期刊
BRITISH JOURNAL OF PSYCHIATRY
卷 208, 期 6, 页码 522-+出版社
CAMBRIDGE UNIV PRESS
DOI: 10.1192/bjp.bp.115.164715
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资金
- Brain & Behavior Research Foundation [20493]
- Sao Paulo State Foundation [20911-5]
- National Council for Scientific and Technological Development (CNPq) [470904]
- neuroConn GmbH, Ilmenau, Germany
- Brainsway Inc, Jerusalem, Israel
- Australian National Health and Medical Council
- Stanley Medical Research Foundation
- Canadian Institutes of Health Research
- US National Institute of Health (NIH)
- Brainsway Ltd
- Lundbeck Foundation
- Ontario Mental Health Foundation (OMHF)
- Canadian Institutes of Health Research (CIHR)
- Brain and Behaviour Research Foundation
- Temerty Family through the Centre for Addiction and Mental Health (CAMH) Foundation
- Grant Family through the Centre for Addiction and Mental Health (CAMH) Foundation
- Campbell Institute
Background Transcranial direct current stimulation (tDCS) is a non-pharmacological intervention for depression. It has mixed results, possibly caused by study heterogeneity. Aims To assess tDCS efficacy and to explore individual response predictors. Method Systematic review and individual patient data meta-analysis. Results Data were gathered from six randomised sham-controlled trials, enrolling 289 patients. Active tDCS was significantly superior to sham for response (34% v. 19% respectively, odds ratio (OR) = 2.44, 95% CI 1.38-4.32, number needed to treat (NNT) = 7), remission (23.1% v. 12.7% respectively, OR = 2.38, 95% CI 1.22-4.64, NNT = 9) and depression improvement (B coefficient 0.35, 95% CI 0.12-0.57). Mixed-effects models showed that, after adjustment for other predictors and confounders, treatment-resistant depression and higher tDCS 'doses' were, respectively, negatively and positively associated with tDCS efficacy. Conclusions The effect size of tDCS treatment was comparable with those reported for repetitive transcranial magnetic stimulation and antidepressant drug treatment in primary care. The most important parameters for optimisation in future trials are depression refractoriness and tDCS dose.
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