Adolescent depression is a prevalent disorder with substantial morbidity and mortality. Current treatment interventions do not target relevant pathophysiology and are frequently ineffective, thereby leading to a substantial burden for individuals, families, and society. During adolescence, the prefrontal cortex undergoes extensive structural and functional changes. Recent work suggests that frontolimbic development in depressed adolescents is delayed or aberrant. The judicious application of non-invasive brain stimulation techniques to the prefrontal cortex may present a promising opportunity for durable interventions in adolescent depression. Transcranial direct current stimulation (tDCS) applies a low-intensity, continuous current that alters cortical excitability. While this modality does not elicit action potentials, it is thought to manipulate neuronal activity and neuroplasticity. Specifically, tDCS may modulate N-methyl-d-aspartate receptors and L-type voltage-gated calcium channels and effect changes through long-term potentiation or long-term depression-like mechanisms. This mini-review considers the neurobiological rationale for developing tDCS protocols in adolescent depression, reviews existing work in adult mood disorders, surveys the existing tDCS literature in adolescent populations, reviews safety studies, and discusses distinct ethical considerations in work with adolescents.
Bibliographical noteFunding Information:
We would like to thank Hedva Chiu for her contributions to the literature review and manuscript preparation. PC is supported by the Brain and Behavior Research Foundation, the Mayo Clinic Foundation, the Paul and Betty Woolls Foundation, and the National Institute of Mental Health (K23 MH100266). ZJD is supported by the Ontario Mental Health Foundation, the Canadian Institutes of Health Research, the Brain and Behavior Research Foundation, the Temerty Family, the Grant Family, the Centre for Addiction and Mental Health Foundation, and the Campbell Family Mental Health Research Institute.
© 2017 Lee, Lewis, Daskalakis and Croarkin.
- Adolescent depression
- Non-invasive brain stimulation
- Transcranial current stimulation
- Transcranial direct current stimulation