The neurobiological basis of bipolar disorders (BD) has received increased attention and several brain regions and brain circuits have been correlated with clinical symptoms. These brain regions and circuits may represent targets for neuromodulation techniques such as transcranial Direct Current Stimulation (tDCS). We systematically reviewed the literature to explore the risks and benefits of tDCS in BD and examined all mood states. Following the PRISMA guidelines, a systematic literature search using several databases was performed from April 2002 to June 2017. From the 135 eligible studies, we retained 19 relevant articles for the systematic review, including 170 patients with BD treated by tDCS. Data from 10 studies suggest that tDCS improves depressive symptoms in BD. One case report of add-on-tDCS reported a significant positive response on manic symptoms. In 4 studies, tDCS impacted specific neurocognitive functions in euthymic patients. There is also preliminary evidence that tDCS improves neurological soft signs and sleep quality in euthymia. Side effects were predominantly transient and low-intensity, although 6 cases of hypomanic/manic affective switches have been reported. The majority of studies have been open trials with few patients. More sufficiently powered randomized controlled trials are needed to clarify the effectiveness of tDCS. Preliminary data suggests that tDCS holds promise as a treatment for BD, especially during depressive episodes. Perhaps most promising are emerging data suggesting tDCS may impact neurocognition and sleep quality in euthymia and be useful for relapse prevention.
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We are very grateful to Bennabi D., Martin D. and Palm U. who kindly replied to our queries and provided data about their studies.
This Psychiatric Quarterly submission did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Conflict of Interest
Pierre A. Geoffroy has received travel awards or financial compensation from AstraZeneca, Lundbeck, Menarini France and Otsuka.
Author Clément Dondé, Nicholas H. Neufeld and Pierre A. Geoffroy declare that they have no conflicts of interest pertaining to this Psychiatric Quarterly submission.
This Psychiatric Quarterly submission does not contain any studies with human participants or animals performed by any of the authors.
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Dondé, C., Neufeld, N.H. & Geoffroy, P.A. The Impact of Transcranial Direct Current Stimulation (tDCS) on Bipolar Depression, Mania, and Euthymia: a Systematic Review of Preliminary Data. Psychiatr Q 89, 855–867 (2018). https://doi.org/10.1007/s11126-018-9584-5
- Bipolar disorders
- Mood disorder
- Neurocognitive impairment
- Transcranial direct current stimulation