Abstract
Adolescent depression is a prevalent disorder with substantial morbidity and mortality. Current treatment interventions do not target relevant pathophysiology and are frequently ineffective, thereby leading to a substantial burden for individuals, families, and society. During adolescence, the prefrontal cortex undergoes extensive structural and functional changes. Recent work suggests that frontolimbic development in depressed adolescents is delayed or aberrant. The judicious application of non-invasive brain stimulation techniques to the prefrontal cortex may present a promising opportunity for durable interventions in adolescent depression. Transcranial direct current stimulation (tDCS) applies a low-intensity, continuous current that alters cortical excitability. While this modality does not elicit action potentials, it is thought to manipulate neuronal activity and neuroplasticity. Specifically, tDCS may modulate N-methyl-d-aspartate receptors and L-type voltage-gated calcium channels and effect changes through long-term potentiation or long-term depression-like mechanisms. This mini-review considers the neurobiological rationale for developing tDCS protocols in adolescent depression, reviews existing work in adult mood disorders, surveys the existing tDCS literature in adolescent populations, reviews safety studies, and discusses distinct ethical considerations in work with adolescents.
Highlights
Transcranial direct current stimulation is a form of non-invasive brain stimulation (NIBS) that has demonstrated efficacy in treating depression [1]
Davis argues that several questions remain unanswered regarding Transcranial direct current stimulation (tDCS) in pediatric patients, including the potential unknown effects of stimulation, differential side effects in children, limited evidence to guide dosing parameters, and a dearth of translational studies focused on children and adolescents [77]
Existing therapies are inadequate to meet the needs of adolescents with depression. tDCS may offer hope, as available evidence suggests it is safe, tolerable, and acceptable
Summary
Transcranial direct current stimulation (tDCS) is a form of non-invasive brain stimulation (NIBS) that has demonstrated efficacy in treating depression [1]. In the first study [56], participants underwent five sessions of anodal tDCS (1 mA, 20 min) to the left DLPFC or sham stimulation over one week, followed by a 4-week washout period, and five sessions of the opposite condition. Fourteen participants aged 5–12 years with learning disorders and a variety of comorbidities [which included pervasive developmental disorders/ASD, attention-deficit/hyperactivity disorder (ADHD), and intellectual disability] underwent ten 30-min sessions over two weeks of open-label anodal tDCS (2 mA) applied to Broca’s area during social and speech-related activities.
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