Transcranial stimulation: Innovative headset to help with depression

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The black and white headset from Swedish start-up Flow Neuroscience is not placed on the ears, but on the front of the head above the temples. And instead of sound waves, it generates electricity. The device is designed to help combat depression and can also be used at home by those affected. In a study from the UK and the USA, which was co-financed by the manufacturer and recently published in the journal Nature Medicine, more than half of the participants benefited from the treatment.

The method that works here is called transcranial direct current stimulation, or tDCS (transcranial Direct Current Stimulation) for short, and is not new in itself. It is considered to be well tolerated and is also offered by some clinics in Germany. The electrodes that generate the current are not usually placed in a headset, but under a cap or headband. The current placebo-controlled double-blind study is the first for home use over a period of ten weeks.

How direct current helps people with depression

The direct current generated affects a region of the brain that is involved in decision-making, among other things: the so-called dorsolateral prefrontal cortex. The nerve cells in this area of the brain are often less active in people with depression, says study co-author Cynthia Fu from King's College London. "tDCS uses a weak current that makes it easier for brain cells to discharge or fire." Among other things, it changes the electrical charges on the membranes of the nerve cells, increases or decreases their excitability and also influences the interaction between the neurons. The authors write that home therapy could save sufferers frequent visits to specialist clinics.

Study with people with moderate depression

120 women and 54 men with at least moderate depression took part in the study with the tDCS headset for home use. Fu and the international team from the UK initially examined the patients via telemedicine and randomly divided them into two groups. One group received a weak current of two milliamperes via the headset to the scalp five times a week for 30 minutes during the first three weeks. In the last four weeks, it was three units of current per week. In the control group, the device only emitted a pulse at the beginning of a treatment session.

The researchers used standardized interviews and the Hamilton Depression Scale (HAMD) to determine how the severity of the depression changed as a result of the treatment. According to this, a score of zero to eight points is considered clinically inconspicuous. From nine points, experts speak of mild depression and over 25 points of severe depression.

At the start of the study, the participants had an average severity level of around 19 points. After the ten-week treatment, more than half of the participants in the treated group felt better. Around 45 percent were even free of depression according to the Hamilton scale. In the control group, the symptoms improved in 38 percent of the test subjects and 22 percent were classified as depression-free. On average, the severity of depression in the treated group fell to around nine and a half points and in the placebo group to eleven and a half points.

What works for whom?

The researchers use magnetic resonance imaging (MRI), among other things, to investigate which therapy and dosages help which people best. Abnormalities in the brain tissue can apparently provide valuable information. Statistical methods such as machine learning, which extract characteristic patterns from clinical data, also provide clues. "The combination of biomarkers from imaging, clinical data and specific stimulation approaches opens up new avenues in the treatment of depressive disorders, which can be individually combined with both medication and psychotherapy," Padberg told the German Society for Clinical Neurophysiology and Functional Imaging (DGKN).

According to the DGKN, it can sometimes take years to find the optimal treatment for depression. A tailor-made therapy would significantly shorten the period of suffering. It remains to be seen what role an anti-depression headset for use at home can play in this.

This article was first published on t3n.de .

(olb)