Abstract
Transcranial direct current stimulation (tDCS) is a form of neurostimulation that has recently regained popularity in its experimental use. tDCS utilizes a direct current applied to the scalp via electrodes to induce long-term changes to cortical excitability. A series of recent studies and reviews concluded its efficacy as a potential treatment for major depressive disorder. However, further research is required to establish effective montages and intensities of treatment to promote efficacy while reducing adverse effects. These potential future studies should include wider representative samples with more detailed reporting of adverse effects. Until then, this perspective piece argues that tDCS should continue to be considered as a potential addition to the therapies used to manage depression.
Highlights
Depression is an illness affecting at least 9% of the British adult population.[1]
In current investigations into the use of Transcranial direct current stimulation (tDCS) towards in depression, the anode is placed over the left dorsolateral prefrontal cortex (DLPFC) and the cathode is placed over lateral aspect of the contralateral orbit.[9]
There are already other forms of brain stimulation used in the treatment of severe depression, so what are the advantages of tDCS over others? In comparison to alternative forms of brain stimulation, tDCS is more cost effective,[6] easier to use, less invasive,[7] and has potentially fewer side effects.[7]
Summary
Depression is an illness affecting at least 9% of the British adult population.[1]. It led to the loss of 10.4 million working days in 2012/3.2 Currently, the standard treatment regimen involves the use of both selective serotonin reuptake inhibitor (SSRI) antidepressant drugs[3] and psychotherapy.[4]. The first recorded application of a direct current to the brain for therapeutic purposes can be found in the experiments of Mesmer and Aldini.[5] Interest was reawakened in the 1960s when it was shown that tDCS may affect neuroexcitability and improve cognitive performance, but this discovery was overlooked due to the development of effective psychopharmacy.[7] long-term treatment with psychopharmaceuticals is often associated with undesirable side effects and treatment resistance. As to the mechanisms behind tDCS, the anode is thought to produce increased neuronal excitability at the targeted site while the cathode is thought to decrease it. These excitability changes do not lead to the production of an action potential directly but alter the probability of a neuron firing.[8]. This article briefly attempts to justify its inclusion in future treatment guidelines
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