1. Transcranial direct current stimulation for the acute major depressive episode: a meta-analysis of individual patient data.
André R. Brunoni, MD, PhD ; Adriano Moffa, BS ; Felipe Fregni, MD, PhD ; Ulrich Palm MD ; Frank Padberg MD, PhD ; Daniel M. Blumberger, MD ; Zafiris J Daskalakis,
MD ; Djamila Bennabi, MD ; Emmanuel Haffen, MD; Angelo Alonzo, PhD ; Colleen K Loo, MD
Instituto de Psicologia, University of São Paulo, São Paulo, Brasil.
Hospital Universitario, University of São Paulo, São Paulo, Brasil.
To assess tDCS efficacy and to explore individual predictors of response
Objectives
Methods
Systematic review and individual patient data meta-analysis
Table 1: PEDro scale (internal validity)
Table 2: Cochrane checklist (risk of bias)
Figure1: Flow Chart
 Data were fetched from six randomized sham-controlled trials, enrolling 289 patients. Active tDCS was significantly superior to sham for response (34% vs. 19%, respectively; OR=2.44, 95%CI= , NNT=7), remission (23.1% vs. 12.7%, respectively; OR=2.38, 95%CI= , NNT=9) and depression improvement (B coefficient=0.35, 95%CI= 0.12–0.57). After adjustment for other predictors and confounders, treatment-resistant depression and higher tDCS “doses” were respectively negatively and positively associated with tDCS efficacy.
Results
The effect size of tDCS treatment was comparable to those reported for repetitive Transcranial Magnetic Stimulation (rTMS) and antidepressant drug treatment in primary care. The most important parameters for optimization in future trials are depression refractoriness and tDCS dose.
Conclusions
Figure 2. Individual patient data meta-analysis comparing active vs. sham transcranial direct current stimulation in terms of Response; Remission and Depression improvement.
Funded by the sponsoring agency
Grant number 2012/