Transcranial Direct Current Stimulation as an Add-on Treatment to Cognitive-Behavior Therapy in First Episode...

Area of Science:

• Neuroscience
• Psychiatry
• Clinical Psychology

Background:

• Major Depressive Disorder (MDD) affects over 264 million globally, with ~30% treatment resistance.
• Current treatments (psychotherapy, drugs) have limitations; non-pharmacological interventions are needed.
• Transcranial Direct Current Stimulation (tDCS) shows potential for MDD symptom relief, especially as an add-on therapy.

Purpose of the Study:

• To evaluate the synergistic effects of CBT combined with tDCS in drug-naïve, first-episode MDD patients.
• To assess if this combined treatment improves depressive symptoms more than sham treatment.
• To explore the neurobiological mechanisms underlying the treatment effects on prefrontal cortex function.

Main Methods:

• A parallel, randomized, triple-blind, sham-controlled trial involving 90 first-episode MDD patients.
• Participants received 6 weeks of CBT combined with either active or sham tDCS targeting the dorsolateral prefrontal cortex (DLPFC).
• Primary outcome: depressive symptom improvement (MADRS); Secondary outcome: EEG-assessed prefrontal cortex activity and connectivity.

Main Results:

• (Study protocol, results pending) The primary outcome measure is the change in Montgomery-Asberg Depression Rating Scale (MADRS) scores at 6 weeks.
• (Study protocol, results pending) Secondary measures include resting-state and task-eliciting EEG to assess prefrontal cortex modulation.
• (Study protocol, results pending) The study aims to demonstrate the efficacy and mechanistic effects of combined CBT and tDCS.

Conclusions:

• This trial investigates the combined efficacy of CBT and tDCS for first-episode, drug-naïve MDD.
• First-episode patients offer a unique opportunity to study treatment effects without confounding factors from prior interventions or chronicity.
• The study protocol is registered (NCT03548545) and aims to provide novel insights into MDD treatment.