SHORT INTERVAL PERIODIC TRANSCRANIAL DIRECT CURRENT STIMULATIONS INDUCED LONG-TERM REMISSION OF SYMPTOMS IN A PATIENT WITH POST-STROKE DEPRESSION
*Auwal Bello Hassan1, Musa Sani Danazumi2, Cornelius Mahdi Ishaku1
1Department of Physiotherapy, Faculty of Allied Health Sciences, College of Medical Sciences, University of Maiduguri.
1Department of Physiotherapy, Federal Medical Center, Nguru, Yobe State, Nigeria.
Email: auwalbello0907@yahoo.com
ABSTRACT
Objective: We present report of a patient with PSD who had long-term mood improvement upon receiving periodic tDCS sessions with short inter-sessions intervals following relapse of symptoms at 3 weeks after improvement due to stimulations with long inter-sessions intervals.
Background: tDCS has been shown to be effective in the management of patients with post-stroke depression, but with high relapse rate.
Materials and Methods: A 60 years old patient presented with moderate PSD, having BDI score of 25. She received anodal tDCS to the left dorsolateral prefrontal cortex using two different application protocols. Initially, a stimulation session of 2mA intensity for 20 minutes was given every working day for two weeks. After 3 weeks, she then received 7 sessions of periodic stimulations of 2mA intensity for 13 minutes each with 20 minutes inter-sessions interval. BDI score was taken before the intervention, immediately after, and at 3 weeks and 6 months post-intervention.
Results: Immediately following the last session of the initial protocol of stimulation, the BDI score reduced from 25 to 7. However, the symptoms relapsed at 3 weeks post intervention to initial the BDI score of 25. There was no change in the BDI score immediately after follow-up with short interval periodic stimulations. Nonetheless, the BDI score improved to 18 at three weeks and later to 7 at six months post-intervention.
Conclusions: Series of periodic tDCS with short-intersession intervals may be more effective in inducing long-term mood improvement in patients with post-stroke depression.
Key words: Transcranial direct current stimulation, Post-stroke depression, Non-invasive brain stimulation, Major depression, Long-term potentiation