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

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.