The Sertraline vs Electrical Current Therapy for Treating Depression Clinical Study

Brunoni, André R.; Valiengo, Leandro; Baccaro, Alessandra; Zanão, Tamires; Oliveira, Janaina Farias de; Goulart, Alessandra Carvalho; Boggio, Paulo S.; Lotufo, Paulo A.; Benseñor, Isabela M.; Fregni, Felipe

doi:10.1001/2013.jamapsychiatry.32

Cited by 523 publications

(442 citation statements)

References 64 publications

(86 reference statements)

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“…It has been shown that a minimum of 10-20 sessions of tDCS need to be performed in order to induce relevant clinical improvements [39][40][41][42]. However, in clinical trials involving patients with severe disabilities, such as SCI as in the present study, we experienced a high rate of drop-out which limits the power of clinical results.…”

Section: Adherence To Extended Tdcs Protocolmentioning

confidence: 87%

Delayed pain decrease following M1 tDCS in spinal cord injury: A randomized controlled clinical trial

Thibaut

Carvalho

Morse

et al. 2017

Neuroscience Letters

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Section: Adherence To Extended Tdcs Protocolmentioning

confidence: 87%

Delayed pain decrease following M1 tDCS in spinal cord injury: A randomized controlled clinical trial

Thibaut

Carvalho

Morse

et al. 2017

Neuroscience Letters

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“…This work aligns with the rapidly growing body of research that indicates tDCS may have beneficial effects for psychiatric conditions associated with altered prefrontal activity or connectivity, including depression (Drevets, Price, & Furey, 2008), schizophrenia (Meyer‐Lindenberg et al., 2002), and obsessive–compulsive disorder (Chamberlain et al., 2008). For instance, recent studies have demonstrated tDCS to reduce severity of depression (Brunoni et al., 2013, 2016; Shiozawa et al., 2014) as well as promising results to reduce severity of symptoms associated with schizophrenia (Brunelin et al., 2012; Hoy, Arnold, Emonson, Daskalakis, & Fitzgerald, 2014). Yet, data on the potential effectiveness of tDCS for PTSD are limited to a small sample pilot study reporting improvement on cognitive and emotional performance after working memory training combined with tDCS (Saunders et al., 2015).…”

Section: Introductionmentioning

confidence: 99%

Transcranial direct current stimulation may modulate extinction memory in posttraumatic stress disorder

et al. 2017

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BackgroundAbnormalities in fear extinction and recall are core components of posttraumatic stress disorder (PTSD). Data from animal and human studies point to a role of the ventromedial prefrontal cortex (vmPFC) in extinction learning and subsequent retention of extinction memories. Given the increasing interest in developing noninvasive brain stimulation protocols for psychopathology treatment, we piloted whether transcranial direct current stimulation (tDCS) during extinction learning, vs. during consolidation of extinction learning, might improve extinction recall in veterans with warzone‐related PTSD.MethodsTwenty‐eight veterans with PTSD completed a 2‐day Pavlovian fear conditioning, extinction, and recall paradigm. Participants received one 10‐min session of 2 mA anodal tDCS over AF3, intended to target the vmPFC. Fourteen received tDCS that started simultaneously with extinction learning onset, and the remaining 14 participants received tDCS during extinction consolidation. Normalized skin conductance reactivity (SCR) was the primary outcome measure. Linear mixed effects models were used to test for effects of tDCS on late extinction and early extinction recall 24 hr later.ResultsDuring early recall, veterans who received tDCS during extinction consolidation showed slightly lower SCR in response to previously extinguished stimuli as compared to veterans who received tDCS simultaneous with extinction learning (p = .08), generating a medium effect size (Cohen's d = .38). There was no significant effect of tDCS on SCR during late extinction.ConclusionsThese preliminary findings suggest that testing the effects of tDCS during consolidation of fear extinction may have promise as a way of enhancing extinction recall.

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“…Although it is well-defined that multiple sessions of tDCS and TMS have cumulative effects, the impact of spaced sessions in abolishing, potentiating or having no effect still needs to be further clarified [16,[33][34][35]. This was explored by Zanão et al (2014), based on their previous trial [36] where some patients did not attend all visit [37]. They showed that missing one or two tDCS visits (out of 10) did not alter the treatment effectiveness [37].…”

Section: Discussionmentioning

confidence: 99%

“…In the present review, we noticed that most RCTs did not report missed visits and less than 10% of the RCTs reviewed clearly stated how these missed visits were managed when they occurred. We proposed a plan to handle this issue by allowing up to 20% of appointments to be missed and replacing those visits at the end of the designated stimulations period as successfully done in several RCTs [20,21,27,48]. This method seems to have an appropriate balance between the rigor required in RCT and the flexibility needed for patients with depression or chronic pain, or other conditions inclined to missed treatment visits.…”

Section: Expert Commentarymentioning

confidence: 99%

Strategies for replacing non-invasive brain stimulation sessions: recommendations for designing neurostimulation clinical trials

Thibaut

O’Brien

Fregni

2017

Expert Review of Medical Devices

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Introduction: Despite the potential impact of missed visits on the outcomes of neuromodulation treatments, it is not clear how this issue has been addressed in clinical trials. Given this gap in the literature, we reviewed articles on non-invasive brain stimulation in participants with depression or chronic pain, and investigated how missed visits were handled. Areas covered:We performed a search on PUBMED/MEDLINE using the keywords: "tDCS", "transcranial direct current stimulation", "transcranial magnetic stimulation¨, "depression", and "pain". We included studies with a minimum of five participants who were diagnosed with depression or chronic pain, who underwent a minimum of five tDCS or TMS sessions. A total of 181 studies matched our inclusion criteria, 112 on depression and 69 on chronic pain. Of these, only fifteen (8%) articles reported or had a protocol addressing missed visits. This review demonstrates that, in most of the trials, there is no reported plan to handle missed visits.Expert commentary: Based on our findings and previous studies, we developed suggestions on how to handle missed visits in neuromodulation protocols. A maximum of 20% of missing sessions should be allowed before excluding a patient and these sessions should be replaced at the end of the stimulation period.

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The Sertraline vs Electrical Current Therapy for Treating Depression Clinical Study

Cited by 523 publications

References 64 publications

Delayed pain decrease following M1 tDCS in spinal cord injury: A randomized controlled clinical trial

Delayed pain decrease following M1 tDCS in spinal cord injury: A randomized controlled clinical trial

Transcranial direct current stimulation may modulate extinction memory in posttraumatic stress disorder

Strategies for replacing non-invasive brain stimulation sessions: recommendations for designing neurostimulation clinical trials

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