Evidence map›Paper›PMID 30837453›Full record

Trial reportTranslational psychiatry2019

Double-blind, randomized pilot clinical trial targeting alpha oscillations with transcranial alternating current stimulation (tACS) for the treatment of major depressive disorder (MDD).

Morgan L Alexander, Sankaraleengam Alagapan, Courtney E Lugo, Juliann M Mellin, Caroline Lustenberger, David R Rubinow, Flavio Fröhlich

2 registry-linked trialsOpen access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Translational psychiatry, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 119 papers, 12 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
119citing papers in PubMed, 12 pooled it
9.9field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05772702 nacompletednot on this mapstarted 2023, after this paper: background citation

Closed-Loop Transcranial Alternating Current Stimulation for the Treatment of Depression (CLACS): Single-Site Open-Label Pilot Study

TypeinterventionalSponsorElectromedical Products International, Inc.Ran2023 to 2024Enrolled26ConditionsDepression, Major Depressive Disorder, tACSArmsClosed-loop tACS
NCT06874374 nacompletednot on this mapstarted 2025, after this paper: background citation

Closed-Loop Transcranial Alternating Current Stimulation (CL-tACS) for the Treatment of Major Depressive Disorder: Double-Blind, Sham-Controlled Randomized Pilot Study

TypeinterventionalSponsorPulvinar Neuro, LLCRan2025 to 2026Enrolled40ConditionsDepression - Major Depressive Disorder, Transcranial Alternating Current StimulationArmsClosed-loop tACS, Sham Comparator
3 · Its place in the literature

Who cites it

119 citing papers in PubMed, 12 syntheses or guidelines pooled it, 212 citations in OpenAlex.

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59 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 2 countries.

Morgan L AlexanderDepartment of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.
Sankaraleengam AlagapanDepartment of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.
Courtney E LugoDepartment of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.
Juliann M MellinDepartment of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.
Caroline LustenbergerDepartment of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.
David R RubinowDepartment of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.
Flavio FröhlichDepartment of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA. flavio_frohlich@med.unc.edu.ORCID http://orcid.org/0000-0002-3724-5621
University of North Carolina at Chapel Hill · US

Funding

North Carolina Translational & Clinical Sciences Institute (NC TraCS)UL1TR001111 · NCATS · UNIV OF NORTH CAROLINA CHAPEL HILL · PI BUSE, JOHN BERNARD, CAREY, TIMOTHY S · 2013 to 2017
$43.9M
Targeting Cortical Dynamics: Rational Design of Individualized Brain StimulationR01MH101547 · NIMH · UNIV OF NORTH CAROLINA CHAPEL HILL · PI FROHLICH, FLAVIO · 2013 to 2017
$2.2M
NCATS NIH HHS UL1 TR001111NIMH NIH HHS R01 MH101547
6 · The paper itself

Abstract

Major depressive disorder (MDD) is one of the most common psychiatric disorders, but pharmacological treatments are ineffective in a substantial fraction of patients and are accompanied by unwanted side effects. Here we evaluated the feasibility and efficacy of transcranial alternating current stimulation (tACS) at 10 Hz, which we hypothesized would improve clinical symptoms by renormalizing alpha oscillations in the left dorsolateral prefrontal cortex (dlPFC). To this end, 32 participants with MDD were randomized to 1 of 3 arms and received daily 40 min sessions of either 10 Hz-tACS, 40 Hz-tACS, or active sham stimulation for 5 consecutive days. Symptom improvement was assessed using the Montgomery-Åsberg Depression Rating Scale (MADRS) as the primary outcome. High-density electroencephalograms (hdEEGs) were recorded to measure changes in alpha oscillations as the secondary outcome. For the primary outcome, we did not observe a significant interaction between treatment condition (10 Hz-tACS, 40 Hz-tACS, sham) and session (baseline to 4 weeks after completion of treatment); however, exploratory analyses show that 2 weeks after completion of the intervention, the 10 Hz-tACS group had more responders (MADRS and HDRS) compared with 40 Hz-tACS and sham groups (n = 30, p = 0.026). Concurrently, we found a significant reduction in alpha power over the left frontal regions in EEG after completion of the intervention for the group that received per-protocol 10 Hz-tACS (n = 26, p < 0.05). Our data suggest that targeting oscillations with tACS has potential as a therapeutic intervention for treatment of MDD.

Indexed as

AdultDouble-Blind MethodElectroencephalographyFemaleHumansMajor Depressive DisorderMaleMiddle AgedPilot ProjectsPrefrontal CortexPsychiatric Status Rating ScalesTranscranial Direct Current StimulationTreatment OutcomeYoung Adult

Identifiers

PMID30837453
PMCPMC6401041
OpenAlexW2920234746

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.