Dragon Katharina, Abdelnaim Mohamed A, Weber Franziska C, Heuschert Markus, Englert Leon, Langguth Berthold, Hebel Tobias, Schecklmann Martin
Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany.
University Medical Center, University of Regensburg, Regensburg, Germany.
Front Psychiatry. 2024 Mar 4;15:1335243. doi: 10.3389/fpsyt.2024.1335243. eCollection 2024.
Treating major depressive disorder (MDD) with transcranial direct current stimulation (tDCS) devices at home has various logistic advantages compared to tDCS treatment in the clinic. However, preliminary (controlled) studies showed side effects such as skin lesions and difficulties in the implementation of home-based tDCS. Thus, more data are needed regarding the feasibility and possible disadvantages of home-based tDCS.
Ten outpatients (23-69 years) with an acute depressive episode were included for this one-arm feasibility study testing home-based tDCS. All patients self-administered prefrontal tDCS (2 mA, 20 min, anodal left, cathodal right) at home on 30 consecutive working days supported by video consultations. Correct implementation of the home-based treatment was analyzed with tDCS recordings. Feasibility was examined by treatment compliance. For additional analyses of effectiveness, three depression scores were used: Hamilton depression rating scale (HDRS-21), Major Depression Inventory (MDI), and the subscale depression of the Depression-Anxiety-Stress Scale (DASS). Furthermore, usability was measured with the user experience questionnaire (UEQ). Tolerability was analyzed by the number of reported adverse events (AEs).
Eight patients did not stick to the protocol. AEs were minimal. Four patients responded to the home treatment according to the MDI. Usability was judged positive by the patients.
Regular video consultations or other safety concepts are recommended regardless of the number of video sessions actually conducted. Home-based tDCS seems to be safe and handy in our feasibility study, warranting further investigation.
与在诊所进行经颅直流电刺激(tDCS)治疗相比,在家中使用tDCS设备治疗重度抑郁症(MDD)具有多种后勤方面的优势。然而,初步(对照)研究显示了诸如皮肤损伤和在家中实施tDCS存在困难等副作用。因此,需要更多关于在家中进行tDCS的可行性和可能缺点的数据。
本单臂可行性研究纳入了10名(23 - 69岁)患有急性抑郁发作的门诊患者,以测试在家中进行tDCS治疗。所有患者在视频会诊的支持下,连续30个工作日在家中自行进行前额叶tDCS治疗(2毫安,20分钟,阳极在左,阴极在右)。通过tDCS记录分析在家治疗的正确实施情况。通过治疗依从性检查可行性。为了进一步分析疗效,使用了三个抑郁评分:汉密尔顿抑郁评定量表(HDRS - 21)、抑郁自评量表(MDI)以及抑郁焦虑压力量表(DASS)的抑郁分量表。此外,使用用户体验问卷(UEQ)测量可用性。通过报告的不良事件(AE)数量分析耐受性。
8名患者未遵守方案。不良事件极少。根据MDI,4名患者对家庭治疗有反应。患者对可用性的评价为积极。
无论实际进行的视频会诊次数多少,都建议进行定期视频会诊或采用其他安全措施。在我们的可行性研究中,在家中进行tDCS似乎安全且方便,值得进一步研究。