Department of Psychology, Shahryar Branch, Islamic Azad University, Shahryar, Iran.
Department of Clinical-Educational Psychology, Central Tehran Branch, Islamic Azad University, Tehran, Iran.
J Psychiatr Res. 2021 Jun;138:68-74. doi: 10.1016/j.jpsychires.2021.03.047. Epub 2021 Mar 30.
Transcranial direct current stimulation (tDCS) of the prefrontal cortex is known as a promising intervention in major depression disorder (MDD). However, limited information on predictors of therapeutic response to tDCS are available. This study aimed to investigate clinical and demographic predictors of therapeutic response in patients taking no medications. For this purpose, the required data were collected from 2 independent tDCS trials on 116 MDD patients. Accordingly, 84 patients underwent 10 sessions of 2 mA tDCS daily each one lasted for 20 min and 32 patients received 10 twice sessions of 2 mA tDCS daily each one lasted for 20 min. Anodal electrode was located over the left dorsolateral prefrontal cortex (DLPFC), and cathode was over the right supraorbital region. Depression symptoms and the underlying clinical dimensions were assessed using the Beck Depression Inventory (BDI-II) at baseline and after the tDCS treatment. Of the included 116 patients, 47.4% showed an antidepressant response. Results of logistic regression analysis showed that the reduction in BDI-II scores after tDCS was associated with the baseline values of cognitive-affective symptoms factor, loss of pleasure, loss of interest, and sleep problems. Pronounced sleep disturbances and cognitive-affective symptoms were identified as the potential clinical predictors of response to tDCS. However, more prospective tDCS studies are necessary to validate the predictive value of the derived model.
经颅直流电刺激（tDCS）于前额叶皮层被认为是治疗重度抑郁症（MDD）的一种很有前途的干预手段。然而，目前关于 tDCS 治疗反应的预测因素的信息有限。本研究旨在调查接受无药物治疗的患者对 tDCS 治疗反应的临床和人口统计学预测因素。为此，从 2 项独立的 tDCS 试验中收集了 116 名 MDD 患者的所需数据。相应地，84 名患者接受了 10 次 2 mA tDCS 治疗，每天一次，每次持续 20 分钟，32 名患者接受了 10 次 2 mA tDCS 治疗，每天两次，每次持续 20 分钟。阳极电极置于左侧背外侧前额叶皮层（DLPFC），阴极置于右侧眶上区域。在 tDCS 治疗前后使用贝克抑郁量表（BDI-II）评估抑郁症状和潜在的临床维度。在纳入的 116 名患者中，47.4%表现出抗抑郁反应。逻辑回归分析的结果表明，tDCS 后 BDI-II 评分的降低与认知情感症状因子、快感丧失、兴趣丧失和睡眠问题的基线值相关。明显的睡眠障碍和认知情感症状被确定为对 tDCS 反应的潜在临床预测因素。然而，需要更多的前瞻性 tDCS 研究来验证所提出模型的预测价值。
