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Efficacy of transcranial direct current stimulation for depression: individual patient data meta-analysis.

Year: 2026
Type: article
Abstract: BACKGROUND: Transcranial direct current stimulation (tDCS) shows promise for treating depression, but heterogeneous findings from randomised controlled trials (RCTs) - likely due to patient characteristics and methodological differences - limit clear conclusions about its efficacy. AIMS: This individual patient data meta-analysis (IPD-MA) aims to evaluate the efficacy of tDCS for depression and explore moderators of clinical depression improvement. METHOD: Databases (PubMed, Embase, Web of Science, Cochrane Library) were searched up to 1 February 2025 for RCTs comparing active versus sham tDCS in acute depressive episodes. The outcomes were Hedges' g for continuous measures of depressive symptoms, odds ratio for response and remission rates and analyses of individual/methodological moderators of clinical improvement. Acceptability was assessed via dropout rates. Heterogeneity was quantified using the I² statistic. Publication and risk of bias were evaluated with Egger's test and Cochrane Risk of Bias Tool, respectively. RESULTS: Of 29 eligible RCTs, 18 data-sets provided IPD, totalling 1246 included in the IPD-MA (651 active, 595 sham; mean age 43.2, 63.4% female). Most studies (90%) had low risk of bias. Active tDCS showed small but statistically significant effects on depression improvement (Hedges' d = 0.24, 95% CI = 0.11-0.35) and response rates (odds ratio 1.33, 95% CI = 1.04-1.72), with low-to-moderate heterogeneity. No significant difference in remission rates (odds ratio 1.30, 95% CI = 0.98-1.74) and dropout rates (12.7% active, 11.3% sham) were observed between groups. Only sample size significantly moderated clinical improvement, with larger trials showing smaller between-group differences. CONCLUSIONS: In this IPD data-set, tDCS showed modest efficacy for depression. Future research should clarify its mechanisms, considering non-specific placebo effects.
DOI: 10.17863/cam.125664
Authors: Razza, Lais B, Luethi, Matthias S, Moffa, Adriano, Aust, Sabine, Blumberger, Daniel M, Brunelin, Jerome, Burkhardt, Gerrit, Chiarenza, Cecilia, Loo, Colleen K, Moirand, Remi, Myung, Woojae, Nord, Camilla L, Palm, Ulrich, Segrave, Rebecca, Valiengo, Leandro, Padberg, Frank, Paim Diaz, Alexandre, Brunoni, André R, Vanderhasselt, Marie-Anne
Language: English
Subfield: Neurology
Open Access status: green
OpenAlex ID: W7128008989
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