Advertisement

Quantifying clinical improvements in patients with depression under the treatment of transcranial direct current stimulation using event related potentials

  • Yeganeh Shahsavar
  • Majid Ghoshuni
  • Ali Talaei
Scientific Paper
  • 53 Downloads

Abstract

The main goal of this study was to assess the changes in brain activities of patients with severe depression by applying transcranial direct current stimulation (tDCS) using event related potentials (ERPs). Seven patients (four males, with the mean age 34.85 ± 4.25) were asked to fill out Beck’s depression questionnaires. EEG signals of subjects were recorded during Stroop test. This test entailed 360 stimulations, which included 120 congruent, 120 incongruent, and 120 neutral stimulations lasting for 12 min. Subsequently, the dorso lateral prefrontal cortex in patients’ left hemisphere was stimulated for six sessions using tDCS. At the end of tDCS treatment period, subjects filled out Beck’s depression questionnaires again and EEG signal recordings were repeated simultaneously with Stroop test. Wavelet coefficients of EEG frequency bands in every stimulation type were extracted from ERP components. The changes in Beck score before and after tDCS were estimated using neural network model. The ERP results showed that the latency period of N400 component after applying tDCS decreased significantly. Moreover, a significant correlation was observed between percentage changes of congruent and incongruent accuracy and the increase in the average energy of wavelet coefficients in alpha band in Pz electrode with p = 0.0128, r = 0.9060 and p = 0.0037, r = 0.95, respectively. Additionally, the results of neural network model revealed that the changes in Beck score were estimated with an average error of 0.0519. Consequently, the improvement of depressed patients treated with tDCS could be estimated with good accuracy using average energy of wavelet coefficients in alpha band.

Keywords

Depression Transcranial direct current stimulation Stroop test Event related potentials Dorso lateral prefrontal cortex 

Notes

Acknowledgements

Financial support from the Cognitive Technology and Science Development Staff is greatly appreciated.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Robins LN, Helzer JE, Croughan J, Ratcliff KS (1981) National Institute of Mental Health diagnostic interview schedule: its history, characteristics, and validity. Arch Gen Psychiatry 38:381–389CrossRefGoogle Scholar
  2. 2.
    Gandhi M, Kapadia MS, Sarvaiya VU (2012) Comparative study of thiopentone versus propofol for anaesthesia in electroconvulsive therapy. Gujarat Med J 67:42–49Google Scholar
  3. 3.
    Wassermann EM (1998) Risk and safety of repetitive transcranial magnetic stimulation: report and suggested guidelines from the International Workshop on the Safety of Repetitive Transcranial Magnetic Stimulation, June 5–7, 1996. Electroencephalogr Clin Neurophysiol 108:1–16CrossRefGoogle Scholar
  4. 4.
    Fregni F, Boggio PS, Mansur CG, Wagner T, Ferreira MJL, Lima MC, Rigonatti SP, Marcolin MA, Freedman SD, Nitsche MA et al (2005) Transcranial direct current stimulation of the unaffected hemisphere in stroke patients Neuroreport 16:1551–1555CrossRefGoogle Scholar
  5. 5.
    Nitsche MA, Cohen LG, Wassermann EM, Priori A, Lang N, Antal A, Paulus W, Hummel F, Boggio PS, Fregni F et al (2008) Transcranial direct current stimulation: state of the art 2008. Brain Stimulation 1:206–223CrossRefGoogle Scholar
  6. 6.
    Fregni F, Boggio PS, Nitsche MA, Marcolin MA, Rigonatti SP, Pascual-Leone A (2006) Treatment of major depression with transcranial direct current stimulation. Bipolar Disord 8:203–204CrossRefGoogle Scholar
  7. 7.
    Nitsche MA, Paulus W (2000) Excitability changes induced in the human motor cortex by weak transcranial direct current stimulation. J Physiol 527:633–639CrossRefGoogle Scholar
  8. 8.
    Costain R, Redfearn JWT, Lippold OCJ (1964) A controlled trial of the therapeutic effects of polarization of the brain in depressive illness. Br J Psychiatry 110:786–799CrossRefGoogle Scholar
  9. 9.
    Last CG, Hersen M (1988) Handbook of anxiety disorders. Pergamon Press, OxfordGoogle Scholar
  10. 10.
    Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J (1961) An inventory for measuring depression. Arch Gen Psychiatry 4:561–571CrossRefGoogle Scholar
  11. 11.
    Rigonatti SP, Boggio PS, Myczkowski ML, Otta E, Fiquer JT, Ribeiro RB, Nitsche MA, Pascual-Leone A, Fregni F (2008) Transcranial direct stimulation and fluoxetine for the treatment of depression. Eur Psychiatry 23:74–76CrossRefGoogle Scholar
  12. 12.
    Song M, Shin Y, Yun K (2014) Beta-frequency EEG activity increased during transcranial direct current stimulation. Neuroreport 25:1433–1436CrossRefGoogle Scholar
  13. 13.
    Rowland N, Meile MJ, Nicolaidis S et al (1985) EEG alpha activity reflects attentional demands, and beta activity reflects emotional and cognitive processes. Science 228:750–752CrossRefGoogle Scholar
  14. 14.
    Al-Kaysi AM, Al-Ani A, Loo CK, Powell TY, Martin DM, Breakspear M, Boonstra TW (2017) Predicting tDCS treatment outcomes of patients with major depressive disorder using automated EEG classification. J Affect Disord 208:597–603CrossRefGoogle Scholar
  15. 15.
    Miller J, Berger B, Sauseng P (2015) Anodal transcranial direct current stimulation (tDCS) increases frontal–midline theta activity in the human EEG: a preliminary investigation of non-invasive stimulation. Neurosci Lett 588:114–119CrossRefGoogle Scholar
  16. 16.
    Fregni F, Boggio PS, Nitsche M, Bermpohl F, Antal A, Feredoes E, Marcolin MA, Rigonatti SP, Silva MTA, Paulus W et al (2005) Anodal transcranial direct current stimulation of prefrontal cortex enhances working memory. Exp Brain Res 166:23–30CrossRefGoogle Scholar
  17. 17.
    Brunoni AR, Nitsche MA, Bolognini N, Bikson M, Wagner T, Merabet L, Edwards DJ, Valero-Cabre A, Rotenberg A, Pascual-Leone A et al (2012) Clinical research with transcranial direct current stimulation (tDCS): challenges and future directions. Brain Stimulation 5:175–195CrossRefGoogle Scholar
  18. 18.
    Nunez PL, Srinivasan R (2006) Electric fields of the brain: the neurophysics of EEG. Oxford University Press, OxfordCrossRefGoogle Scholar
  19. 19.
    Sumich AL, Kumari V, Heasman BC, Gordon E, Brammer M (2006) Abnormal asymmetry of N200 and P300 event-related potentials in subclinical depression. J Affect Disord 92:171–183CrossRefGoogle Scholar
  20. 20.
    Padberg F, Kumpf U, Mansmann U, Palm U, Plewnia C, Langguth B, Zwanzger P, Fallgatter A, Nolden J, Burger M et al (2017) Prefrontal transcranial direct current stimulation (tDCS) as treatment for major depression: study design and methodology of a multicenter triple blind randomized placebo controlled trial (Depression DC). Eur Arch Psychiatry Clin Neurosci 267:751–766CrossRefGoogle Scholar
  21. 21.
    Powell TY, Boonstra TW, Martin DM, Loo CK, Breakspear M (2014) Modulation of cortical activity by transcranial direct current stimulation in patients with affective disorder. PLoS ONE 9:e98503CrossRefGoogle Scholar
  22. 22.
    Pathak Y, Kopell BH, Szabo A, Rainey C, Harsch H, Butson CR (2013) The role of electrode location and stimulation polarity in patient response to cortical stimulation for major depressive disorder. Brain Stimulation 6:254–260CrossRefGoogle Scholar
  23. 23.
    World Health Organization (1992) The ICD-10 classification of mental and behavioural disorders: clinical descriptions and diagnostic guidelines. World Health Organization, GenevaGoogle Scholar
  24. 24.
    Stroop JR (1935) Studies of interference in serial verbal reactions. J Exp Psychol 18:643–662.CrossRefGoogle Scholar
  25. 25.
    Rosso OA, Blanco S, Yordanova J, Kolev V, Figliola A, Schürmann M, Başar E (2001) Wavelet entropy: a new tool for analysis of short duration brain electrical signals. J Neurosci Methods 105:65–75CrossRefGoogle Scholar
  26. 26.
    Maeoka H, Matsuo A, Hiyamizu M, Morioka S, Ando H (2012) Influence of transcranial direct current stimulation of the dorsolateral prefrontal cortex on pain related emotions: a study using electroencephalographic power spectrum analysis. Neurosci Lett 512:12–16CrossRefGoogle Scholar
  27. 27.
    Zaehle T, Sandmann P, Thorne JD, Jäncke L, Herrmann CS (2011) Transcranial direct current stimulation of the prefrontal cortex modulates working memory performance: combined behavioural and electrophysiological evidence. BMC Neurosci 12:2CrossRefGoogle Scholar
  28. 28.
    Prichep LS, Lieber AL, John ER, Alper K, Gomez-Mont F, Essig-Peppard T, Flitter M (1986) Quantitative EEG in depressive disorders. In: Brain electrical potentials and psychopathology. Elsevier, Amsterdam, pp. 223–224Google Scholar
  29. 29.
    Leuchter AF, Cook IA, Hunter AM, Cai C, Horvath S (2012) Resting-state quantitative electroencephalography reveals increased neurophysiologic connectivity in depression. PLoS One 7:e32508CrossRefGoogle Scholar
  30. 30.
    Davidson RJ, Henriques JB (2000) Regional brain function in sadness and depression. In: The neuropsychology of emotion. Oxford University Press, Oxford, pp. 269–297Google Scholar

Copyright information

© Australasian College of Physical Scientists and Engineers in Medicine 2018

Authors and Affiliations

  1. 1.Department of Biomedical Engineering, Mashhad BranchIslamic Azad UniversityMashhadIran
  2. 2.Medical and Behavioral Sciences Research CenterUniversity of Medical SciencesMashhadIran

Personalised recommendations