High-definition Transcranial Direct Current Stimulation (HD-tDCS) in Late-life Depression (LLD)
Depression in Old Age
About this trial
This is an interventional treatment trial for Depression in Old Age focused on measuring augmentation therapy, late-life depression
Eligibility Criteria
Inclusion Criteria:
- 60 years of age or above
- Right-handedness, as determined by the Edinburgh Handedness Inventory (to homogenise neuroanatomical targeting)
- Chinese ethnicity
- Fulfil the criteria of Major Depressive Disorder (single or recurrent episode) and in partial remission, defined by the 5th Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
- Presence of mild to severe level of depressive symptoms measured and defined by HAM-D-17 score ≥8 and ≤ 52[22]
- Suboptimal treatment response with at least one adequate antidepressant trial defined as full or best tolerated doses at least 6 weeks
- Stable dosage of antidepressants or other treatments for depression in recent 4 weeks
- Valid informed written consent
Exclusion Criteria:
- A DSM-5 diagnosis other than Depressive Disorders (e.g., bipolar and related disorders, schizophrenia spectrum and other psychotic disorders).
- A Hong Kong Chinese version of the Montreal Cognitive Assessment (HK-MoCA) score below the second percentile according to the subject's age and education level (to exclude subjects with existing dementia)
- Alcohol or substance dependence
- Active suicidal ideation or a suicide attempt within the past month
- Concomitant unstable medical condition or major neurological conditions
- Significant communication impairment
Sites / Locations
- Department of Psychiatry, University of Hong KongRecruiting
Arms of the Study
Arm 1
Arm 2
Active Comparator
Sham Comparator
active HD-tDCS
sham-HD-tDCS
The participants will be instructed to relax during the first 5 minutes of the session while the equipment is set up. A mild stimulation (with a level of only 2 milliamps stimulation) will be delivered for 20 minutes, with the current gradually increased and decreased over 30 seconds. The patients will be instructed to relax and remain motionless during the intervention. The administrator will closely monitor the impedance throughout each session and record any side effects experienced by the participants. The participants will be allowed 5 minutes of rest after the intervention and will be actively asked about any discomfort. Each session will last around 30 minutes, with a total of 10 sessions (two consecutive weeks of treatment for 5 days per week).
The procedure for sham stimulation will be identical, except that the current will be gradually ramped down to zero after the first 30 s, thus giving the same initial sensation of HD-tDCS. The stimulator will be programmed to switch the current on and off, so no intervention by the operator will be required. The computer will be placed behind the subjects' heads so they cannot see the readout.