Citation

Moreno ML, Goerigk SA, Bertola L, Suemoto CK, Razza LB, Moffa AH, Veronezi BP, Tort L, Nogueira BS, Gattaz WF, Fráguas R, Padberg F, Lotufo PA, Benseñor IM, Brunoni AR. J. Affect. Disord. 2020; 263: 344-352.

Copyright

(Copyright © 2020, Elsevier Publishing)

DOI

10.1016/j.jad.2019.12.009

PMID

31969264

Abstract

BACKGROUND: Cognitive deficits in major depressive disorder (MDD) are associated with low quality of life and higher suicide risk. Antidepressant drugs have modest to null effects in improving such deficits. Therefore, we investigated the cognitive effects of transcranial direct current stimulation (tDCS), which is a promising antidepressant non-pharmacological intervention, in MDD.
METHODS: An exploratory analysis on cognitive performance was conducted in 243 depressed patients from the Escitalopram vs. Electric Current Therapy for Treating Depression Clinical Study (ELECT-TDCS), a sham-controlled study comparing the efficacy of tDCS vs. escitalopram. A neuropsychological battery was applied at baseline and endpoint (10 weeks of treatment) to create composite cognitive scores (processing speed, working memory, and verbal fluency). Linear mixed regression models were used to evaluate changes according to intervention groups, adjusted for confounding variables (age, years of schooling, gender, and benzodiazepine use) and depression improvement.
RESULTS: No cognitive deterioration was observed in any group. Patients receiving tDCS presented reduced practice gains compared to placebo in processing speed. In patients receiving escitalopram vs. placebo and in the subgroup of clinical responders (>50% depression improvement from baseline), those receiving tDCS vs. placebo presented increased performance in verbal fluency. No significant differences between tDCS and escitalopram groups were detected.
LIMITATIONS: Absence of healthy controls.
CONCLUSION: Prefrontal tDCS did not lead to cognitive deficits in depressed patients, although it reduced practice effects in processing speed. tDCS responders presented increased performance in verbal fluency. Further investigation of tDCS cognitive effects in depression is warranted.

Language: en

Keywords

Humans; Safety; Psychiatry; Treatment Outcome; Cognition; Double-Blind Method; Quality of Life; Major depressive disorder; Dorsolateral prefrontal cortex; Citalopram; Depressive Disorder, Major; Prefrontal Cortex; Mental Processes; Transcranial direct current stimulation (tDCS); Selective Serotonin Reuptake Inhibitors; Transcranial Direct Current Stimulation