Transcranial electrical stimulation in the treatment of late-life depression: New opportunities and prospects

Abstract

Introduction . Late-life depression is one of the main causes of the burden of mental illness in modern society, leading to a reduction in healthy life expectancy and increased costs of care for those affected. Treatment of late-life depression presents significant challenges, making the development of additional methods to improve its effectiveness increasingly important. Currently, transcranial electrical stimulation is a non-invasive brain stimulation method, being actively studied both as a standalone therapy for mental disorders and in combination with psychopharmacological medications. Aim . To evaluate the effectiveness of using transcranial direct current stimulation (tDCS) as an adjunct to standard treatment in patients with late-life depression. Materials and methods. Cohort – 52 hospitalized patients 60 years and older with a current depressive episode according to ICD-10: depressive episode (F32.0) – 7.7%, depressive phase within recurrent depressive disorder (F33.0) – 92.3%. Patients were randomly assigned to two groups. The group 1 (25 people) received high-resolution tDCS (direct current electrostimulation syndrome) along with antidepressant therapy. The group 2 (27 people) received standard antidepressant therapy. A comparative evaluation of the effectiveness of a 28-day course of therapy in the groups was conducted. Methods – clinical, psychopathological, psychometric, neurophysiological, statistical. Results . The effectiveness of treatment was significantly higher in the group of patients with complex therapy with antidepressants in combination with tDCS compared with antidepressant monotherapy: the average total score on the HAMD-17 scale decreased by 65.63% and 55.23%, the proportion of respondents was 100% and 62.9%, respectively (p < 0.05). In patients with complex therapy There was a more pronounced improvement in cognitive functioning. Conclusion . Treatment efficacy was significantly higher in the group 1: the average total HAMD-17 score decreased by 65.63% and 55.23%, with the responder rates being 100% and 62.9%, respectively (p<0.05). The reduction of anxiety disorders by the end of the course of therapy was 65.07 and 57.30%, respectively (p < 0.05), and the average degree of improvement in cognitive functioning (on the MMSE scale) was 7.26 and 3.29%, respectively (p < 0.05).