Identifying treatment response classes to transcranial direct current stimulation from daily ecological momentary assessment patterns in patients with depression
Abstract
Abstract Importance Transcranial direct current stimulation (tDCS) is known to be promising for depression, but heterogeneity across studies highlights the need for strategies to optimize treatment effectiveness. Identifying distinct response patterns based on ecological momentary assessment (EMA) may enhance therapeutic outcomes and support the development of personalized and precision psychiatry. Objective To identify distinct EMA-derived response profiles to tDCS in patients with depression and examine how the identified subtypes differentially predict treatment responses and symptom return following treatment termination. Design A secondary analysis of a double-blind, multicenter randomized clinical trial investigating the effects of tDCS on depression. Daily EMA data on mood and sleep duration during the intervention period were processed using time-series feature extraction and clustered via Gaussian Mixture Modeling. Participants One hundred and ninety-seven participants (original study) and 147 participants (current study) diagnosed with mild-to-moderate depression. Interventions or Exposures Six-week active tDCS vs 3-week active and 3-week sham tDCS. Main Outcomes and Measures Beck Depression Inventory-II (BDI-II) and Montgomery–Åsberg Depression Rating Scale (MADRS) measured at baseline (V1), post-treatment (V3), and 6-week follow-up (V4). Results Clustering analysis identified 3 response types: (1) stable improvement (gradual mood reduction, stable sleep duration,…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 147 participants or records.
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