People with depression could administer brain stimulation at home, test shows
People with severe depression could ease their symptoms by administering a form of electrical brain stimulation at home, according to a clinical trial of the therapy.
Patients who completed a 10-week course of treatment were about twice as likely to have their depression go into remission than those in a control group who performed the same procedure with the power turned off.
The findings suggest that people with depression can receive beneficial brain stimulation without having to go to a clinic, and that the treatment could become an effective alternative for people who don’t want or don’t respond to more traditional therapies.
“This is a potential first-line treatment for depression,” said Cynthia Fu, professor of affective neuroscience and psychotherapy at King’s College London and senior author of the study.
“It can also be used for people whose depression has not improved with antidepressants, for people who do not like antidepressants, or who do not want psychotherapy.”
For the phase two study, 174 people with major depressive disorder were fitted with headphones to deliver so-called transcranial direct current stimulation (tDCS). The headset, produced by Flow Neuroscience, which also funded the trial, contains two electrodes that apply a weak current of up to 2 milliamps to the forehead.
The ten-week course was delivered in real time via video conference calls, starting with five 30-minute sessions per week for three weeks, followed by three 30-minute sessions per week for the next seven weeks.
While half of the participants received electrical brain stimulation as expected, the other half unknowingly received an ‘inactive’ therapy, in which the device delivered a short, weak current at the beginning and end of the session, but otherwise provided no stimulation whatsoever.
Writing in the diary Naturopathythe researchers reported that depression improved in both groups over the 10-week course, according to their scores on standard depression scales.
But those who had active brain stimulation improved the most. The remission rate in the brain stimulation group was 44.9% compared to 21.8% in the inactive control group.
It is estimated that 5% of adults worldwide live with depression. The most common treatments are antidepressants and psychological therapies, but over a third of people with major depressive disorder do not achieve complete clinical remission.
tDCS causes neurons in the frontal areas of the brain to fire more easily, an effect that is thought to have a beneficial impact on the broader brain network affected by depression.
“We saw a placebo effect, where people who received the inactive treatment showed an improvement,” Fu told the Guardian. “But there were more people in the active treatment arm whose depression improved than in the inactive treatment arm.”
tDCS is already used to treat conditions such as psychosis and eating disorders, and studies to date show the procedure to be safe. The current delivered to the brain is at least 400 times weaker than the current used in electroconvulsive therapy, which causes a generalized seizure in the brain. To reduce the risks of prolonged stimulation, the device turns off after 30 minutes.
“Although tDCS for depression has been in the Nice (National Institute for Health and Care Excellence) guidelines since 2015 and is considered ‘safe’, uncertainties remain about its efficacy,” said Myles Jones, senior lecturer in psychology at the University of Sheffield. who was not involved in the research.
“This study shows that repeated home use of tDCS is associated with a reduction in an important depression measure.”
He added: “While single doses of tDCS have proven equivocal in altering neural activity and cognitive performance, long-term use over days or weeks has been shown to be clinically effective in depression, tinnitus and a range of conditions.”