A pilot study of alternative transcranial direct current stimulation electrode montages for the treatment of major depression

Kerrie-Anne Ho; Siwei Bai; Donel Martin; Angelo Alonzo; Socrates Dokos; Pablo Puras; Colleen K Loo

doi:10.1016/j.jad.2014.06.022

A pilot study of alternative transcranial direct current stimulation electrode montages for the treatment of major depression

J Affect Disord. 2014:167:251-8. doi: 10.1016/j.jad.2014.06.022. Epub 2014 Jun 18.

Authors

Kerrie-Anne Ho¹, Siwei Bai², Donel Martin¹, Angelo Alonzo¹, Socrates Dokos², Pablo Puras³, Colleen K Loo⁴

Affiliations

¹ School of Psychiatry, University of New South Wales, Black Dog Institute, Sydney, NSW 2031, Australia.
² Graduate School of Biomedical Engineering, University of New South Wales, Sydney, Australia.
³ Department of Psychiatry, Hospital Universitario de Getafe, Getafe, Madrid, Spain; School of Psychiatry, University of New South Wales, Black Dog Institute, Sydney, NSW 2031, Australia.
⁴ School of Psychiatry, University of New South Wales, Black Dog Institute, Sydney, NSW 2031, Australia; Department of Psychiatry, St George Hospital, Sydney, Australia. Electronic address: colleen.loo@unsw.edu.au.

PMID: 24998841
DOI: 10.1016/j.jad.2014.06.022

Abstract

Background: Typically, transcranial direct current stimulation (tDCS) treatments for depression have used bifrontal montages with anodal (excitatory) stimulation targeting the left dorsolateral prefrontal cortex (DLPFC). There is limited research examining the effects of alternative electrode montages.

Objective/hypothesis: This pilot study aimed to examine the feasibility, tolerability and safety of two alternative electrode montages and provide preliminary data on efficacy. The montages, Fronto-Occipital (F-O) and Fronto-Cerebellar (F-C), were designed respectively to target midline brain structures and the cerebellum.

Methods: The anode was placed over the left supraorbital region and the cathode over the occipital and cerebellar region for the F-O and F-C montages respectively. Computational modelling was used to determine the electric fields produced in the brain regions of interest compared to a standard bifrontal montage. The two montages were evaluated in an open label study of depressed participants (N=14). Mood and neuropsychological functioning were assessed at baseline and after four weeks of tDCS.

Results: Computational modelling revealed that the novel montages resulted in greater activation in the anterior cingulate cortices and cerebellum than the bifrontal montage, while activation of the DLPFCs was higher for the bifrontal montage. After four weeks of tDCS, overall mood improvement rates of 43.8% and 15.9% were observed under the F-O and F-C conditions, respectively. No significant neuropsychological changes were found.

Limitations: The clinical pilot was open-label, without a control condition and computational modelling was based on one healthy participant.

Conclusions: Results found both montages safe and feasible. The F-O montage showed promising antidepressant potential.

Keywords: Computer simulation; Depression; Direct current; Stimulation; Therapy.

Publication types

Clinical Trial

MeSH terms

Adult
Affect
Antidepressive Agents / therapeutic use
Cerebellum*
Computer Simulation
Depressive Disorder, Major / diagnosis*
Depressive Disorder, Major / psychology
Depressive Disorder, Major / therapy*
Electrodes, Implanted* / adverse effects
Feasibility Studies
Female
Humans
Male
Middle Aged
Neuropsychological Tests
Occipital Lobe*
Pilot Projects
Prefrontal Cortex*
Transcranial Direct Current Stimulation* / instrumentation
Transcranial Direct Current Stimulation* / methods
Treatment Outcome

Substances

Antidepressive Agents