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An electric field modeling study with meta-analysis to understand the antidepressant effects of transcranial direct current stimulation (tDCS)

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Abstract
Objective: Transcranial direct current stimulation (tDCS) has mixed effects for major depressive disorder (MDD) symptoms, partially owing to large inter -experimental variability in tDCS protocols and their correlated induced electric fields (E -fields). We investigated whether the E-field strength of distinct tDCS parameters was associated with antidepressant effect. Methods: A meta -analysis was performed with placebo -controlled clinical trials of tDCS enrolling MDD patients. PubMed, EMBASE, and Web of Science were searched from inception to March 10, 2023. Effect sizes of tDCS protocols were correlated with E-field simulations (SimNIBS) of brain regions of interest (bilateral dorsolateral prefrontal cortex [DLPFC] and bilateral subgenual anterior cingulate cortex [sgACC]). Moderators of tDCS responses were also investigated. Results: A total of 20 studies were included (21 datasets, 1,008 patients), using 11 distinct tDCS protocols. Results revealed a moderate effect for MDD (g = 0.41, 95%CI 0.18-0.64), while cathode position and treatment strategy were found to be moderators of response. A negative association between effect size and tDCS-induced E-field magnitude was seen, with stronger E -fields in the right frontal and medial parts of the DLPFC (targeted by the cathode) leading to smaller effects. No association was found for the left DLPFC and the bilateral sgACC. An optimized tDCS protocol is proposed. Conclusions: Our results highlight the need for a standardized tDCS protocol in MDD clinical trials. Registration number: PROSPERO CRD42022296246.
Keywords
Psychiatry and Mental health, subgenual anterior cingulate cortex, dorsolateral prefrontal cortex, major depressive disorder, meta-analysis, electric field, computational modeling analysis, depression, Transcranial direct current stimulation

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MLA
Boralli Razza, Laís, et al. “An Electric Field Modeling Study with Meta-Analysis to Understand the Antidepressant Effects of Transcranial Direct Current Stimulation (TDCS).” BRAZILIAN JOURNAL OF PSYCHIATRY, vol. 45, no. 6, Editora Scientific, 2023, pp. 518–29, doi:10.47626/1516-4446-2023-3116.
APA
Boralli Razza, L., Wischnewski, M., Suen, P., De Smet, S., da Silva, P. H. R., Puerta Catoira, B., … Vanderhasselt, M.-A. (2023). An electric field modeling study with meta-analysis to understand the antidepressant effects of transcranial direct current stimulation (tDCS). BRAZILIAN JOURNAL OF PSYCHIATRY, 45(6), 518–529. https://doi.org/10.47626/1516-4446-2023-3116
Chicago author-date
Boralli Razza, Laís, Miles Wischnewski, Paulo Suen, Stefanie De Smet, Pedro Henrique Rodrigues da Silva, Beatriz Puerta Catoira, André R. Brunoni, and Marie-Anne Vanderhasselt. 2023. “An Electric Field Modeling Study with Meta-Analysis to Understand the Antidepressant Effects of Transcranial Direct Current Stimulation (TDCS).” BRAZILIAN JOURNAL OF PSYCHIATRY 45 (6): 518–29. https://doi.org/10.47626/1516-4446-2023-3116.
Chicago author-date (all authors)
Boralli Razza, Laís, Miles Wischnewski, Paulo Suen, Stefanie De Smet, Pedro Henrique Rodrigues da Silva, Beatriz Puerta Catoira, André R. Brunoni, and Marie-Anne Vanderhasselt. 2023. “An Electric Field Modeling Study with Meta-Analysis to Understand the Antidepressant Effects of Transcranial Direct Current Stimulation (TDCS).” BRAZILIAN JOURNAL OF PSYCHIATRY 45 (6): 518–529. doi:10.47626/1516-4446-2023-3116.
Vancouver
1.
Boralli Razza L, Wischnewski M, Suen P, De Smet S, da Silva PHR, Puerta Catoira B, et al. An electric field modeling study with meta-analysis to understand the antidepressant effects of transcranial direct current stimulation (tDCS). BRAZILIAN JOURNAL OF PSYCHIATRY. 2023;45(6):518–29.
IEEE
[1]
L. Boralli Razza et al., “An electric field modeling study with meta-analysis to understand the antidepressant effects of transcranial direct current stimulation (tDCS),” BRAZILIAN JOURNAL OF PSYCHIATRY, vol. 45, no. 6, pp. 518–529, 2023.
@article{01H5S19DY9ZSQKTJQQXAVYYKKX,
  abstract     = {{Objective: Transcranial direct current stimulation (tDCS) has mixed effects for major depressive disorder (MDD) symptoms, partially owing to large inter -experimental variability in tDCS protocols and their correlated induced electric fields (E -fields). We investigated whether the E-field strength of distinct tDCS parameters was associated with antidepressant effect. Methods: A meta -analysis was performed with placebo -controlled clinical trials of tDCS enrolling MDD patients. PubMed, EMBASE, and Web of Science were searched from inception to March 10, 2023. Effect sizes of tDCS protocols were correlated with E-field simulations (SimNIBS) of brain regions of interest (bilateral dorsolateral prefrontal cortex [DLPFC] and bilateral subgenual anterior cingulate cortex [sgACC]). Moderators of tDCS responses were also investigated. Results: A total of 20 studies were included (21 datasets, 1,008 patients), using 11 distinct tDCS protocols. Results revealed a moderate effect for MDD (g = 0.41, 95%CI 0.18-0.64), while cathode position and treatment strategy were found to be moderators of response. A negative association between effect size and tDCS-induced E-field magnitude was seen, with stronger E -fields in the right frontal and medial parts of the DLPFC (targeted by the cathode) leading to smaller effects. No association was found for the left DLPFC and the bilateral sgACC. An optimized tDCS protocol is proposed. Conclusions: Our results highlight the need for a standardized tDCS protocol in MDD clinical trials. Registration number: PROSPERO CRD42022296246.}},
  author       = {{Boralli Razza, Laís and Wischnewski, Miles and Suen, Paulo and De Smet, Stefanie and da Silva, Pedro Henrique Rodrigues and Puerta Catoira, Beatriz and Brunoni, André R. and Vanderhasselt, Marie-Anne}},
  issn         = {{1516-4446}},
  journal      = {{BRAZILIAN JOURNAL OF PSYCHIATRY}},
  keywords     = {{Psychiatry and Mental health,subgenual anterior cingulate cortex,dorsolateral prefrontal cortex,major depressive disorder,meta-analysis,electric field,computational modeling analysis,depression,Transcranial direct current stimulation}},
  language     = {{eng}},
  number       = {{6}},
  pages        = {{518--529}},
  publisher    = {{Editora Scientific}},
  title        = {{An electric field modeling study with meta-analysis to understand the antidepressant effects of transcranial direct current stimulation (tDCS)}},
  url          = {{http://doi.org/10.47626/1516-4446-2023-3116}},
  volume       = {{45}},
  year         = {{2023}},
}

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