Efficacy and acceptability of transcranial direct current stimulation (tDCS) for major depressive disorder: An individual patient data meta-analysis.
Fiche publication
Date publication
décembre 2019
Journal
Progress in neuro-psychopharmacology & biological psychiatry
Auteurs
Membres identifiés du Cancéropôle Est :
Pr HAFFEN Emmanuel
Tous les auteurs :
Moffa AH, Martin D, Alonzo A, Bennabi D, Blumberger DM, Benseñor IM, Daskalakis Z, Fregni F, Haffen E, Lisanby SH, Padberg F, Palm U, Razza LB, Sampaio-Jr B, Loo C, Brunoni AR
Lien Pubmed
Résumé
We evaluated the efficacy and acceptability of transcranial direct current stimulation (tDCS) for treating acute depressive episodes using individual patient data that provide more precise estimates than aggregate data meta-analysis. A systematic review of placebo-controlled trials on tDCS as only intervention was conducted until December-2018. Data from each study was collated to estimate odds ratio (OR) and number needed to treat (NNT) of response and remission, and depression improvement. Endpoints were pre-determined. Nine eligible studies (572 participants), presenting moderate/high certainty of evidence, were included. Active tDCS was significantly superior to sham for response (30.9% vs. 18.9% respectively; OR = 1.96, 95%CI [1.30-2.95], NNT = 9), remission (19.9% vs. 11.7%, OR = 1.94 [1.19-3.16], NNT = 13) and depression improvement (effect size of β = 0.31, [0.15-0.47]). Moreover, continuous clinical improvement was observed even after the end of acute tDCS treatment. There were no differences in all-cause discontinuation rates and no predictors of response were identified. To conclude, active tDCS was statistically superior to sham in all outcomes, although its clinical effects were moderate.
Mots clés
Bipolar disorder, Individual patient data, Major depressive disorder, Meta-analysis, Non-invasive brain stimulation, Randomized clinical trial, Systematic review, Transcranial direct current stimulation
Référence
Prog. Neuropsychopharmacol. Biol. Psychiatry. 2019 Dec 11;:109836