Multichannel tDCS with Advanced Targeting for Major Depressive Disorder: A Tele-Supervised At-Home Pilot Study

Ruffini, Salvador, Castaldo et al. — Frontiers in Psychiatry 15, 1427365, 2024.

Why I cared. The modelling only matters if it reaches a patient. I wanted to see model-designed stimulation actually delivered — at home, to people living with depression — not just simulated.

What we did. We ran an open-label, multicentre pilot: 35 people with major depressive disorder, each receiving 37 at-home sessions of multichannel tDCS over the left DLPFC, with the electrode montage optimised by computational models, all remotely supervised over eight weeks.

What we found. It is feasible and safe — most participants completed the full course at home, with no serious adverse events — and the exploratory antidepressant signal was large: a median ~64% drop in MADRS at follow-up and a ~73% response rate. Enough to motivate properly controlled trials.

What it opened. The model chose the montage — so how much of the effect is the targeting, and could per-patient models do better? And does tele-supervised, at-home stimulation quietly change who can be treated at all?