Reduction in Left Frontal Alpha Oscillations by Transcranial Alternating Current Stimulation in Major Depressive Disorder Is Context Dependent in a Randomized Clinical Trial

  • Justin Riddle
    Affiliations
    Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina

    Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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  • Morgan L. Alexander
    Affiliations
    Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina

    Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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  • Crystal Edler Schiller
    Affiliations
    Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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  • David R. Rubinow
    Affiliations
    Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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  • Flavio Frohlich
    Correspondence
    Address correspondence to Flavio Frohlich, Ph.D.
    Affiliations
    Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina

    Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina

    Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina

    Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina

    Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina

    Neuroscience Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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      Abstract

      Background

      Left frontal alpha oscillations are associated with decreased approach motivation and have been proposed as a target for noninvasive brain stimulation for the treatment of depression and anhedonia. Indeed, transcranial alternating current stimulation (tACS) at the alpha frequency reduced left frontal alpha power and was associated with a higher response rate than placebo stimulation in patients with major depressive disorder (MDD) in a recent double-blind, placebo-controlled clinical trial.

      Methods

      In this current study, we aimed to replicate successful target engagement by delineating the effects of a single session of bifrontal tACS at the individualized alpha frequency (IAF-tACS) on alpha oscillations in patients with MDD. Eighty-four participants were randomized to receive verum or sham IAF-tACS. Electrical brain activity was recorded during rest and while viewing emotionally salient images before and after stimulation to investigate whether the modulation of alpha oscillation by tACS exhibited specificity with regard to valence.

      Results

      In agreement with the previous study of tACS in MDD, we found that a single session of bifrontal IAF-tACS reduced left frontal alpha power during the resting state when compared with placebo. Furthermore, the reduction of left frontal alpha oscillation by tACS was specific for stimuli with positive valence. In contrast, these effects on left frontal alpha power were not found in healthy control participants.

      Conclusions

      Together, these results support an important role of tACS in reducing left frontal alpha oscillations as a future treatment for MDD.

      Keywords

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