Transcranial Brain Stimulation Techniques For Major Depression: Should We Extend TMS Lessons to tDCS?



Bernardo Dell’Osso*, A. Carlo Altamura
University of Milan, Milano (I), Dept of Neurosciences, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Via F. Sforza 28, 20122, Milano (I), Italy


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© Dell’Osso and Altamura; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the University of Milan, Milano (I), Dept of Neurosciences, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Via F. Sforza 28, 20122, Milano (I), Italy; Tel: 0039-02- 55035994; Fax: 0039-02- 50325994; E-mail: bernardo.dellosso@unimi.it


Abstract

Transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) are non-invasive brain stimulation techniques that, by means of magnetic fields and low intensity electrical current, respectively, aim to interefere with and modulate cortical excitability, at the level of dorsolateral prefrontal cortex, in patients with major depression and poor response to standard antidepressants. While the clinical efficacy of TMS in major depression has been extensively investigated over the last 10 years, tDCS has attracted research interest only in the last years, with fewer randomized clinical trials (RCTs) in the field. Nevertheless, in spite of the different rationale and mechanism of action of the two techniques, tDCS recent acquisitions, in relation to the treatment of major depression, seem to parallel those previously obtained with TMS, in terms of treatment duration to achieve optimal benefit and patient's history of drug-resistance. After briefly introducing the two techniques, the article examines possible common pathways of clinical use for TMS and tDCS, emerging from recent RCTs and likely orienting future investigation with non invasive brain stimulation for the treatment of major depression.

Keywords: Brain stimulation, major depression, transcranial direct current stimulation (tDCS), transcranial magnetic stimulation (TMS)..