Transcranial alternating current stimulation for treating depression: a randomized controlled trial.

Abstract

Treatment of depression with antidepressants is partly effective. Transcranial alternating current stimulation can provide a non-pharmacological alternative for adult patients with major depressive disorder. However, no study has used the stimulation to treat first-episode and drug-naïve patients with major depressive disorder. We used a randomized, double-blind, sham-controlled design to examine the clinical efficacy and safety of the stimulation in treating first-episode drug-naïve patients in a Chinese Han population. From 4 June 2018 to 30 December 2019, 100 patients were recruited and randomly assigned to receive 20 daily 40-min, 77.5 Hz, 15 mA, one forehead and two mastoid sessions of active or sham stimulation (n = 50 for each group) in four consecutive weeks (Week 4), and were followed for additional 4-week efficacy/safety assessment without stimulation (Week 8). The primary outcome was a remission rate defined as the 17-item Hamilton Depression Rating Scale (HDRS-17) score ≤ 7 at Week 8. Secondary analyses were response rates (defined as a reduction of ≥ 50% in the HDRS-17), changes in depressive symptoms and severity from baseline to Week 4 and Week 8, and rates of adverse events. Data were analysed in an intention-to-treat sample. Forty-nine in the active and 46 in the sham completed the study. Twenty-seven of 50 (54%) in the active treatment group and 9 of 50 (18%) in the sham group achieved remission at the end of Week 8. The remission rate was significantly higher in the active group compared to that in the sham group with a risk ratio of 1.78 (95% confidence interval, 1.29, 2.47). Compared with the sham, the active group had a significantly higher remission rate at Week 4, response rates at Weeks 4 and 8, and a larger reduction in depressive symptoms from baseline to Weeks 4 and 8. Adverse events were similar between the groups. In conclusion, the stimulation on the frontal cortex and two mastoids significantly improved symptoms in first-episode drug-naïve patients with major depressive disorder and may be considered as a non-pharmacological intervention for them in an outpatient setting.

• Authors: Hongxing Wang, Kun Wang, Qing Xue, Mao Peng, Lu Yin, Xuecun Gu, Haixia Leng, Juan Lu, Hongzhi Liu, Di Wang, Jin Xiao, Zhichao Sun, Ning Li, Kai Dong, Qian Zhang, Shuqin Zhan, Chunqiu Fan, Baoquan Min, Aihong Zhou, Yunyan Xie, Haiqing Song, Jing Ye, Aihua Liu, Ran Gao, Liyuan Huang, Lidong Jiao, Yang Song, Huiqing Dong, Zichen Tian, Tianmei Si, Xiangyang Zhang, Xinmin Li, Atsushi Kamiya, Fiammetta Cosci, Keming Gao, Yuping Wang
• Journal: Brain : a journal of neurology (Brain) Vol. 145 Issue 1 Pg. 83-91 (03 29 2022) ISSN: 1460-2156 [Electronic] England
• PMID: 35353887 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: © The Author(s) (2021). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For permissions, please email: [email protected].

Topics

• Adult
• Depression
• Depressive Disorder, Major (drug therapy)
• Humans
• Transcranial Direct Current Stimulation
• Transcranial Magnetic Stimulation
• Treatment Outcome