11/25/2024
Could tDCS be an effective, inexpensive, accessible treatment for PTSD and depression?
Transcranial direct current stimulation (tDCS) is a non-invasive form of brain stimulation that is less powerful than the current standard, transcranial magnetic stimulation (TMS). It is done by sending a weak direct current to the scalp through electrodes that can be worn in a cap or attached with rubber headbands. Both studies highlighted below used 2 milliamperes. Although tDCS does not cause firing or inhibition of nerve cells it is thought to impact excitability of brain cells just beneath the scalp. Two recent clinical trials using this treatment are reporting promising results.
A double-blinded, randomized, placebo-controlled trial was conducted by two Brown University researchers, Noah S. Philip, M.D., and Mascha van ’t Wout-Frank, Ph.D, and their team. They utilized tDCS for the treatment of warzone-related PTSD in fifty-four U.S. military veterans. Participants' average age was mid forties and most individuals suffered from an additional psychiatric illness. While receiving tDCS all participants experienced a standardized virtual reality exposure simulation. Results showed that active tDCS used with the exposure simulation lead to a “significantly meaningful” reduction of PTSD symptoms, with continued symptom improvement over time, and enhanced psychophysiological habituation to VR warzone cues. This may suggest that the treatment helps aid individuals in anticipating fears as well as learning to manage them. Three months after beginning treatment individuals showed improvements in social and occupational functioning. Thanks to the inexpensive nature of tDCS the team has hopes that if these results could be replicated in larger groups this treatment could be successfully put into practice.
A second clinical trial used home-based tDCS treatment for individuals with major depressive disorder. Lead by Cynthia H. Y. Fu, M.D., Ph.D., Allan H. Young, M.D., Ph.D., and Jair Soares, M.D., Ph.D this phase two, randomized, placebo-based study was completely remote and included ten weeks of home-based tDCS. There were a total of 174 participants, who on average were in their late thirties. Approximately one third were not receiving any treatment prior to the study, while two thirds were on an antidepressant and fifteen percent were receiving psychotherapy. Those receiving active tDCS followed a schedule of five self-administered tDCS treatments a week for three weeks followed by three sessions weekly for seven weeks, with sessions lasting thirty minutes. During treatment the individuals would be supervised through videoconferencing, additionally they had the ability to contact the team at any hour of the day during the trial. The team observed a “significant improvement” in depression symptoms. Prior to the trial participants had a moderate score on the Hamilton Depression Rating Scale (HDRS) but following treatment scores decreased by an average of 9.4 points with forty-five percent of individuals having a remission after ten weeks.
Results of two recently published clinical trials demonstrate the versatility and potential effectiveness of transcranial direct current stimulation (tDCS) in reducing symptoms of psychiatric illness, specifically, in PTSD and major depressive disorder. BBRF grantees co-led both trials, which were e...