Personalized brain stimulation shows benefit for depression

(Press-News.org) A more precise and personalized form of electric brain stimulation may be a more effective and faster treatment for people with moderate to major depression compared to other similar treatments, according to a UCLA Health study.

The study, published in JAMA Network Open, examined the effectiveness of a noninvasive brain stimulation treatment known as high-definition transcranial direct current stimulation (HD-tDCS) in treating depression. Transcranial direct current stimulation uses electrodes placed on a patient’s scalp to deliver noninvasive, safe levels of electrical currents to targeted areas of the brain. For depression, the treatment is used to target brain networks that regulate emotional processing and self-referential thoughts. TDCS has not been approved by the U.S. Food and Drug Administration as a treatment for depression, and clinical research into various forms of tDCS is ongoing.

HD-tDCS is a newer form of tDCS that works to create a more precise, focused and personalized delivery of the treatment using a combination of smaller electrodes and neuroimaging to determine the optimal brain target. The current study focuses on investigating mood improvements associated with HD-tDCS therapy and builds on prior work that confirmed dose-delivery and modulation of depression-relevant brain networks by HD-tDCS. Seventy-one eligible participants were divided into two treatment groups, with one group receiving HD-tDCS treatment for 12 consecutive working days while the second group received a sham treatment for the same period. Researchers assessed participants at different intervals prior to, during and after the treatment to determine changes in mood.

Participants who received HD-tDCS treatment reported significant improvements to mood scores compared to those who underwent sham treatment. These improvements were shown to be more effective, sustained and faster – with significant mood improvements shown after six days of treatment – compared to results shown in comparable studies of conventional tDCS on depression, as well as other treatment options such as psychotherapy and medications. Mood improvements were also maintained during the 2-week and four-week assessments following treatment.

“By honing in on the precise brain regions affected by depression, we've shown that stimulation can significantly improve mood and daily functioning,” said study first author Dr. Mayank Anant Jog, assistant professor of neurology at UCLA Health and a faculty member of the UCLA Ahmanson-Lovelace Brain Mapping Center (ALMBC). “Our data indicates that HD-tDCS therapy may also be effective for treating anxiety disorders, though dedicated studies to investigate this possibility are needed.”

“Overall, the HD-tDCS therapy was effective and well-tolerated, with only mild to no side-effects observed in the study. Coupled with tDCS’s potential for convenient at-home use, this approach may offer a new treatment option for those seeking alternatives to medication or talk therapy,” said the study’s Principal Investigator Dr. Katherine Narr, professor of neurology at UCLA Health and faculty member of the ALBMC.

The conducted study does have some limitations that the authors will seek to address in future work. Briefly, the study did not investigate interactions between the treatment and psychotropic medications, which may have influenced the effects among participants taking these medications. The study was also not designed to empirically validate personalization of HD-tDCS. Follow-up studies are also needed to test whether mood improvements continue during a longer treatment period with appropriate maintenance treatments.

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