Neuromodulation approaches for the treatment of major depression: Challenges and recommendations from a working group meeting Estratégias de neuromodulação para o tratamento da depressão maior: Desafios e recomendações de uma força-tarefa

Brunoni A.R.; Teng C.T.; Correa C.; Imamura M.; Brasil-Neto J.P.; Boechat R.; Rosa M.; Caramelli P.; Cohen R.; del Porto J.A.; Boggio P.S.; Fregni F.

Neuromodulation approaches for the treatment of major depression: Challenges and recommendations from a working group meeting Estratégias de neuromodulação para o tratamento da depressão maior: Desafios e recomendações de uma força-tarefa

Tipo

Artigo de revisão

Data de publicação

2010

Periódico

Arquivos de Neuro-Psiquiatria

Citações (Scopus)

73

Autores

Brunoni A.R.
Teng C.T.
Correa C.
Imamura M.
Brasil-Neto J.P.
Boechat R.
Rosa M.
Caramelli P.
Cohen R.
del Porto J.A.
Boggio P.S.
Fregni F.

Resumo

The use of neuromodulation as a treatment for major depressive disorder (MDD) has recently attracted renewed interest due to development of other non-pharmacological therapies besides electroconvulsive therapy (ECT) such as transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), deep brain stimulation (DBS), and vagus nerve stimulation (VNS). Method: We convened a working group of researchers to discuss the updates and key challenges of neuromodulation use for the treatment of MDD. Results: The state-of-art of neuromodulation techniques was reviewed and discussed in four sections: [1] epidemiology and pathophysiology of MDD; [2] a comprehensive overview of the neuromodulation techniques; [3] using neuromodulation techniques in MDD associated with non-psychiatric conditions; [4] the main challenges of neuromodulation research and alternatives to overcome them. Discussion: ECT is the first-line treatment for severe depression. TMS and tDCS are strategies with a relative benign profile of side effects; however, while TMS effects are comparable to antidepressant drugs for treating MDD; further research is needed to establish the role of tDCS. DBS and VNS are invasive strategies with a possible role in treatment-resistant depression. In summary, MDD is a chronic and incapacitating condition with a high prevalence; therefore clinicians should consider all the treatment options including invasive and non-invasive neuromodulation approaches.