TY - JOUR
T1 - Transcranial alternating current stimulation for treating depression
T2 - a randomized controlled trial
AU - Wang, Hongxing
AU - Wang, Kun
AU - Xue, Qing
AU - Peng, Mao
AU - Yin, Lu
AU - Gu, Xuecun
AU - Leng, Haixia
AU - Lu, Juan
AU - Liu, Hongzhi
AU - Wang, Di
AU - Xiao, Jin
AU - Sun, Zhichao
AU - Li, Ning
AU - Dong, Kai
AU - Zhang, Qian
AU - Zhan, Shuqin
AU - Fan, Chunqiu
AU - Min, Baoquan
AU - Zhou, Aihong
AU - Xie, Yunyan
AU - Song, Haiqing
AU - Ye, Jing
AU - Liu, Aihua
AU - Gao, Ran
AU - Huang, Liyuan
AU - Jiao, Lidong
AU - Song, Yang
AU - Dong, Huiqing
AU - Tian, Zichen
AU - Si, Tianmei
AU - Zhang, Xiangyang
AU - Li, Xinmin
AU - Kamiya, Atsushi
AU - Cosci, Fiammetta
AU - Gao, Keming
AU - Wang, Yuping
N1 - Publisher Copyright:
© 2021 The Author(s) (2021). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For permissions, please email: journals.permissions@oup.com.
PY - 2022/1/1
Y1 - 2022/1/1
N2 - Treatment of depression with antidepressants is partly effective. Transcranial alternating current stimulation can provide a non-pharmacological alternative for adult patients with major depressive disorder. However, no study has used the stimulation to treat first-episode and drug-naïve patients with major depressive disorder. We used a randomized, double-blind, sham-controlled design to examine the clinical efficacy and safety of the stimulation in treating first-episode drug-naïve patients in a Chinese Han population. From 4 June 2018 to 30 December 2019, 100 patients were recruited and randomly assigned to receive 20 daily 40-min, 77.5 Hz, 15 mA, one forehead and two mastoid sessions of active or sham stimulation (n = 50 for each group) in four consecutive weeks (Week 4), and were followed for additional 4-week efficacy/safety assessment without stimulation (Week 8). The primary outcome was a remission rate defined as the 17-item Hamilton Depression Rating Scale (HDRS-17) score ≤ 7 at Week 8. Secondary analyses were response rates (defined as a reduction of ≥ 50% in the HDRS-17), changes in depressive symptoms and severity from baseline to Week 4 and Week 8, and rates of adverse events. Data were analysed in an intention-to-treat sample. Forty-nine in the active and 46 in the sham completed the study. Twenty-seven of 50 (54%) in the active treatment group and 9 of 50 (18%) in the sham group achieved remission at the end of Week 8. The remission rate was significantly higher in the active group compared to that in the sham group with a risk ratio of 1.78 (95% confidence interval, 1.29, 2.47). Compared with the sham, the active group had a significantly higher remission rate at Week 4, response rates at Weeks 4 and 8, and a larger reduction in depressive symptoms from baseline to Weeks 4 and 8. Adverse events were similar between the groups. In conclusion, the stimulation on the frontal cortex and two mastoids significantly improved symptoms in first-episode drug-naïve patients with major depressive disorder and may be considered as a non-pharmacological intervention for them in an outpatient setting.
AB - Treatment of depression with antidepressants is partly effective. Transcranial alternating current stimulation can provide a non-pharmacological alternative for adult patients with major depressive disorder. However, no study has used the stimulation to treat first-episode and drug-naïve patients with major depressive disorder. We used a randomized, double-blind, sham-controlled design to examine the clinical efficacy and safety of the stimulation in treating first-episode drug-naïve patients in a Chinese Han population. From 4 June 2018 to 30 December 2019, 100 patients were recruited and randomly assigned to receive 20 daily 40-min, 77.5 Hz, 15 mA, one forehead and two mastoid sessions of active or sham stimulation (n = 50 for each group) in four consecutive weeks (Week 4), and were followed for additional 4-week efficacy/safety assessment without stimulation (Week 8). The primary outcome was a remission rate defined as the 17-item Hamilton Depression Rating Scale (HDRS-17) score ≤ 7 at Week 8. Secondary analyses were response rates (defined as a reduction of ≥ 50% in the HDRS-17), changes in depressive symptoms and severity from baseline to Week 4 and Week 8, and rates of adverse events. Data were analysed in an intention-to-treat sample. Forty-nine in the active and 46 in the sham completed the study. Twenty-seven of 50 (54%) in the active treatment group and 9 of 50 (18%) in the sham group achieved remission at the end of Week 8. The remission rate was significantly higher in the active group compared to that in the sham group with a risk ratio of 1.78 (95% confidence interval, 1.29, 2.47). Compared with the sham, the active group had a significantly higher remission rate at Week 4, response rates at Weeks 4 and 8, and a larger reduction in depressive symptoms from baseline to Weeks 4 and 8. Adverse events were similar between the groups. In conclusion, the stimulation on the frontal cortex and two mastoids significantly improved symptoms in first-episode drug-naïve patients with major depressive disorder and may be considered as a non-pharmacological intervention for them in an outpatient setting.
KW - drug-naïve
KW - efficacy
KW - first-episode
KW - major depressive disorder
KW - transcranial alternating current stimulation
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U2 - 10.1093/brain/awab252
DO - 10.1093/brain/awab252
M3 - Article
C2 - 35353887
AN - SCOPUS:85127279730
SN - 0006-8950
VL - 145
SP - 83
EP - 91
JO - Brain
JF - Brain
IS - 1
ER -