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PsychotherapyPlus: augmentation of cognitive behavioral therapy (CBT) with prefrontal transcranial direct current stimulation (tDCS) in major depressive disorder—study design and methodology of a multicenter double-blind randomized placebo-controlled trial

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Title: PsychotherapyPlus: augmentation of cognitive behavioral therapy (CBT) with prefrontal transcranial direct current stimulation (tDCS) in major depressive disorder—study design and methodology of a multicenter double-blind randomized placebo-controlled trial
Authors: Bajbouj, Malek, Aust, Sabine, Spies, Jan, Herrera-Melendez, Ana-Lucia, Mayer, Sarah V., Peters, Maike, Plewnia, Christian, Fallgatter, Andreas J., Frase, Lukas, Normann, Claus, Behler, Nora, Wulf, Linda, Brakemeier, Eva-Lotta, Padberg, Frank
Source: European Archives of Psychiatry & Clinical Neuroscience. Dec2018, Vol. 268 Issue 8, p797-808. 12p. 1 Color Photograph, 1 Chart.
Subjects: Mental depression, Mental illness, Psychotherapy, Psychopharmacology, Prefrontal cortex, Transcranial direct current stimulation
Abstract: Major Depressive Disorder (MDD) is one of the most prevalent psychiatric disorders worldwide. About 20-30% of patients do not respond to the standard psychopharmacological and/or psychotherapeutic interventions. Mounting evidence from neuroimaging studies in MDD patients reveal altered activation patterns in lateral prefrontal brain areas. Successful cognitive behavioral therapy (CBT) is associated with a recovery of these neural alterations. Moreover, it has been demonstrated that transcranial direct current stimulation (tDCS) is capable of influencing prefrontal cortex activity and cognitive functions such as working memory and emotion regulation. Thus, a clinical trial investigating the effects of an antidepressant intervention combining CBT with tDCS seems promising. The present study investigates the antidepressant efficacy of a combined CBT-tDCS intervention as compared to CBT with sham-tDCS or CBT alone. A total of 192 patients (age range 20-65 years) with MDD (Hamilton Depression Rating Scale Score ≥ 15, 21-item version) will be recruited at four study sites across Germany (Berlin, Munich, Tuebingen, and Freiburg) and randomly assigned to one of the following three treatment arms: (1) CBT + active tDCS; (2) CBT + sham-tDCS; and (3) CBT alone. All participants will attend a 6-week psychotherapeutic intervention comprising 12 sessions of CBT each lasting 100 min in a closed group setting. tDCS will be applied simultaneously with CBT. Active tDCS includes stimulation with an intensity of 2 mA for 30 min with the anode placed over F3 and the cathode over F4 according to the EEG 10-20 system, if assigned. The primary outcome measure is the change in Montgomery-Åsberg Depression Rating Scale scores from baseline to 6, 18, and 30 weeks after the first session. Participants also undergo pre- and post-treatment neuropsychological testing and functional magnetic resonance imaging (fMRI) to assess changes in prefrontal functioning and connectivity. The study investigates whether CBT can be augmented by non-invasive brain stimulation techniques such as tDCS in the treatment of MDD. It is designed as a proof-of-principle trial for the combined tDCS-CBT treatment, but also allows the investigation of the neurobiological underpinnings of the interaction between both interventions in MDD.Trial registration ClinicalTrials.gov Identifier NCT02633449. [ABSTRACT FROM AUTHOR]
Copyright of European Archives of Psychiatry & Clinical Neuroscience is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: PsychotherapyPlus: augmentation of cognitive behavioral therapy (CBT) with prefrontal transcranial direct current stimulation (tDCS) in major depressive disorder—study design and methodology of a multicenter double-blind randomized placebo-controlled trial
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  Data: <searchLink fieldCode="AR" term="%22Bajbouj%2C+Malek%22">Bajbouj, Malek</searchLink><br /><searchLink fieldCode="AR" term="%22Aust%2C+Sabine%22">Aust, Sabine</searchLink><br /><searchLink fieldCode="AR" term="%22Spies%2C+Jan%22">Spies, Jan</searchLink><br /><searchLink fieldCode="AR" term="%22Herrera-Melendez%2C+Ana-Lucia%22">Herrera-Melendez, Ana-Lucia</searchLink><br /><searchLink fieldCode="AR" term="%22Mayer%2C+Sarah+V%2E%22">Mayer, Sarah V.</searchLink><br /><searchLink fieldCode="AR" term="%22Peters%2C+Maike%22">Peters, Maike</searchLink><br /><searchLink fieldCode="AR" term="%22Plewnia%2C+Christian%22">Plewnia, Christian</searchLink><br /><searchLink fieldCode="AR" term="%22Fallgatter%2C+Andreas+J%2E%22">Fallgatter, Andreas J.</searchLink><br /><searchLink fieldCode="AR" term="%22Frase%2C+Lukas%22">Frase, Lukas</searchLink><br /><searchLink fieldCode="AR" term="%22Normann%2C+Claus%22">Normann, Claus</searchLink><br /><searchLink fieldCode="AR" term="%22Behler%2C+Nora%22">Behler, Nora</searchLink><br /><searchLink fieldCode="AR" term="%22Wulf%2C+Linda%22">Wulf, Linda</searchLink><br /><searchLink fieldCode="AR" term="%22Brakemeier%2C+Eva-Lotta%22">Brakemeier, Eva-Lotta</searchLink><br /><searchLink fieldCode="AR" term="%22Padberg%2C+Frank%22">Padberg, Frank</searchLink>
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  Data: <searchLink fieldCode="JN" term="%22European+Archives+of+Psychiatry+%26+Clinical+Neuroscience%22">European Archives of Psychiatry & Clinical Neuroscience</searchLink>. Dec2018, Vol. 268 Issue 8, p797-808. 12p. 1 Color Photograph, 1 Chart.
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  Data: <searchLink fieldCode="DE" term="%22Mental+depression%22">Mental depression</searchLink><br /><searchLink fieldCode="DE" term="%22Mental+illness%22">Mental illness</searchLink><br /><searchLink fieldCode="DE" term="%22Psychotherapy%22">Psychotherapy</searchLink><br /><searchLink fieldCode="DE" term="%22Psychopharmacology%22">Psychopharmacology</searchLink><br /><searchLink fieldCode="DE" term="%22Prefrontal+cortex%22">Prefrontal cortex</searchLink><br /><searchLink fieldCode="DE" term="%22Transcranial+direct+current+stimulation%22">Transcranial direct current stimulation</searchLink>
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  Data: Major Depressive Disorder (MDD) is one of the most prevalent psychiatric disorders worldwide. About 20-30% of patients do not respond to the standard psychopharmacological and/or psychotherapeutic interventions. Mounting evidence from neuroimaging studies in MDD patients reveal altered activation patterns in lateral prefrontal brain areas. Successful cognitive behavioral therapy (CBT) is associated with a recovery of these neural alterations. Moreover, it has been demonstrated that transcranial direct current stimulation (tDCS) is capable of influencing prefrontal cortex activity and cognitive functions such as working memory and emotion regulation. Thus, a clinical trial investigating the effects of an antidepressant intervention combining CBT with tDCS seems promising. The present study investigates the antidepressant efficacy of a combined CBT-tDCS intervention as compared to CBT with sham-tDCS or CBT alone. A total of 192 patients (age range 20-65 years) with MDD (Hamilton Depression Rating Scale Score ≥ 15, 21-item version) will be recruited at four study sites across Germany (Berlin, Munich, Tuebingen, and Freiburg) and randomly assigned to one of the following three treatment arms: (1) CBT + active tDCS; (2) CBT + sham-tDCS; and (3) CBT alone. All participants will attend a 6-week psychotherapeutic intervention comprising 12 sessions of CBT each lasting 100 min in a closed group setting. tDCS will be applied simultaneously with CBT. Active tDCS includes stimulation with an intensity of 2 mA for 30 min with the anode placed over F3 and the cathode over F4 according to the EEG 10-20 system, if assigned. The primary outcome measure is the change in Montgomery-Åsberg Depression Rating Scale scores from baseline to 6, 18, and 30 weeks after the first session. Participants also undergo pre- and post-treatment neuropsychological testing and functional magnetic resonance imaging (fMRI) to assess changes in prefrontal functioning and connectivity. The study investigates whether CBT can be augmented by non-invasive brain stimulation techniques such as tDCS in the treatment of MDD. It is designed as a proof-of-principle trial for the combined tDCS-CBT treatment, but also allows the investigation of the neurobiological underpinnings of the interaction between both interventions in MDD.Trial registration ClinicalTrials.gov Identifier NCT02633449. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of European Archives of Psychiatry & Clinical Neuroscience is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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