwaran, Soumya 2015. International Encyclopedia of the Social & Behavioral Sciences.


    Block, Samantha G. and Nemeroff, Charles B. 2014. Emerging antidepressants to treat major depressive disorder. Asian Journal of Psychiatry, Vol. 12, p. 7.


    Allan, Charlotte L. Topiwala, Anya Ebmeier, Klaus P. Semple, David and Steele, Douglas 2013. The Wiley-Blackwell Handbook of Mood Disorders.


    Scholkmann, Felix 2015. Two emerging topics regarding long-range physical signaling in neurosystems: Membrane nanotubes and electromagnetic fields. Journal of Integrative Neuroscience, Vol. 14, Issue. 02, p. 135.


    George, Mark S. Taylor, Joseph J. and Short, Baron 2013. Brain Stimulation.


    Woods, Adam J. and Martin, Donel M. 2016. Transcranial Direct Current Stimulation in Neuropsychiatric Disorders.


    Brunoni, Andre and Boggio, Paulo 2014. The Stimulated Brain.


    Pecchinenda, Anna Ferlazzo, Fabio and Lavidor, Michal 2015. Modulation of selective attention by polarity-specific tDCS effects. Neuropsychologia, Vol. 68, p. 1.


    Brunoni, André and Loo, Colleen 2016. Transcranial Direct Current Stimulation in Neuropsychiatric Disorders.


    Kadosh, Roi 2013. Using transcranial electrical stimulation to enhance cognitive functions in the typical and atypical brain. Translational Neuroscience, Vol. 4, Issue. 1,


    Delmonte, Dario Barbini, Barbara and Smeraldi, Enrico 2013. Clinical Management of Bipolar Disorder.


    Knechtel, Lilly Thienel, Renate and Schall, Ulrich 2013. Transcranial direct current stimulation: neurophysiology and clinical applications. Neuropsychiatry, Vol. 3, Issue. 1, p. 89.


    STEINBERG, H. 2013. Letter to the Editor: Transcranial direct current stimulation (tDCS) has a history reaching back to the 19th century. Psychological Medicine, Vol. 43, Issue. 03, p. 669.


    Jones, N. P. Chase, H. W. and Fournier, J. C. 2016. Brain mechanisms of anxiety's effects on cognitive control in major depressive disorder. Psychological Medicine, Vol. 46, Issue. 11, p. 2397.


    Chua, Elizabeth F. and Ahmed, Rifat 2016. Electrical stimulation of the dorsolateral prefrontal cortex improves memory monitoring. Neuropsychologia, Vol. 85, p. 74.


    Loo, Colleen and Martin, Donel 2016. Neuromodulation in Psychiatry.


    Grimshaw, Gina M. and Carmel, David 2014. An asymmetric inhibition model of hemispheric differences in emotional processing. Frontiers in Psychology, Vol. 5,


    David, Christopher N Rapoport, Judith L and Gogtay, Nitin 2013. Treatments in context: transcranial direct current brain stimulation as a potential treatment in pediatric psychosis. Expert Review of Neurotherapeutics, Vol. 13, Issue. 4, p. 447.


    Valiengo, Leandro Benseñor, Isabela Martins Goulart, Alessandra C. de Oliveira, Janaina Farias Zanao, Tamires Araujo Boggio, Paulo Sérgio Lotufo, Paulo Andrade Fregni, Felipe and Brunoni, André Russowsky 2013. THE SERTRALINE VERSUS ELECTRICAL CURRENT THERAPY FOR TREATING DEPRESSION CLINICAL STUDY (SELECT-TDCS): RESULTS OF THE CROSSOVER AND FOLLOW-UP PHASES. Depression and Anxiety, Vol. 30, Issue. 7, p. 646.


    ×

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

  • U. G. Kalu (a1), C. E. Sexton (a1), C. K. Loo (a1) and K. P. Ebmeier (a1)
  • DOI: http://dx.doi.org/10.1017/S0033291711003059
  • Published online: 12 January 2012
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.

Copyright
Corresponding author
*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)
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

E Arfai , G Theano , JD Montagu , AA Robin (1970). A controlled study of polarization in depression. British Journal of Psychiatry 116, 433434.

AP Arul-Anandam , C Loo , P Mitchell (2010). Induction of hypomanic episode with transcranial direct current stimulation. Journal of ECT 26, 6869.


CB Begg , M Mazumdar (1994). Operating characteristics of a rank correlation test for publication bias. Biometrics 50, 10881101.

LJ Bindman , OCJ Lippold , JW Redfearn (1964). The action of brief polarizing currents on cerebral cortex of the rat (1) during current flow and (2) in production of long-lasting after-effects. Journal of Physiology 172, 369382.

PS Boggio , SP Rigonatti , RB Ribeiro , ML Myczkowski , MA Nitsche , A Pascual-Leone , F Fregni (2008). A randomized, double-blind clinical trial on the efficacy of cortical direct current stimulation for the treatment of major depression. International Journal of Neuropsychopharmacology 11, 249254.

AR Brunoni , J Amadera , B Berbel , MS Volz , BG Rizzerio , F Fregni (2011 a). A systematic review on reporting and assessment of adverse effects associated with transcranial direct current stimulation. International Journal of Neuropsychopharmacology 14, 11331145.

AR Brunoni , R Ferrucci , M Bortolomasi , M Vergari , L Tadini , PS Boggio , M Giacopuzzi , S Barbieri , A Priori (2011 b). Transcranial direct current stimulation (tDCS) in unipolar vs. bipolar depressive disorder. Progress in Neuropsychopharmacology and Biological Psychiatry 35, 96101.

AR Brunoni , L Valiengo , A Baccaro , TA Zanao , JF de Oliveira , GP Vieira , VF Bueno , AC Goulart , PS Boggio , PA Lotufo , IM Bensenor , F Fregni (2011 c). Sertraline vs. ELectrical Current Therapy for Treating Depression Clinical Trial – SELECT TDCS: design, rationale and objectives. Contemporary Clinical Trials 32, 9098.

MW Carney , MD Cashman , BF Sheffield (1970). Polarization in depression. British Journal of Psychiatry 117, 474475.

R Costain , JW Redfearn , OCJ Lippold (1964). Controlled trial of therapeutic effects of polarization of brain depressive-illness. British Journal of Psychiatry 110, 786799.

M Egger , G Davey Smith , M Schneider , C Minder (1997). Bias in meta-analysis detected by a simple, graphical test. British Medical Journal 315, 629634.

F Fregni , PS Boggio , MA Nitsche , MA Marcolin , SP Rigonatti , A Pascual-Leone (2006 a). Treatment of major depression with transcranial direct current stimulation. Bipolar Disorders 8, 203204.

F Fregni , PS Boggio , MA Nitsche , SP Rigonatti , A Pascual-Leone (2006 b). Cognitive effects of repeated sessions of transcranial direct current stimulation in patients with depression. Depression and Anxiety 23, 482484.

V Galvez , A Alonzo , D Martin , PB Mitchell , P Sachdev , CK Loo (2011). Hypomania induction in a patient with bipolar II disorder by transcranial direct current stimulation (tDCS). Journal of ECT 27, 256258.

S Grimm , J Beck , D Schuepbach , D Hell , P Boesiger , F Bermpohl , L Niehaus , H Boeker , G Northoff (2008). Imbalance between left and right dorsolateral prefrontal cortex in major depression is linked to negative emotional judgment: an fMRI study in severe major depressive disorder. Biological Psychiatry 63, 369376.

D Hedges , J Vevea (1998). Fixed- and random-effects models in meta-analysis. Psychological Methods 3, 486504.

M Heo , CF Murphy , BS Meyers (2007). Relationship between the Hamilton Depression Rating Scale and the Montgomery–Asberg Depression Rating Scale in depressed elderly: a meta-analysis. American Journal of Geriatric Psychiatry 15, 899905.

JP Higgins , SG Thompson , JJ Deeks , DG Altman (2003). Measuring inconsistency in meta-analyses. British Medical Journal 327, 557560.

M Koenigs , D Ukueberuwa , P Campion , J Grafman , E Wassermann (2009). Bilateral frontal transcranial direct current stimulation: failure to replicate classic findings in healthy subjects. Clinical Neurophysiology 120, 8084.

MF Kuo , J Grosch , F Fregni , W Paulus , MA Nitsche (2007). Focusing effect of acetylcholine on neuroplasticity in the human motor cortex. Journal of Neuroscience 27, 1444214447.

MF Kuo , W Paulus , MA Nitsche (2008). Boosting focally-induced brain plasticity by dopamine. Cerebral Cortex 18, 648651.

OCJ Lippold , JW Redfearn (1964). Mental changes resulting from passage of small direct currents through human brain. British Journal of Psychiatry 110, 768772.

C Loo , D Martin , A Alonzo , S Gandevia , P Mitchell , P Sachdev (2011). Avoiding skin burns with transcranial direct current stimulation: preliminary considerations. International Journal of Neuropsychopharmacology 14, 425426.

CK Loo , A Alonzo , D Martin , P Mitchell , V Galvez , P Sachdev (2012). A three-week, randomized, sham-controlled trial of transcranial direct current stimulation in depression. British Journal of Psychiatry 200, 18. doi:10.1192/bjp.bp.111.097634.

CK Loo , P Sachdev , D Martin , M Pigot , A Alonzo , GS Malhi , J Lagopoulos , P Mitchell (2010). A double-blind, sham-controlled trial of transcranial direct current stimulation for the treatment of depression. International Journal of Neuropsychopharmacology 13, 6169.

DM Martin , A Alonzo , PB Mitchell , P Sachdev , V Galvez , CK Loo (2011). Fronto-extracephalic transcranial direct current stimulation as a treatment for major depression: an open-label pilot study. Journal of Affective Disorders 134, 459463.

DK Nias , MB Shapiro (1974). The effects of small electrical currents upon depressive symptoms. British Journal of Psychiatry 125, 414415.

MA Nitsche , PS Boggio , F Fregni , A Pascual-Leone (2009). Treatment of depression with transcranial direct current stimulation (tDCS): a review. Experimental Neurology 219, 1419.

MA Nitsche , K Fricke , U Henschke , A Schlitterlau , D Liebetanz , N Lang , S Henning , F Tergau , W Paulus (2003). Pharmacological modulation of cortical excitability shifts induced by transcranial direct current stimulation in humans. Journal of Physiology 553, 293301.

MA Nitsche , L Niehaus , KT Hoffmann , S Hengst , D Liebetanz , W Paulus , BU Meyer (2004). MRI study of human brain exposed to weak direct current stimulation of the frontal cortex. Clinical Neurophysiology 115, 24192423.

MA Nitsche , W Paulus (2000). Excitability changes induced in the human motor cortex by weak transcranial direct current stimulation. Journal of Physiology 527, 633639.

MA Nitsche , W Paulus (2001). Sustained excitability elevations induced by transcranial DC motor cortex stimulation in humans. Neurology 57, 18991901.

U Palm , D Keeser , C Schiller , Z Fintescu , M Nitsche , E Reisinger , F Padberg (2008). Skin lesions after treatment with transcranial direct current stimulation (tDCS). Brain Stimulation 1, 386387.

A Priori (2003). Brain polarization in humans: a reappraisal of an old tool for prolonged non-invasive modulation of brain excitability. Clinical Neurophysiology 114, 589595.

A Priori , A Berardelli , S Rona , N Accornero , M Manfredi (1998). Polarization of the human motor cortex through the scalp. Neuroreport 9, 22572260.

JC Ramsay , G Schlagenhauf (1966). Treatment of depression with low voltage direct current. Southern Medical Journal 59, 932934.

JW Redfearn , R Costain , OCJ Lippold (1964). Preliminary account of clinical effects of polarizing brain in certain psychiatric disorders. British Journal of Psychiatry 110, 773785.

CW Slotema , JD Blom , HW Hoek , IE Sommer (2010). Should we expand the toolbox of psychiatric treatment methods to include repetitive transcranial magnetic stimulation (rTMS)? A meta-analysis of the efficacy of rTMS in psychiatric disorders. Journal of Clinical Psychiatry 71, 873884.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Psychological Medicine
  • ISSN: 0033-2917
  • EISSN: 1469-8978
  • URL: /core/journals/psychological-medicine
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords:

Type Description Title
UNKNOWN
Supplementary Materials

Kalu Supplementary Material
Kalu Supplementary Material

 Unknown (58 KB)
58 KB