Application of transcranial Direct Current Stimulation (tDCS) in the treatment of cognitive disorders in depressive disorder and bipolar disorder

Authors

  • Andrea Barbaro Dipartimento di Psicologia, Università degli Studi della Campania “Luigi Vanvitelli”, Caserta; Corresponding author: andrea.barbaro@unicampania.it
  • Chiara Giacobbe Dipartimento di Psicologia, Università degli Studi della Campania “Luigi Vanvitelli”, Caserta
  • Gabriella Santangelo Dipartimento di Psicologia, Università degli Studi della Campania “Luigi Vanvitelli”, Caserta

Keywords:

Major Depressive Disorder, Bipolar Disorder, transcranial Direct Current Stimulation, tDCS, Cognition, Non-pharmacological treatment

Abstract

Cognitive decline is a condition that significantly affects the daily functioning and quality of life of patients with Major Depressive Disorder (MDD) and patients with Bipolar Disorder (BD). For this reason, the identification of an effective treatment in the recovery of cognitive functions in these psychiatric conditions is very important. Transcranial Direct Current Stimulation (tDCS) is a non-pharmacological treatment consisting in the administration of a low-intensity direct current through electrodes in order to induce a modulation of cortical excitability and, therefore, could provide a possible solution to this need. Numerous studies have reported about the efficacy of the application of tDCS in the recovery of cognitive abilities in neurological and psychiatric patients. Research based on the use of this tool in the enhancement of cognitive functions in subjects with MDD and BD has shown encouraging, but still inconclusive results. The present study is a literature review conducted with the aim of exploring in a thoroughly the effectiveness of tDCS treatment in reducing the severity of cognitive impairments in patients with MDD and BD. The results showed that tDCS, in combination or not with cognitive training and/or appropriate pharmacological treatment, is effective in improving certain cognitive domains in these patients.

 

doi: 10.53240/2024topic2.033.002

References

Alonso, J., Angermeyer, M. C., Bernert, S., Bruffaerts, R., Brugha, T. S., Bryson, H., de Girolamo, G., Graaf, R., Demyttenaere, K., Gasquet, I., Haro, J. M., Katz, S. J., Kessler, R. C., Kovess, V., Lépine, J. P., Ormel, J., Polidori, G., Russo, L. J., Vilagut, G., Almansa, J., S., Arbabzadeh-Bouchez, J., Autonell, M., Bernal, M., A., Buist-Bouwman, M., Codony, A., Domingo-Salvany, M., Ferrer, S. S., Joo, M., Martínez-Alonso, H., Matschinger, F., Mazzi, Z., Morgan, P., Morosini, C., Palacín, B., Romera, N., Taub, W. A. M., Vollebergh; ESEMeD/MHEDEA 2000 Investigators, European Study of the Epidemiology of Mental Disorders (ESEMeD) Project (2004). Disability and quality of life impact of mental disorders in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project. Acta psychiatrica Scandinavica. Supplementum, (420), 38–46. https://doi.org/10.1111/j.1600-0047.2004.00329.x

Baune, B. T., e Malhi, G. S. (2015). A review on the impact of cognitive dysfunction on social, occupational, and general functional outcomes in bipolar disorder. Bipolar disorders, 17 Suppl 2, 41–55. https://doi.org/10.1111/bdi.12341

Bersani, F. S., Minichino, A., Bernabei, L., Spagnoli, F., Corrado, A., Vergnani, L., Mannarelli, D., Pauletti, C., Fattapposta, F., Biondi, M., e Delle Chiaie, R. (2017). Prefronto-cerebellar tDCS enhances neurocognition in euthymic bipolar patients. Findings from a placebo-controlled neuropsychological and psychophysiological investigation. Journal of affective disorders, 209, 262–269. https://doi.org/10.1016/j.jad.2016.11.037

Bindman, L. J., Lippold, O. C., e Redfearn, J. W. (1964). The action of brief polarizing currents on the cerebral cortex of the rat (1) during current flow and (2) in the production of long-lasting after-effects. The Journal of physiology, 172(3), 369–382. https://doi.org/10.1113/jphysiol.1964.sp007425

Boggio, P. S., Bermpohl, F., Vergara, A. O., Muniz, A. L., Nahas, F. H., Leme, P. B., Rigonatti, S. P., e Fregni, F. (2007). Go-no-go task performance improvement after anodal transcranial DC stimulation of the left dorsolateral prefrontal cortex in major depression. Journal of affective disorders, 101(1-3), 91–98. https://doi.org/10.1016/j.jad.2006.10.026

Bora, E., e Pantelis, C. (2015). Meta-analysis of Cognitive Impairment in First-Episode Bipolar Disorder: Comparison With First-Episode Schizophrenia and Healthy Controls. Schizophrenia bulletin, 41(5), 1095–1104. https://doi.org/10.1093/schbul/sbu198

Bora, E., Yucel, M., e Pantelis, C. (2009). Cognitive endophenotypes of bipolar disorder: a meta-analysis of neuropsychological deficits in euthymic patients and their first-degree relatives. Journal of affective disorders, 113(1-2), 1–20. https://doi.org/10.1016/j.jad.2008.06.009

Brunoni, A. R., Moffa, A. H., Sampaio-Junior, B., Borrione, L., Moreno, M. L., Fernandes, R. A., Veronezi, B. P., Nogueira, B. S., Aparicio, L. V. M., Razza, L. B., Chamorro, R., Tort, L. C., Fraguas, R., Lotufo, P. A., Gattaz, W. F., Fregni, F., Benseñor, I. M., e ELECT-TDCS Investigators (2017). Trial of Electrical Direct-Current Therapy versus Escitalopram for Depression. The New England journal of medicine, 376(26), 2523–2533. https://doi.org/10.1056/NEJMoa1612999

Burton, C. Z., Garnett, E. O., Capellari, E., Chang, S. E., Tso, I. F., Hampstead, B. M., e Taylor, S. F. (2023). Combined Cognitive Training and Transcranial Direct Current Stimulation in Neuropsychiatric Disorders: A Systematic Review and Meta-analysis. Biological psychiatry. Cognitive neuroscience and neuroimaging, 8(2), 151–161. https://doi.org/10.1016/j.bpsc.2022.09.014

Ciullo, V., Spalletta, G., Caltagirone, C., Banaj, N., Vecchio, D., Piras, F., e Piras, F. (2021). Transcranial Direct Current Stimulation and Cognition in Neuropsychiatric Disorders: Systematic Review of the Evidence and Future Directions. The Neuroscientist: a review journal bringing neurobiology, neurology and psychiatry, 27(3), 285–309. https://doi.org/10.1177/1073858420936167

Daglas, R., Yücel, M., Cotton, S., Allott, K., Hetrick, S., e Berk, M. (2015). Cognitive impairment in first-episode mania: a systematic review of the evidence in the acute and remission phases of the illness. International journal of bipolar disorders, 3, 9. https://doi.org/10.1186/s40345-015-0024-2

Dondé, C., Neufeld, N. H., e Geoffroy, P. A. (2018). The Impact of Transcranial Direct Current Stimulation (tDCS) on Bipolar Depression, Mania, and Euthymia: a Systematic Review of Preliminary Data. The Psychiatric quarterly, 89(4), 855–867. https://doi.org/10.1007/s11126-018-9584-5

D'Urso, G., Toscano, E., Barone, A., Palermo, M., Dell'Osso, B., Di Lorenzo, G., Mantovani, A., Martinotti, G., Fornaro, M., Iasevoli, F., e de Bartolomeis, A. (2023). Transcranial direct current stimulation for bipolar depression: systematic reviews of clinical evidence and biological underpinnings. Progress in neuro-psychopharmacology e biological psychiatry, 121, 110672. https://doi.org/10.1016/j.pnpbp.2022.110672

Dymond, A. M., Coger, R. W., e Serafetinides, E. A. (1975). Intracerebral current levels in man during electrosleep therapy. Biological psychiatry, 10(1), 101–104.

Figeys, M., Zeeman, M., e Kim, E. S. (2021). Effects of Transcranial Direct Current Stimulation (tDCS) on Cognitive Performance and Cerebral Oxygen Hemodynamics: A Systematic Review. Frontiers in human neuroscience, 15, 623315. https://doi.org/10.3389/fnhum.2021.623315

Filmer, H. L., Dux, P. E., e Mattingley, J. B. (2014). Applications of transcranial direct current stimulation for understanding brain function. Trends in neurosciences, 37(12), 742–753. https://doi.org/10.1016/j.tins.2014.08.003

Fregni, F., Boggio, P. S., Nitsche, M. A., Rigonatti, S. P., e Pascual-Leone, A. (2006). Cognitive effects of repeated sessions of transcranial direct current stimulation in patients with depression. Depression and anxiety, 23(8), 482–484. https://doi.org/10.1002/da.20201

Grimm, S., Beck, J., Schuepbach, D., Hell, D., Boesiger, P., Bermpohl, F., Niehaus, L., Boeker, H., e Northoff, G. (2008). Imbalance between left and right dorsolateral prefrontal cortex in major depression is linked to negative emotional judgment: an fMRI study in severe major depressive disorder. Biological psychiatry, 63(4), 369–376. https://doi.org/10.1016/j.biopsych.2007.05.033

Hasselbalch, B. J., Knorr, U., e Kessing, L. V. (2011). Cognitive impairment in the remitted state of unipolar depressive disorder: a systematic review. Journal of affective disorders, 134(1-3), 20–31. https://doi.org/10.1016/j.jad.2010.11.011

Lefaucheur, J. P., Antal, A., Ayache, S. S., Benninger, D. H., Brunelin, J., Cogiamanian, F., Cotelli, M., De Ridder, D., Ferrucci, R., Langguth, B., Marangolo, P., Mylius, V., Nitsche, M. A., Padberg, F., Palm, U., Poulet, E., Priori, A., Rossi, S., Schecklmann, M., Vanneste, S., Ziemann, U., Garcia-Larrea, L., e Paulus, W. (2017). Evidence-based guidelines on the therapeutic use of transcranial direct current stimulation (tDCS). Clinical neurophysiology: official journal of the International Federation of Clinical Neurophysiology, 128(1), 56–92. https://doi.org/10.1016/j.clinph.2016.10.087

Lima, I. M. M., Peckham, A. D., e Johnson, S. L. (2018). Cognitive deficits in bipolar disorders: Implications for emotion. Clinical psychology review, 59, 126–136. https://doi.org/10.1016/j.cpr.2017.11.006

Lin, Y. Y., Chang, C. C., Huang, C. C., Tzeng, N. S., Kao, Y. C., e Chang, H. A. (2021). Efficacy and neurophysiological predictors of treatment response of adjunct bifrontal transcranial direct current stimulation (tDCS) in treating unipolar and bipolar depression. Journal of affective disorders, 280(Pt A), 295–304. https://doi.org/10.1016/j.jad.2020.11.030

Lolas F. (1977). Brain polarization: behavioral and therapeutic effects. Biological psychiatry, 12(1), 37–47.

Long, Z., Duan, X., Wang, Y., Liu, F., Zeng, L., Zhao, J. P., e Chen, H. (2015). Disrupted structural connectivity network in treatment-naive depression. Progress in neuro-psychopharmacology e biological psychiatry, 56, 18–26. https://doi.org/10.1016/j.pnpbp.2014.07.007

Loo, C. K., Alonzo, A., Martin, D., Mitchell, P. B., Galvez, V., e Sachdev, P. (2012). Transcranial direct current stimulation for depression: 3-week, randomised, sham-controlled trial. The British journal of psychiatry: the journal of mental science, 200(1), 52–59. https://doi.org/10.1192/bjp.bp.111.097634

Mardani, P., Javdani, H., Zolghadriha, A., Mousavi, S. E., e Dadashi, M. (2023). A Randomized Clinical Trial to Assess the Effect of Medication Therapy Plus tDCS on Problem-solving and Emotion Regulation of Patients with Bipolar Disorder Type I. Clinical psychopharmacology and neuroscience: the official scientific journal of the Korean College of Neuropsychopharmacology, 21(3), 466–477. https://doi.org/10.9758/cpn.22.988

Martin, D. M., Chan, H. N., Alonzo, A., Green, M. J., Mitchell, P. B., e Loo, C. K. (2015). Transcranial direct current stimulation to enhance cognition in euthymic bipolar disorder. Bipolar disorders, 17(8), 849–858. https://doi.org/10.1111/bdi.12350

McClintock, S. M., Martin, D. M., Lisanby, S. H., Alonzo, A., McDonald, W. M., Aaronson, S. T., Husain, M. M., O'Reardon, J. P., Weickert, C. S., Mohan, A., e Loo, C. K. (2020). Neurocognitive effects of transcranial direct current stimulation (tDCS) in unipolar and bipolar depression: Findings from an international randomized controlled trial. Depression and anxiety, 37(3), 261–272. https://doi.org/10.1002/da.22988

Millan, M. J., Agid, Y., Brüne, M., Bullmore, E. T., Carter, C. S., Clayton, N. S., Connor, R., Davis, S., Deakin, B., DeRubeis, R. J., Dubois, B., Geyer, M. A., Goodwin, G. M., Gorwood, P., Jay, T. M., Joëls, M., Mansuy, I. M., Meyer-Lindenberg, A., Murphy, D., Rolls, E., Saletu, B., Spedding, M., Sweeney, J., Whittington, M., e Young, L. J. (2012). Cognitive dysfunction in psychiatric disorders: characteristics, causes and the quest for improved therapy. Nature reviews. Drug discovery, 11(2), 141–168. https://doi.org/10.1038/nrd3628

Minichino, A., Bersani, F. S., Bernabei, L., Spagnoli, F., Vergnani, L., Corrado, A., Taddei, I., Biondi, M., e Delle Chiaie, R. (2015). Prefronto-cerebellar transcranial direct current stimulation improves visuospatial memory, executive functions, and neurological soft signs in patients with euthymic bipolar disorder. Neuropsychiatric disease and treatment, 11, 2265–2270. https://doi.org/10.2147/NDT.S79108

Mirabel-Sarron, C., e Giachetti, R. (2012). Non pharmacological treatment for bipolar disorder. L'Encephale, 38 Suppl 4, S160–S166. https://doi.org/10.1016/S0013-7006(12)70094-5

Moreno, M. L., Vanderhasselt, M. A., Carvalho, A. F., Moffa, A. H., Lotufo, P. A., Benseñor, I. M., e Brunoni, A. R. (2015). Effects of acute transcranial direct current stimulation in hot and cold working memory tasks in healthy and depressed subjects. Neuroscience letters, 591, 126–131. https://doi.org/10.1016/j.neulet.2015.02.036

Morey-Nase, C., Phillips, L. J., Bryce, S., Hetrick, S., Wright, A. L., Caruana, E., e Allott, K. (2019). Subjective experiences of neurocognitive functioning in young people with major depression. BMC psychiatry, 19(1), 209. https://doi.org/10.1186/s12888-019-2197-1

Nitsche, M. A., e Paulus, W. (2000). Excitability changes induced in the human motor cortex by weak transcranial direct current stimulation. The Journal of physiology, 527 Pt 3(Pt 3), 633–639. https://doi.org/10.1111/j.1469-7793.2000.t01-1-00633.x

Nitsche, M. A., e Paulus, W. (2001). Sustained excitability elevations induced by transcranial DC motor cortex stimulation in humans. Neurology, 57(10), 1899–1901. https://doi.org/10.1212/wnl.57.10.1899

Nitsche, M. A., Cohen, L. G., Wassermann, E. M., Priori, A., Lang, N., Antal, A., Paulus, W., Hummel, F., Boggio, P. S., Fregni, F., e Pascual-Leone, A. (2008). Transcranial direct current stimulation: State of the art 2008. Brain stimulation, 1(3), 206–223. https://doi.org/10.1016/j.brs.2008.06.004

Oliveira, J. F., Zanão, T. A., Valiengo, L., Lotufo, P. A., Benseñor, I. M., Fregni, F., e Brunoni, A. R. (2013). Acute working memory improvement after tDCS in antidepressant-free patients with major depressive disorder. Neuroscience letters, 537, 60–64. https://doi.org/10.1016/j.neulet.2013.01.023

Priori, A., Berardelli, A., Rona, S., Accornero, N., e Manfredi, M. (1998). Polarization of the human motor cortex through the scalp. Neuroreport, 9(10), 2257–2260. https://doi.org/10.1097/00001756-199807130-00020

Robinson, L. J., Thompson, J. M., Gallagher, P., Goswami, U., Young, A. H., Ferrier, I. N., e Moore, P. B. (2006). A meta-analysis of cognitive deficits in euthymic patients with bipolar disorder. Journal of affective disorders, 93(1-3), 105–115. https://doi.org/10.1016/j.jad.2006.02.016

Roiser, J. P., Elliott, R., e Sahakian, B. J. (2012). Cognitive mechanisms of treatment in depression. Neuropsychopharmacology: official publication of the American College of Neuropsychopharmacology, 37(1), 117–136. https://doi.org/10.1038/npp.2011.183

Ronold, E. H., Schmid, M. T., Oedegaard, K. J., e Hammar, Å. (2020). A Longitudinal 5-Year Follow-Up Study of Cognitive Function After First Episode Major Depressive Disorder: Exploring State, Scar and Trait Effects. Frontiers in psychiatry, 11, 575867. https://doi.org/10.3389/fpsyt.2020.575867

Rush, A. J., Zimmerman, M., Wisniewski, S. R., Fava, M., Hollon, S. D., Warden, D., Biggs, M. M., Shores-Wilson, K., Shelton, R. C., Luther, J. F., Thomas, B., e Trivedi, M. H. (2005). Comorbid psychiatric disorders in depressed outpatients: demographic and clinical features. Journal of affective disorders, 87(1), 43–55. https://doi.org/10.1016/j.jad.2005.03.005

Rush, S., e Driscoll, D. A. (1968). Current distribution in the brain from surface electrodes. Anesthesia and analgesia, 47(6), 717–723.

Shin, Y. I., Foerster, Á., e Nitsche, M. A. (2015). Reprint of: Transcranial direct current stimulation (tDCS) - Application in neuropsychology. Neuropsychologia, 74, 74–95. https://doi.org/10.1016/j.neuropsychologia.2015.06.021

Snyder H. R. (2013). Major depressive disorder is associated with broad impairments on neuropsychological measures of executive function: a meta-analysis and review. Psychological bulletin, 139(1), 81–132. https://doi.org/10.1037/a0028727

Stagg, C. J., e Nitsche, M. A. (2011). Physiological basis of transcranial direct current stimulation. The Neuroscientist: a review journal bringing neurobiology, neurology and psychiatry, 17(1), 37–53. https://doi.org/10.1177/1073858410386614

Torres, I. J., Boudreau, V. G., e Yatham, L. N. (2007). Neuropsychological functioning in euthymic bipolar disorder: a meta-analysis. Acta psychiatrica Scandinavica. Supplementum, (434), 17–26. https://doi.org/10.1111/j.1600-0447.2007.01055.x

Wolkenstein, L., e Plewnia, C. (2013). Amelioration of cognitive control in depression by transcranial direct current stimulation. Biological psychiatry, 73(7), 646–651. https://doi.org/10.1016/j.biopsych.2012.10.010

Zendjidjian, X., Richieri, R., Adida, M., Limousin, S., Gaubert, N., Parola, N., Lançon, C., e Boyer, L. (2012). Quality of life among caregivers of individuals with affective disorders. Journal of affective disorders, 136(3), 660–665. https://doi.org/10.1016/j.jad.2011.10.011

Downloads

Published

2024-05-16

How to Cite

Barbaro, A., Giacobbe, C., & Santangelo, G. (2024). Application of transcranial Direct Current Stimulation (tDCS) in the treatment of cognitive disorders in depressive disorder and bipolar disorder. TOPIC - Temi Di Psicologia dell’Ordine Degli Psicologi Della Campania, 3(2). Retrieved from https://topic.oprc.it/index.php/topic/article/view/82

Issue

Vol. 3 No. 2 (2024): TOPIC-Temi di Psicologia dell’Ordine degli Psicologi della Campania

Section

Neuropsicologia e neuroscienze

License

Copyright (c) 2024 TOPIC - Temi di Psicologia dell'Ordine degli Psicologi della Campania

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Per le condizioni di licenza consultare il sito: https://creativecommons.org/licenses/by/4.0/deed.it