About this trial
The purpose of this research study is to determine the effectiveness of Transcranial direct current stimulation (tDCS) therapy in the treatment of participants with Late-life depression (LLD).
The study will evaluate feasibility, safety, and tolerability of high-dose (6mA) bilateral tDCS delivered as three daily sessions, 3 times a week, for 3 weeks in older adults (60 y/o and older) with late-life depression.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
age 60 years or older;
diagnosis of unipolar major depressive disorder according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), confirmed by the Mini International Neuropsychiatric Interview (MINI);
score of 17 or higher on the 17-item Hamilton Depression Rating Scale (HDRS-17) at screening;
stable antidepressant regimen for at least four weeks prior to enrollment, if applicable;
Disqualifiers
contraindications to tDCS including metallic cranial implants, skin conditions at electrode sites (eczema, open wounds, burns, lesions), or history of adverse reaction to tDCS;
contraindications to magnetic resonance imaging (MRI) including pacemaker, cochlear implants, ferromagnetic implants, or claustrophobia;
history of seizures or epilepsy;
bipolar disorder, psychotic disorders, or severe personality disorder;
Trial design
Single group
Treatments tested in this trial
High-intensity (6 mA) transcranial direct current stimulation (tDCS)
DeviceHigh-intensity (6 mA), spaced (three daily sessions, 3 times a week, for 3 weeks) transcranial direct current stimulation (tDCS) in older adults (60 y/o and over) with Late-Life Depression
Treatment groups
Trial outcomes
Primary outcomes
Completion Rate
The proportion of enrolled participants who complete at least 7 of 9 treatment days.
Target dose achievement
The proportion of participants who reach their calculated target dose without dose-limiting intolerance.
Session completion
The proportion of scheduled sessions completed across all participants.
Adverse event profile
Including incidence, severity, and time course of adverse events.
Secondary outcomes
Target engagement
Resting-state fMRI measures functional connectivity between the DLPFC and subgenual anterior cingulate cortex (sgACC). The DLPFC-sgACC connectivity is a biomarker of depression that predicts treatment response to neuromodulation. Target engagement would be a significant change in DLPFC-sgACC connectivity.
Clinical - HDRS-17
Clinical outcomes are assessed using the HDRS-17 at baseline, weeks 1-5, and week 6. Response is defined as ≥50% reduction in HDRS-17 from baseline. Remission is defined as HDRS-17 ≤7.
Correlation of Stimulation Dose With Change in HDRS 17 Scores
Exploratory dose-response analyses will examine correlations between the device stimulation and the changes in clinical outcomes (HDRS-17). This is assessed by correlating achieved baseline E-field (Structural MRI (T1- and T2-weighted) values) and changes in clinical outcomes measured by Hamilton Depression Rating Scale-17 item (HDRS-17). Change in HDRS 17 is defined as the difference between baseline and post-treatment scores at 6 weeks. Correlation analyses (Pearson or Spearman coefficients) are used to quantify the relationship.
Sponsors and contacts
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Andre Russowsky Brunoni
Lead sponsor
University of Texas Southwestern Medical Center
Sponsor institution
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