Efficacy and acceptability of transcranial direct current stimulation (tDCS) for major depressive disorder: An individual patient data meta-analysis

被引：92

作者：

Moffa, Adriano H. ^{[1
,2
]}

Martin, Donel ^{[1
]}

Alonzo, Angelo ^{[1
]}

Bennabi, Djamila ^{[3
,4
]}

Blumberger, Daniel M. ^{[5
,6
,7
]}

Bensenor, Isabela M. ^{[8
,9
]}

Daskalakis, Zafiris ^{[5
,6
,7
]}

Fregni, Felipe ^{[10
]}

Haffen, Emmanuel ^{[3
,4
]}

Lisanby, Sarah H. ^{[11
]}

Padberg, Frank ^{[12
]}

Palm, Ulrich ^{[12
]}

Razza, Lais B. ^{[2
]}

Sampaio-Jr, Bernardo ^{[2
]}

Loo, Colleen ^{[1
]}

Brunoni, Andre R. ^{[2
,8
,9
]}

机构：

[1] Univ New South Wales, Sch Psychiat, Black Dog Inst, Hosp Rd, Sydney, NSW 2031, Australia

[2] Univ Sao Paulo, Inst Nacl Biomarcadores Neuropsiquiatria INBioN, Fac Med, Dept & Inst Psychiat,Lab Neurosci LIM 27, R Dr Ovidio Pires de Campos 785,2o Andar, BR-05403000 Sao Paulo, Brazil

[3] Univ Hosp Besancon, EA Neurosci 481, INSERM, Dept Clin Psychiat,Clin Invest Ctr 1431, Creteil, France

[4] FondaMental Fdn, Creteil, France

[5] Univ Toronto, Temerty Ctr Therapeut Brain Intervent, Toronto, ON, Canada

[6] Univ Toronto, Campbell Family Res Inst, Toronto, ON, Canada

[7] Univ Toronto, Dept Psychiat, Toronto, ON, Canada

[8] Univ Sao Paulo, Fac Med, Dept Internal Med, Av Prof Lineu Prestes 2565, BR-05508000 Sao Paulo, Brazil

[9] Univ Sao Paulo, Hosp Univ, Av Prof Lineu Prestes 2565, BR-05508000 Sao Paulo, Brazil

[10] Harvard Med Sch, Spaulding Rehabil Hosp, Spaulding Neuromodulat Ctr, Boston, MA 02115 USA

[11] NIMH, Noninvas Neuromodulat Unit, Expt Therapeut & Pathophysiol Branch, Intramural Res Program,NIH, Bethesda, MD 20892 USA

[12] Ludwig Maximilian Univ Munich, Dept Psychiat & Psychotherapy, Munich, Germany

来源：

PROGRESS IN NEURO-PSYCHOPHARMACOLOGY & BIOLOGICAL PSYCHIATRY | 2020年 / 99卷

关键词：

Major depressive disorder; Bipolar disorder; Individual patient data; Systematic review; Meta-analysis; Randomized clinical trial; Transcranial direct current stimulation; Non-invasive brain stimulation; RANDOMIZED DOUBLE-BLIND; BRAIN-STIMULATION; CONTROLLED TRIAL; CURRENT THERAPY; SERTRALINE; GUIDELINES; SAFETY; DYSFUNCTION; FACTORIAL; NETWORK;

D O I：

10.1016/j.pnpbp.2019.109836

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

We evaluated the efficacy and acceptability of transcranial direct current stimulation (tDCS) for treating acute depressive episodes using individual patient data that provide more precise estimates than aggregate data metaanalysis. A systematic review of placebo-controlled trials on tDCS as only intervention was conducted until December-2018. Data from each study was collated to estimate odds ratio (OR) and number needed to treat (NNT) of response and remission, and depression improvement. Endpoints were pre-determined. Nine eligible studies (572 participants), presenting moderate/high certainty of evidence, were included. Active tDCS was significantly superior to sham for response (30.9% vs. 18.9% respectively; OR = 1.96, 95%CI [1.30-2.95], NNT = 9), remission (19.9% vs. 11.7%, OR = 1.94 [1.19-3.16], NNT = 13) and depression improvement (effect size of beta = 0.31, [0.15-0.47]). Moreover, continuous clinical improvement was observed even after the end of acute tDCS treatment. There were no differences in all-cause discontinuation rates and no predictors of response were identified. To conclude, active tDCS was statistically superior to sham in all outcomes, although its clinical effects were moderate.

引用

页数：10

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