P017 Transcranial direct current stimulation (tDCS) for the treatment of depression during pregnancy: A pilot study

Abstract

Question tDCS has shown favorable results as an add-on to pharmacologic treatment for depressive disorders ( Brunoni et al., 2016 ). The technique is deemed safe when correctly applied ( Palm et al., 2016 ). Due to the lack of systemic reactions, it has been proposed for treatment of depression during pregnancy and pilot studies have been initiated in Canada ( Vigod et al., 2014 ) and at the Ludwig-Maximilian University of Munich. Here we report the first and preliminary results in three patients of this open-label pilot study. Methods Ten drug-free female patients (18–45 years) with major depressive disorder during pregnancy (later than 10th gestational week) will be included in this pilot study. Patients will be treated with twice-daily tDCS (2 mA, 30 min, anode: F3, cathode: F4) over ten days during inpatient stay and with once-daily tDCS over 10 days during an optional outpatient stay. Clinical (HAMD-21, BDI) and neuropsychological ratings (Trail Making Test A/B) are performed at baseline, after two and four weeks as well as an obstetric examination. Results Three right-handed females (23, 28, and 32 years, 19.-31. gestational week) were treated so far, two of them completed in- and outpatient phases. tDCSwas well tolerated and no adverse effects occurred. Clinical ratings: Mean baseline HAMD-21 was 24.7 ± 10.6 and sank to 15.7 ± 3.7 in week2 (p = 0.17; paired t-test, 2-tailed), and to 7.0 ± 7.1 in week 4 (p = 0.41). Mean baseline BDI was 35.3 ± 12.5 and declined to 12.0 ± 1.73 in week 2 (p = 0.10), and to 11.0 ± 2.8 in week 4 (p = 0.34). Neuropsychological ratings: Mean baseline TMT-A was 25.0 ± 6.4 and changed to 23.3 ± 9.7 in week 2 (p = 1.00), and to 18.5 ± 4.9 in week 4 (p = 0.20). Mean baseline TMT-B was 81.0 ± 56.9 and sank to 69.3 ± 42.4 in week 2 (p = 0.38), and to 40.5 ± 12.0 in week 4 (p = 0.53). Conclusions No statistically significant changes could be observed yet. One patient achieved remission.