Abstract| Volume 16, ISSUE 1, P262, January 2023

Real-world data showing the benefit of tDCS for patients with major depressive disorder and suggesting characteristics for treatment personalization

      This study characterizes the real-life effectiveness and tolerability of transcranial direct current stimulation (tDCS) and aims to identify predictors of treatment outcome in patients with MDD.
      tDCS was delivered using the Sooma tDCS™ device and head cap (electrodes 35 cm2, anode over F3 and cathode over F4 of DLPFC, at 2 mA). Treatment was given as 30-min-sessions, scheduled as five sessions per week usually for 2-4 weeks of acute treatment, and after as a maintenance treatment according to each patient's individual needs evaluated by the prescribing clinic. Depending on the routines of each clinic, some of the patients received the treatments at the clinic whereas some of them self-administered the treatment at home after being trained at the clinic.
      Treatment data was collected by the treating physician to a structured data collection form, on the patients who were treated with tDCS as a part of routine clinical practice. Symptoms were scored according to common validated depression scales before and after the tDCS treatment (depression scales of choice differed between clinics). The study outcomes were clinical response (defined as >50% reduction from the baseline depression score) and remission. Furthermore, the data set allowed us to investigate possible predictors of outcome, such as use of concurrent psychotropics, baseline depression severity and number of tDCS sessions taken. We found, perhaps unsurprisingly, that severe depression at baseline predicted less optimal outcome from tDCS treatment. However, we saw that if the severe cases were treated with longer treatment period, the outcomes improved. As the use of psychotropics was negatively associated with the tDCS treatment outcome, we went further to dissect the possible effects of different drug classes on it.
      This real-world study showed good tolerability and efficacy of tDCS in patients with MDD. The results suggest that tDCS is a well-suited treatment alternative for MDD.
      Research Category and Technology and Methods
      Clinical Research: 9. Transcranial Direct Current Stimulation (tDCS)
      Keywords: Depression, Real-world data, Personalization, tDCS