Effects of transcranial direct current stimulation for post-stroke depression: A systematic review and meta-analysis

The aim of this investigation was to evaluate the effect of transcranial direct current stimulation (tDCS) on post-stroke depression (PSD).

Databases were searched through February 2021. Randomized Controlled Trial(RCT) investigating the efficacy of tDCS in PSD using a standardized depression scale as outcome measure was included. The Cochrane Manual of Systematic Evaluation 5.1.0 bias risk assessment tool was used to assess the risk of bias. Effect sizes were calculated from extracted data and combined for an overall summary statistic.

Eight studies involving 412 patients were included. These trials revealed a significant pooled effect size (standardized mean differences(SMD) = 1.61, 95% confidence interval(CI) 1.02-2.19, P < 0.00001). For the subgroup analyses, neither comparisons of high- vs low-intensity or left dorsolateral prefrontal cortex vs primary motor cortex revealed a significant result. tDCS had no obvious effect on the anxiety state in patients with PSD(SMD = 1.09, 95% CI, -0.22 to 2.40, P = 0.10), while it resulted in improved ability of daily life(ADL) in these patients(SMD = 0.82, 95% CI, 0.16-1.48, P = 0.01) CONCLUSIONS: tDCS has an effect on improvement in PSD, while it is still not clear which stimulus program is best.

Further trials with larger sample sizes are needed to determine the best and most effective tDCS regimen and to realize potential clinical applications.