Abstract
Major depression (MD) is a debilitating condition associated with huge personal, social, and economic costs, as well as excessive mortality and disability. A large proportion of subjects doesn’t reach adequate clinical improvements with psychosocial and pharmacologic interventions and are exposed to side effects. In recent years, novel neuromodulation techniques such as rTMS and tDCS have become available with a literature on their usefulness rapidly expanding. As the field gradually mature, evidence is growing about their efficacy: rTMS have not only statistically but also clinically significant effect on remission and response rates with overall odds’ ratio > 2. More recent than rTMS, tDCS is now straddling the threshold for clinical significance. Nevertheless there remain crucial unanswered questions: improvement of efficacy thanks to optimized parameters and protocols; better indication accuracy based on response markers; better stratification and individual support with the use of patient-centered outcomes; assessment of the medium-to long-term efficacy and cost-utility. After a comprehensive overview of recent findings those questions will be deepened and developed through the following interventions: “tDCS in depression: where do we go from here?”by Dr Djamila Bennabi; “Biomarkers on tDCS trials for depression: insights from ELECT-tDCS” by Pr Andre Brunoni; “A novel two-step tDCS treatment regimen for major depressive disorder” by Pr Ulrich Palm; “rTMS in depression: achieving diffusion, starting personalization” by Dr Samuel Bulteau.
Published Version
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