Effectiveness of Transcranial Direct Current Stimulation on Worry, Anxiety, and Depression in Generalized Anxiety Disorder: A Randomized, Single-Blind Pharmacotherapy and Sham-Controlled Clinical Trial

Abstract

Background: Due to low adherence to treatment and side effects of pharmacotherapy, using new brain stimulation, such as transcranial direct current stimulation in patients with anxiety disorders are available. Objectives: The present research was performed to evaluate the efficacy of transcranial direct current stimulation and compare tDCS with pharmacotherapy on reduction of worry, depression, and anxiety in a group of Iranian patients with generalized anxiety disorder (GAD). Methods: This study was a quasi-experimental research. A total of 18 patients (46% females and 64% males) with GAD were randomly assigned either to tDCS, pharmacotherapy or sham conditions. Stimulation was delivered over the contralateral deltoid at 2 m/A during 20 minutes in 10 sessions of 4 weeks. Symptoms were assessed by a 7-item GAD scale, HARS, HDRS, and PSWQ in pre-test, post-test and follow up assessment (2 months later). Analysis of variance with repeated measure was used to analyze the data. Results:The results showed that both tDCS and pharmacotherapy were effective in reducing worry symptoms, also the pharmacotherapy group compared with the tDCS group and sham condition was more effective in treating of worry. Anxiety symptoms were reduced by both tDCS and pharmacotherapy and the difference between the 2 methods was not significant. Finally, the effectiveness of tDCS therapy on reducing depressive symptoms was more significant than pharmacotherapy. Conclusions:The tDCS is a promising treatment for generalized anxiety disorder, especially in depressive and worry symptoms.

The Impact of transcranial Direct Current Stimulation on Rumination: A Systematic Review of the Sham-controlled Studies in Healthy and Clinical Samples

“…Three studies relied on a within-subjects design; each study including a betweensession interval of at least 48 hours. Moreover, the two studies relying on a clinical sample included multiple sessions of active tDCS (Movahed et al, 2018;Vanderhasselt et al, 2015). Table 2.…”

“…In another study (i.e., Kelley et al, 2013), a bihemispheric tDCS-montage (anode on the right dlPFC and the cathode on the left dlPFC) increased state rumination, as compared to the opposite tDCS-montage (i.e., the anode on the left dlFPC and the cathode on the right dlPFC) and sham stimulation. Finally, one study (i.e., Movahed et al, 2018) indicated that a 10-session cathodal stimulation program (over the right dlPFC) reduced trait worry compared to sham stimulation, among patients with a general anxiety disorder. The four other studies did not report any direct effect of tDCS on state or trait ruminations.…”

“…Only two studies had a clinical sample qualifying either for generalized anxiety disorder (Movahed et al 2018) or major depressive disorder (Vanderhasselt et al, 2015); others relied exclusively on healthy volunteers.…”

“…Moreover, one study had a montage wherein the cathode was placed over the right dlPFC and the anode over the contralateral deltoid muscle (Movahed et al, 2018).…”

Repenser la comorbidité psychiatrique : Une revue conceptuelle au départ de la comordibité anxio-dépressive

“…Des techniques de neuromodulation, telle que la stimulation transcrânienne à courant continu (tDCS ; pour une revue francophone sur cette méthode, voir Heeren, Coussement, et al, 2016), montrent aujourd'hui des résultats prometteurs en termes d'intervention sur les processus trandiagnostiques impliqués dans la comorbidité anxiodépressive. A titre d'exemple, plusieurs études ont montré une diminution des ruminations Vanderhasselt et al, 2017), des inquiétudes (Movahed et al, 2018) ou des biais attentionnels (Heeren, Baeken, et al, 2015;Heeren, Billieux, et al, 2017) Anxiété et soucis excessifs (attente avec appréhension) survenant la plupart du temps durant au moins 6mois concernant un certain nombre d'événements ou d'activités (tel le travail ou les performances scolaires).…”