Transcranial direct current stimulation for acute major depressive episodes: meta-analysis of individual patient data
Identifieur interne : 000649 ( Pmc/Curation ); précédent : 000648; suivant : 000650Transcranial direct current stimulation for acute major depressive episodes: meta-analysis of individual patient data
Auteurs : André R. Brunoni ; Adriano H. Moffa ; Felipe Fregni ; Ulrich Palm ; Frank Padberg ; Daniel M. Blumberger ; Zafiris J. Daskalakis ; Djamila Bennabi ; Emmanuel Haffen ; Angelo Alonzo ; Colleen K. LooSource :
- The British Journal of Psychiatry [ 0007-1250 ] ; 2016.
Abstract
Transcranial direct current stimulation (tDCS) is a non-pharmacological intervention for depression. It has mixed results, possibly caused by study heterogeneity.
To assess tDCS efficacy and to explore individual response predictors.
Systematic review and individual patient data meta-analysis.
Data were gathered from six randomised sham-controlled trials, enrolling 289 patients. Active tDCS was significantly superior to sham for response (34%
The effect size of tDCS treatment was comparable with those reported for repetitive transcranial magnetic stimulation and antidepressant drug treatment in primary care. The most important parameters for optimisation in future trials are depression refractoriness and tDCS dose.
Url:
DOI: 10.1192/bjp.bp.115.164715
PubMed: 27056623
PubMed Central: 4887722
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Moffa</name></author><author><name sortKey="Fregni, Felipe" sort="Fregni, Felipe" uniqKey="Fregni F" first="Felipe" last="Fregni">Felipe Fregni</name></author><author><name sortKey="Palm, Ulrich" sort="Palm, Ulrich" uniqKey="Palm U" first="Ulrich" last="Palm">Ulrich Palm</name></author><author><name sortKey="Padberg, Frank" sort="Padberg, Frank" uniqKey="Padberg F" first="Frank" last="Padberg">Frank Padberg</name></author><author><name sortKey="Blumberger, Daniel M" sort="Blumberger, Daniel M" uniqKey="Blumberger D" first="Daniel M." last="Blumberger">Daniel M. Blumberger</name></author><author><name sortKey="Daskalakis, Zafiris J" sort="Daskalakis, Zafiris J" uniqKey="Daskalakis Z" first="Zafiris J." last="Daskalakis">Zafiris J. Daskalakis</name></author><author><name sortKey="Bennabi, Djamila" sort="Bennabi, Djamila" uniqKey="Bennabi D" first="Djamila" last="Bennabi">Djamila Bennabi</name></author><author><name sortKey="Haffen, Emmanuel" sort="Haffen, Emmanuel" uniqKey="Haffen E" first="Emmanuel" last="Haffen">Emmanuel Haffen</name></author><author><name sortKey="Alonzo, Angelo" sort="Alonzo, Angelo" uniqKey="Alonzo A" first="Angelo" last="Alonzo">Angelo Alonzo</name></author><author><name sortKey="Loo, Colleen K" sort="Loo, Colleen K" uniqKey="Loo C" first="Colleen K." last="Loo">Colleen K. Loo</name></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">27056623</idno><idno type="pmc">4887722</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4887722</idno><idno type="RBID">PMC:4887722</idno><idno type="doi">10.1192/bjp.bp.115.164715</idno><date when="2016">2016</date><idno type="wicri:Area/Pmc/Corpus">000650</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000650</idno><idno type="wicri:Area/Pmc/Curation">000649</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000649</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Transcranial direct current stimulation for acute major depressive episodes: meta-analysis of individual patient data</title><author><name sortKey="Brunoni, Andre R" sort="Brunoni, Andre R" uniqKey="Brunoni A" first="André R." last="Brunoni">André R. Brunoni</name></author><author><name sortKey="Moffa, Adriano H" sort="Moffa, Adriano H" uniqKey="Moffa A" first="Adriano H." last="Moffa">Adriano H. Moffa</name></author><author><name sortKey="Fregni, Felipe" sort="Fregni, Felipe" uniqKey="Fregni F" first="Felipe" last="Fregni">Felipe Fregni</name></author><author><name sortKey="Palm, Ulrich" sort="Palm, Ulrich" uniqKey="Palm U" first="Ulrich" last="Palm">Ulrich Palm</name></author><author><name sortKey="Padberg, Frank" sort="Padberg, Frank" uniqKey="Padberg F" first="Frank" last="Padberg">Frank Padberg</name></author><author><name sortKey="Blumberger, Daniel M" sort="Blumberger, Daniel M" uniqKey="Blumberger D" first="Daniel M." last="Blumberger">Daniel M. Blumberger</name></author><author><name sortKey="Daskalakis, Zafiris J" sort="Daskalakis, Zafiris J" uniqKey="Daskalakis Z" first="Zafiris J." last="Daskalakis">Zafiris J. Daskalakis</name></author><author><name sortKey="Bennabi, Djamila" sort="Bennabi, Djamila" uniqKey="Bennabi D" first="Djamila" last="Bennabi">Djamila Bennabi</name></author><author><name sortKey="Haffen, Emmanuel" sort="Haffen, Emmanuel" uniqKey="Haffen E" first="Emmanuel" last="Haffen">Emmanuel Haffen</name></author><author><name sortKey="Alonzo, Angelo" sort="Alonzo, Angelo" uniqKey="Alonzo A" first="Angelo" last="Alonzo">Angelo Alonzo</name></author><author><name sortKey="Loo, Colleen K" sort="Loo, Colleen K" uniqKey="Loo C" first="Colleen K." last="Loo">Colleen K. Loo</name></author></analytic><series><title level="j">The British Journal of Psychiatry</title><idno type="ISSN">0007-1250</idno><idno type="eISSN">1472-1465</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p id="P1"><bold>Background</bold></p><p id="P2">Transcranial direct current stimulation (tDCS) is a non-pharmacological intervention for depression. It has mixed results, possibly caused by study heterogeneity.</p><p id="P3"><bold>Aims</bold></p><p id="P4">To assess tDCS efficacy and to explore individual response predictors.</p><p id="P5"><bold>Method</bold></p><p id="P6">Systematic review and individual patient data meta-analysis.</p><p id="P7"><bold>Results</bold></p><p id="P8">Data were gathered from six randomised sham-controlled trials, enrolling 289 patients. Active tDCS was significantly superior to sham for response (34% <italic>v.</italic> 19% respectively, odds ratio (OR) = 2.44, 95% CI 1.38–4.32, number needed to treat (NNT) = 7), remission (23.1% <italic>v.</italic> 12.7% respectively, OR = 2.38, 95% CI 1.22–4.64, NNT = 9) and depression improvement (<italic>B</italic> coefficient 0.35, 95% CI 0.12–0.57). Mixed-effects models showed that, after adjustment for other predictors and confounders, treatment-resistant depression and higher tDCS ‘doses’ were, respectively, negatively and positively associated with tDCS efficacy.</p><p id="P9"><bold>Conclusions</bold></p><p id="P10">The effect size of tDCS treatment was comparable with those reported for repetitive transcranial magnetic stimulation and antidepressant drug treatment in primary care. The most important parameters for optimisation in future trials are depression refractoriness and tDCS dose.</p></div></front></TEI><pmc article-type="review-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Br J Psychiatry</journal-id><journal-id journal-id-type="iso-abbrev">Br J Psychiatry</journal-id><journal-id journal-id-type="hwp">bjprcpsych</journal-id><journal-title-group><journal-title>The British Journal of Psychiatry</journal-title></journal-title-group><issn pub-type="ppub">0007-1250</issn><issn pub-type="epub">1472-1465</issn><publisher><publisher-name>Royal College of Psychiatrists</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">27056623</article-id><article-id pub-id-type="pmc">4887722</article-id><article-id pub-id-type="doi">10.1192/bjp.bp.115.164715</article-id><article-categories><subj-group subj-group-type="heading"><subject>Review Articles</subject></subj-group></article-categories><title-group><article-title>Transcranial direct current stimulation for acute major depressive episodes: meta-analysis of individual patient data</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Brunoni</surname><given-names>André R.</given-names></name><xref ref-type="corresp" rid="cor1"></xref></contrib><contrib contrib-type="author"><name><surname>Moffa</surname><given-names>Adriano H.</given-names></name></contrib><contrib contrib-type="author"><name><surname>Fregni</surname><given-names>Felipe</given-names></name></contrib><contrib contrib-type="author"><name><surname>Palm</surname><given-names>Ulrich</given-names></name></contrib><contrib contrib-type="author"><name><surname>Padberg</surname><given-names>Frank</given-names></name></contrib><contrib contrib-type="author"><name><surname>Blumberger</surname><given-names>Daniel M.</given-names></name></contrib><contrib contrib-type="author"><name><surname>Daskalakis</surname><given-names>Zafiris J.</given-names></name></contrib><contrib contrib-type="author"><name><surname>Bennabi</surname><given-names>Djamila</given-names></name></contrib><contrib contrib-type="author"><name><surname>Haffen</surname><given-names>Emmanuel</given-names></name></contrib><contrib contrib-type="author"><name><surname>Alonzo</surname><given-names>Angelo</given-names></name></contrib><contrib contrib-type="author"><name><surname>Loo</surname><given-names>Colleen K.</given-names></name></contrib><aff><bold>André R. Brunoni</bold>, MD, PhD,<bold>Adriano H. Moffa</bold>, BS, Interdisciplinary Center for Applied Neuromodulation, University Hospital & Service of Interdisciplinary Neuromodulation, Department and Institute of Psychiatry, Laboratory of Neurosciences (LIM-27), University of São Paulo, São Paulo, Brazil;<bold>Felipe Fregni</bold>, MD, PhD, Spaulding Neuromodulation Center, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts, USA;<bold>Ulrich Palm</bold>, MD,<bold>Frank Padberg</bold>, MD, PhD, Department of Psychiatry and Psychotherapy, Ludwig Maximilian University Munich, Munich, Germany;<bold>Daniel M. Blumberger</bold>, MD,<bold>Zafiris J. Daskalakis</bold>, MD, Temerty Centre for Therapeutic Brain Intervention and Campbell Family Research Institute, Centre for Addiction and Mental Health and Department of Psychiatry, University of Toronto, Ontario, Canada;<bold>Djamila Bennabi</bold>, MD,<bold>Emmanuel Haffen</bold>, MD, Department of Clinical Psychiatry, Clinical Investigation Center 1431 Inserm, EA 481 Neurosciences, University Hospital of Besancon and FondaMental Foundation, Créteil, France;<bold>Angelo Alonzo</bold>, PhD,<bold>Colleen K. Loo</bold>, MD, School of Psychiatry, University of New South Wales, Black Dog Institute and St George Hospital, Sydney, Australia</aff></contrib-group><author-notes><corresp id="cor1"><bold>Correspondence</bold>: André R. Brunoni, MD, PhD, Interdisciplinary Center for Applied Neuromodulation, Av. Professor Lineu Prestes, 2565, 3o andar, CEP 05508-000, São Paulo (SP), Brazil. Email: <email>brunoni@usp.br</email></corresp></author-notes><pub-date pub-type="ppub"><month>6</month><year>2016</year></pub-date><volume>208</volume><issue>6</issue><fpage>522</fpage><lpage>531</lpage><history><date date-type="received"><day>3</day><month>2</month><year>2015</year></date><date date-type="rev-recd"><day>6</day><month>7</month><year>2015</year></date><date date-type="accepted"><day>12</day><month>7</month><year>2015</year></date></history><permissions><copyright-statement>© The Royal College of Psychiatrists 2016.</copyright-statement><copyright-year>2016</copyright-year></permissions><self-uri xlink:title="pdf" xlink:href="522.pdf"></self-uri><abstract><p id="P1"><bold>Background</bold></p><p id="P2">Transcranial direct current stimulation (tDCS) is a non-pharmacological intervention for depression. It has mixed results, possibly caused by study heterogeneity.</p><p id="P3"><bold>Aims</bold></p><p id="P4">To assess tDCS efficacy and to explore individual response predictors.</p><p id="P5"><bold>Method</bold></p><p id="P6">Systematic review and individual patient data meta-analysis.</p><p id="P7"><bold>Results</bold></p><p id="P8">Data were gathered from six randomised sham-controlled trials, enrolling 289 patients. Active tDCS was significantly superior to sham for response (34% <italic>v.</italic> 19% respectively, odds ratio (OR) = 2.44, 95% CI 1.38–4.32, number needed to treat (NNT) = 7), remission (23.1% <italic>v.</italic> 12.7% respectively, OR = 2.38, 95% CI 1.22–4.64, NNT = 9) and depression improvement (<italic>B</italic> coefficient 0.35, 95% CI 0.12–0.57). Mixed-effects models showed that, after adjustment for other predictors and confounders, treatment-resistant depression and higher tDCS ‘doses’ were, respectively, negatively and positively associated with tDCS efficacy.</p><p id="P9"><bold>Conclusions</bold></p><p id="P10">The effect size of tDCS treatment was comparable with those reported for repetitive transcranial magnetic stimulation and antidepressant drug treatment in primary care. The most important parameters for optimisation in future trials are depression refractoriness and tDCS dose.</p></abstract><funding-group><award-group id="funding-1"><funding-source>Brain & Behavior Research Foundation</funding-source><award-id>20493</award-id><principal-award-recipient><name><surname>B.</surname><given-names>A.R.</given-names></name></principal-award-recipient></award-group><award-group id="funding-2"><funding-source>São Paulo State Foundation</funding-source><award-id>20911-5</award-id><principal-award-recipient><name><surname>B.</surname><given-names>A.R.</given-names></name></principal-award-recipient></award-group><award-group id="funding-3"><funding-source>National Council for Scientific and Technological Development</funding-source><award-id>470904</award-id><principal-award-recipient><name><surname>B.</surname><given-names>A.R.</given-names></name></principal-award-recipient></award-group><award-group id="funding-4"><funding-source>neuroConn GmbH</funding-source><funding-source>Brainsway Inc</funding-source><principal-award-recipient><name><surname>P.</surname><given-names>F.</given-names></name></principal-award-recipient></award-group><award-group id="funding-5"><funding-source>Australian National Health and Medical Council</funding-source><funding-source>Stanley Medical Research Foundation</funding-source><principal-award-recipient><name><surname>L.</surname><given-names>C.</given-names></name></principal-award-recipient></award-group><award-group id="funding-6"><funding-source>Centre for Addiction and Mental Health</funding-source><funding-source>Canadian Institutes of Health Research</funding-source><funding-source>US National Institute of Health (NIH)</funding-source><funding-source>Brainsway Ltd</funding-source><funding-source>Tonika-Magventure</funding-source><principal-award-recipient><name><surname>B.</surname><given-names>D.M.</given-names></name></principal-award-recipient></award-group><award-group id="funding-7"><funding-source>Lundbeck Foundation</funding-source><principal-award-recipient><name><surname>H.</surname><given-names>E.</given-names></name><name><surname>B.</surname><given-names>D.</given-names></name></principal-award-recipient></award-group><award-group id="funding-8"><funding-source>Brainsway Inc.</funding-source><principal-award-recipient><name><surname>D.</surname><given-names>Z.J.</given-names></name></principal-award-recipient></award-group><award-group id="funding-9"><funding-source>Ontario Mental Health Foundation (OMHF)</funding-source></award-group><award-group id="funding-10"><funding-source>Canadian Institutes of Health Research (CIHR)</funding-source></award-group><award-group id="funding-11"><funding-source>Brain and Behaviour Research Foundation</funding-source></award-group><award-group id="funding-12"><funding-source>Temerty Family and Grant Family</funding-source></award-group><award-group id="funding-13"><funding-source>Centre for Addiction and Mental Health (CAMH) Foundation</funding-source></award-group><award-group id="funding-14"><funding-source>Campbell Institute</funding-source></award-group></funding-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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