Transcranial direct current stimulation (tDCS) for depression in pregnancy: A pilot randomized controlled trial

Brain Stimul. Nov-Dec 2019;12(6):1475-1483. doi: 10.1016/j.brs.2019.06.019. Epub 2019 Jun 19.

Abstract

Background: Depression in pregnancy negatively affects maternal-child health. Transcranial direct current stimulation (tDCS), a non-invasive brain stimulation treatment for depression, has not been evaluated in pregnancy.

Objective: To conduct a pilot randomized controlled trial (RCT) to evaluate tDCS for antenatal depression.

Methods: In this pilot RCT in Toronto, Ontario (October 2014 to December 2016), adult pregnant women 14-32 weeks gestation with major depressive disorder who had declined antidepressant medication were considered for inclusion. Participants were randomly assigned 1:1 to tDCS or sham-control. Active tDCS comprised 30-min sessions of 2 mAmp direct current delivered over the dorsolateral prefrontal cortex, 5 days per week, for 3 weeks. Sham was administered similarly, but with current turned off after 30 s. Main outcomes were feasibility, acceptability, and protocol adherence. Maternal Montgomery Asperg Depression Rating Scale (MADRS) was measured post-treatment and at 4 and 12 weeks postpartum.

Results: Of 20 women randomized, 16 completed treatment and provided data (124 tDCS, 122 sham sessions). Views of treatment were positive with no serious adverse events. Post-treatment estimated marginal mean MADRS scores were 11.8 (standard error, SE 2.66) for tDCS and 15.4 (SE 2.51) for sham (p = 0.34). At 4 weeks postpartum, 75.0% of tDCS women were remitted versus 12.5% sham-control (p = 0.04).

Conclusions: Results support proceeding to a definitive RCT to evaluate tDCS for antenatal depression. The preliminary efficacy estimates immediately post-treatment and in the postpartum, are encouraging with respect to the potential use of tDCS to improve treatment rates in this population. The trial was registered at: clinical trials.gov (NCT02116127).

Keywords: Antenatal depression; Antidepressive agents; Brain stimulation; Pregnancy; Transcranial direct current stimulation; tDCS.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Depressive Disorder, Major / epidemiology
  • Depressive Disorder, Major / psychology*
  • Depressive Disorder, Major / therapy*
  • Female
  • Humans
  • Ontario / epidemiology
  • Pilot Projects
  • Prefrontal Cortex / physiology
  • Pregnancy
  • Pregnancy Complications / epidemiology
  • Pregnancy Complications / psychology*
  • Pregnancy Complications / therapy*
  • Psychiatric Status Rating Scales
  • Transcranial Direct Current Stimulation / methods*
  • Treatment Outcome

Associated data

  • ClinicalTrials.gov/NCT02116127