Efficacy and acceptability of transcranial direct current stimulation for treating depression: A meta-analysis of randomized controlled trials

Ruibin Zhang; Charlene L M Lam; Xiaoling Peng; Dongming Zhang; Chichen Zhang; Ruiwang Huang; Tatia M C Lee

doi:10.1016/j.neubiorev.2021.03.026

Efficacy and acceptability of transcranial direct current stimulation for treating depression: A meta-analysis of randomized controlled trials

Neurosci Biobehav Rev. 2021 Jul:126:481-490. doi: 10.1016/j.neubiorev.2021.03.026. Epub 2021 Mar 28.

Authors

Ruibin Zhang¹, Charlene L M Lam², Xiaoling Peng³, Dongming Zhang⁴, Chichen Zhang⁵, Ruiwang Huang⁶, Tatia M C Lee⁷

Affiliations

¹ Cognitive Control and Brain Healthy Laboratory, Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, 510515, China; Department of Psychiatry, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282, China. Electronic address: ruibinzhang@foxmail.com.
² Laboratory of Clinical Psychology and Affective Neuroscience, The University of Hong Kong, Hong Kong, China.
³ Guangzhou Cana School, Guangzhou, 510515, China.
⁴ Cognitive Control and Brain Healthy Laboratory, Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, 510515, China.
⁵ School of Health Management, Southern Medical University, Guangzhou, China.
⁶ School of Psychology, South China Normal University, Guangzhou, China. Electronic address: ruiwang.huang@gmail.com.
⁷ The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou Medical University, Guangzhou, China; State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China; Laboratory of Neuropsychology and Human Neuroscience, The University of Hong Kong, Hong Kong, China; Center for Brain Science and Brain-Inspired Intelligence, Guangdong-Hong Kong-Macao, Greater Bay Area, China. Electronic address: tmclee@hku.hk.

PMID: 33789158
DOI: 10.1016/j.neubiorev.2021.03.026

Abstract

Background: Transcranial direct current stimulation (tDCS) is a promising nonpharmacological intervention for treating depression. We aimed to provide an updated meta-analysis assessing the anti-depressant efficacy of tDCS.

Methods: We searched the literature from the first available date to 30 December 2020 to identify relevant randomized controlled trials (RCTs).

Results: 27 RCTs (N = 1204 patients, 653 in active tDCS and 551 in sham tDCS) were included. Active tDCS was superior to sham tDCS (g = 0.46, 95 % CI 0.15-0.76) in modulating depressive symptoms measured by depression rating scales. Active tDCS was also superior to sham tDCS in reducing response and remission rates, but these differences did not reach statistically significant levels (OR_response = 1.75, 95 % CI 0.85-3.58; OR_remission = 1.29, 95 % CI 0.59-2.83). The two groups had comparable dropout rates (OR = 1.28, 95 % CI 0.62-1.64).

Conclusion: For treatments of depressive episodes, tDCS may be efficacious. Specific tDCS parameters (e.g., a 2-mA stimulation current and 30-min sessions) and clinical characteristics (e.g., antidepressant-free) may augment the treatment efficacy of tDCS.

Keywords: Clinical response; Depression; Meta-analysis; Remission; tDCS.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't
Review

MeSH terms

Depression / therapy
Humans
Randomized Controlled Trials as Topic
Transcranial Direct Current Stimulation*
Treatment Outcome