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Transcranial direct current stimulation for acute major depressive episodes: meta-analysis of individual patient data.
Brunoni, André R; Moffa, Adriano H; Fregni, Felipe; Palm, Ulrich; Padberg, Frank; Blumberger, Daniel M; Daskalakis, Zafiris J; Bennabi, Djamila; Haffen, Emmanuel; Alonzo, Angelo; Loo, Colleen K.
Afiliación
  • Brunoni AR; André R. Brunoni, MD, PhD, Adriano H. Moffa, BS, Interdisciplinary Center for Applied Neuromodulation, University Hospital & Service of Interdisciplinary Neuromodulation, Department and Institute of Psychiatry, Laboratory of Neurosciences (LIM-27), University of São Paulo, São Paulo, Brazil; Fel
  • Moffa AH; André R. Brunoni, MD, PhD, Adriano H. Moffa, BS, Interdisciplinary Center for Applied Neuromodulation, University Hospital & Service of Interdisciplinary Neuromodulation, Department and Institute of Psychiatry, Laboratory of Neurosciences (LIM-27), University of São Paulo, São Paulo, Brazil; Fel
  • Fregni F; André R. Brunoni, MD, PhD, Adriano H. Moffa, BS, Interdisciplinary Center for Applied Neuromodulation, University Hospital & Service of Interdisciplinary Neuromodulation, Department and Institute of Psychiatry, Laboratory of Neurosciences (LIM-27), University of São Paulo, São Paulo, Brazil; Fel
  • Palm U; André R. Brunoni, MD, PhD, Adriano H. Moffa, BS, Interdisciplinary Center for Applied Neuromodulation, University Hospital & Service of Interdisciplinary Neuromodulation, Department and Institute of Psychiatry, Laboratory of Neurosciences (LIM-27), University of São Paulo, São Paulo, Brazil; Fel
  • Padberg F; André R. Brunoni, MD, PhD, Adriano H. Moffa, BS, Interdisciplinary Center for Applied Neuromodulation, University Hospital & Service of Interdisciplinary Neuromodulation, Department and Institute of Psychiatry, Laboratory of Neurosciences (LIM-27), University of São Paulo, São Paulo, Brazil; Fel
  • Blumberger DM; André R. Brunoni, MD, PhD, Adriano H. Moffa, BS, Interdisciplinary Center for Applied Neuromodulation, University Hospital & Service of Interdisciplinary Neuromodulation, Department and Institute of Psychiatry, Laboratory of Neurosciences (LIM-27), University of São Paulo, São Paulo, Brazil; Fel
  • Daskalakis ZJ; André R. Brunoni, MD, PhD, Adriano H. Moffa, BS, Interdisciplinary Center for Applied Neuromodulation, University Hospital & Service of Interdisciplinary Neuromodulation, Department and Institute of Psychiatry, Laboratory of Neurosciences (LIM-27), University of São Paulo, São Paulo, Brazil; Fel
  • Bennabi D; André R. Brunoni, MD, PhD, Adriano H. Moffa, BS, Interdisciplinary Center for Applied Neuromodulation, University Hospital & Service of Interdisciplinary Neuromodulation, Department and Institute of Psychiatry, Laboratory of Neurosciences (LIM-27), University of São Paulo, São Paulo, Brazil; Fel
  • Haffen E; André R. Brunoni, MD, PhD, Adriano H. Moffa, BS, Interdisciplinary Center for Applied Neuromodulation, University Hospital & Service of Interdisciplinary Neuromodulation, Department and Institute of Psychiatry, Laboratory of Neurosciences (LIM-27), University of São Paulo, São Paulo, Brazil; Fel
  • Alonzo A; André R. Brunoni, MD, PhD, Adriano H. Moffa, BS, Interdisciplinary Center for Applied Neuromodulation, University Hospital & Service of Interdisciplinary Neuromodulation, Department and Institute of Psychiatry, Laboratory of Neurosciences (LIM-27), University of São Paulo, São Paulo, Brazil; Fel
  • Loo CK; André R. Brunoni, MD, PhD, Adriano H. Moffa, BS, Interdisciplinary Center for Applied Neuromodulation, University Hospital & Service of Interdisciplinary Neuromodulation, Department and Institute of Psychiatry, Laboratory of Neurosciences (LIM-27), University of São Paulo, São Paulo, Brazil; Fel
Br J Psychiatry ; 208(6): 522-31, 2016 06.
Article en En | MEDLINE | ID: mdl-27056623
ABSTRACT

BACKGROUND:

Transcranial direct current stimulation (tDCS) is a non-pharmacological intervention for depression. It has mixed results, possibly caused by study heterogeneity.

AIMS:

To assess tDCS efficacy and to explore individual response predictors.

METHOD:

Systematic review and individual patient data meta-analysis.

RESULTS:

Data were gathered from six randomised sham-controlled trials, enrolling 289 patients. Active tDCS was significantly superior to sham for response (34% v. 19% respectively, odds ratio (OR) = 2.44, 95% CI 1.38-4.32, number needed to treat (NNT) = 7), remission (23.1% v. 12.7% respectively, OR = 2.38, 95% CI 1.22-4.64, NNT = 9) and depression improvement (B coefficient 0.35, 95% CI 0.12-0.57). Mixed-effects models showed that, after adjustment for other predictors and confounders, treatment-resistant depression and higher tDCS 'doses' were, respectively, negatively and positively associated with tDCS efficacy.

CONCLUSIONS:

The effect size of tDCS treatment was comparable with those reported for repetitive transcranial magnetic stimulation and antidepressant drug treatment in primary care. The most important parameters for optimisation in future trials are depression refractoriness and tDCS dose.
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Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Trastorno Depresivo Mayor / Evaluación del Resultado de la Atención al Paciente / Estimulación Transcraneal de Corriente Directa Tipo de estudio: Clinical_trials / Prognostic_studies / Systematic_reviews Límite: Humans Idioma: En Revista: Br J Psychiatry Año: 2016 Tipo del documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Trastorno Depresivo Mayor / Evaluación del Resultado de la Atención al Paciente / Estimulación Transcraneal de Corriente Directa Tipo de estudio: Clinical_trials / Prognostic_studies / Systematic_reviews Límite: Humans Idioma: En Revista: Br J Psychiatry Año: 2016 Tipo del documento: Article