Universität zu Köln

Goerigk, Stephan A., Padberg, Frank, Chekroud, Adam ORCID: 0000-0002-0497-596X, Kambeitz, Joseph ORCID: 0000-0002-8988-3959, Buehner, Markus and Brunoni, Andre R. (2021). Parsing the antidepressant effects of non-invasive brain stimulation and pharmacotherapy: A symptom clustering approach on ELECT-TDCS. Brain Stimul., 14 (4). S. 906 - 913. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1876-4754

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Abstract

Background: Transcranial direct current stimulation (tDCS) presents small antidepressant efficacy at group level and considerable inter-individual variability of response. Its heterogeneous effects bring the need to investigate whether specific groups of patients submitted to tDCS could present comparable or larger improvement compared to pharmacotherapy. Aggregate measurements might be insufficient to address its effects. Objective: /Hypothesis: To determine the efficacy of tDCS, compared to pharmacotherapy and placebo, in depressive symptom clusters. Methods: Data from ELECT-TDCS (Escitalopram versus Electrical Direct-Current Therapy for Treating Depression Clinical Study, ClinicalTrials.gov, NCT01894815), in which antidepressant-free, depressed patients were randomized to receive 22 bifrontal tDCS (2 mA, 30 min) sessions (n = 94), escitalopram 20 mg/day (n = 91), or placebo (n = 60) over 10 weeks. Agglomerative hierarchical clustering identified sleep/insomnia, core depressive, guilt/anxiety, and atypical clusters that were the dependent measure. Trajectories were estimated using linear mixed regression models. Effect sizes are expressed in raw HAM-D units. P-values were adjusted for multiple comparisons. Results: For core depressive symptoms, escitalopram was superior to tDCS (ES =-0.56; CI95% =-0.94 to-0.17, p = .009), which was superior to placebo (ES = 0.49; CI95% = 0.06 to 0.92, p = .042). TDCS but not escitalopram was superior to placebo in sleep/insomnia symptoms (ES = 0.87; CI95% = 0.22 to 1.52,p = .015). Escitalopram but not tDCS was superior to placebo in guilt/anxiety symptoms (ES = 1.66; CI95% = 0.58 to 2.75, p = .006). No active intervention was superior to placebo for atypical symptoms. Conclusions: Pharmacotherapy and non-invasive brain stimulation produce distinct effects in depressive symptoms. TDCS or escitalopram could be chosen according to specific clusters of symptoms for a bigger response. (C) 2021 The Authors. Published by Elsevier Inc.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Goerigk, Stephan A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Padberg, Frank UNSPECIFIED UNSPECIFIED UNSPECIFIED Chekroud, Adam UNSPECIFIED orcid.org/0000-0002-0497-596X UNSPECIFIED Kambeitz, Joseph UNSPECIFIED orcid.org/0000-0002-8988-3959 UNSPECIFIED Buehner, Markus UNSPECIFIED UNSPECIFIED UNSPECIFIED Brunoni, Andre R. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-592215
DOI:	10.1016/j.brs.2021.05.008
Journal or Publication Title:	Brain Stimul.
Volume:	14
Number:	4
Page Range:	S. 906 - 913
Date:	2021
Publisher:	ELSEVIER SCIENCE INC
Place of Publication:	NEW YORK
ISSN:	1876-4754
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CURRENT THERAPY; SLEEP QUALITY; DEPRESSION; ESCITALOPRAM; EFFICACY Multiple languages Clinical Neurology; Neurosciences Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/59221