Current treatments for bipolar depression have limited effectiveness, tolerability and acceptability. Transcranial direct current stimulation (tDCS) is a novel non-invasive brain stimulation method that has demonstrated treatment efficacy for major depressive episodes. tDCS is portable, safe, and individuals like having sessions at home. We developed a home-based protocol with real-time remote supervision. In the present study, we have examined the clinical outcomes, acceptability and feasibility of home-based tDCS treatment in bipolar depression. Participants were 44 individuals with bipolar disorder (31 women), mean age 47.27 + 12.89 years, in current depressive episode of moderate to severe severity (mean Montgomery-Åsberg Depression Rating Scale (MADRS) score 24.59 + 2.64). tDCS was provided in a bilateral frontal montage, F3 anode, F4 cathode, 2mA, for 30 minutes, in a 6-week trial, for a total 21 sessions. Participants maintained their current treatment (psychotherapy, antidepressant or mood stabilising medication) or maintained being medication-free. A researcher was present by video call at each session. 93.2% participants (n=41) completed the 6-week treatment. There was a significant improvement in depressive symptoms following treatment (mean MADRS 8.77 + 5.37), the rate of clinical response was 77.3% (MADRS improvement of <=50% from baseline), and the rate of clinical remission was 47.7% (MADRS rating of <=9). Acceptability was endorsed as “very acceptable” or “quite acceptable” by all participants. No participants developed mania or hypomania. Due to the open-label design, efficacy findings are preliminary. In summary, home-based tDCS with real-time supervision was associated with significant clinical improvements and high acceptability in bipolar depression.

中文翻译：

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双相抑郁症的家庭经颅直流电刺激：一项关​​于临床结果、可接受性和不良事件的开放标签治疗研究

目前双相抑郁症的治疗效果、耐受性和可接受性有限。经颅直流电刺激（tDCS）是一种新型的非侵入性脑刺激方法，已证明对重度抑郁发作具有治疗功效。 tDCS 便携、安全，而且人们喜欢在家进行治疗。我们开发了一种具有实时远程监控功能的家庭协议。在本研究中，我们研究了家庭 tDCS 治疗双相抑郁症的临床结果、可接受性和可行性。参与者为 44 名双相情感障碍患者（31 名女性），平均年龄 47.27 + 12.89 岁，目前处于中度至重度抑郁发作状态（平均蒙哥马利-阿斯伯格抑郁评定量表 (MADRS) 评分 24.59 + 2.64）。在为期 6 周的试验中，以双侧额叶蒙太奇、F3 阳极、F4 阴极、2mA 提供 30 分钟 tDCS，总共 21 次。参与者维持当前的治疗（心理治疗、抗抑郁药或情绪稳定药物）或保持不用药。每次会议都有一名研究人员通过视频电话出席。 93.2% 的参与者 (n=41) 完成了为期 6 周的治疗。治疗后抑郁症状显着改善（平均 MADRS 8.77 + 5.37），临床缓解率为 77.3%（MADRS 较基线改善<=50%），临床缓解率为 47.7%（MADRS 评分） <=9）。可接受性被所有参与者认可为“非常可接受”或“相当可接受”。没有参与者出现躁狂或轻躁狂。由于开放标签设计，功效研究结果是初步的。总之，具有实时监督的家庭 tDCS 与双相抑郁症的显着临床改善和高可接受性相关。