Abstract
ObjectiveBipolar Disorder (BD) is one of the most common mental disorders associated with depressive symptoms and impairment in executive functions such as response inhibition. This study aimed to investigate the effectiveness of medication therapy combined with Transcranial Direct Current Stimulation (tDCS) on depression and response inhibition of patients with BD.MethodThis is a double-blinded randomized clinical trial with pretest, posttest, and follow-up design. Participants were 30 patients with BD randomly assigned to two groups of Medication+tDCS (n = 15, receiving medications plus tDCS with 2 mA intensity over dorsolateral prefrontal cortex for 10 days, two sessions per day each for 20 min) and Medication (n = 15, receiving mood stabilizers including 2–5 tables of 300 mg (mg) lithium, 200 mg sodium valproate, and 200 mg carbamazepine two times per day). Pretest, posttest and 3-month follow-up assessments were the 21-item Hamilton Depression Rating Scale (HDRS) and a Go/No-Go test. Collected data were analyzed in SPSS v.20 software.ResultsThe mean HDRS score in both groups was reduced after both interventional techniques, where the group received combined therapy showed more reduction (P < 0.01), although their effects were not maintained after 3 months. In examining response inhibition variable, only the combined therapy could reduce the commission error of patients under a go/no-go task (p < 0.05), but its effect was not maintained after 3 months. There was no significant difference in the group received medication therapy alone.ConclusionMedication in combination with tDCS can reduce the depressive symptoms and improve the response inhibition ability of people with BD.Trial registrationThis study was registred by Iranian Registry of Clinical Trials (Parallel, ID: IRCT20191229045931N1, Registration date: 24/08/2020).
Highlights
Bipolar Disorder (BD) is a common psychological disorder that affects about 1–5% of the total population [1]
The mean Hamilton Depression Rating Scale (HDRS) score in both groups was reduced after both interventional techniques, where the group received combined therapy showed more reduction (P < 0.01), their effects were not maintained after 3 months
There was no significant difference in the group received medication therapy alone
Summary
Bipolar Disorder (BD) is a common psychological disorder that affects about 1–5% of the total population [1]. It is associated with significant impairment in work, family, and social life [2]. According to the Diagnostic and Statistical Manual of Mental Disorders-Fifth edition (DSM-5) [5], bipolar I disorder involves episodes of severe mania and often depression. Depressive episodes in bipolar disorder are similar to regular clinical depression, with depressed mood, loss of pleasure, low energy and activity, feelings of guilt or worthlessness, and thoughts of suicide. One of the most important cognitive processes that can be impaired in BD patients is response inhibition or inhibitory control [13]. It is the ability to inhibit or control impulsive (or automatic) responses, and create responses by using attention and reasoning
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