{
  "abstract": "Importance\n\nTranscranial direct current stimulation (tDCS) has emerged as a home-based treatment in major depressive disorder (MDD), although its effects are typically small to moderate and inconsistently observed. Because tDCS may act synergistically with behavioral interventions, combining both approaches represents a promising strategy for developing more effective home-based treatments for MDD.Objective\n\nTo investigate the feasibility, safety, and efficacy of home-based tDCS and concurrent gamified cognitive control training (CCT) in adults with MDD.Design, setting, and participants\n\nThis multicenter, double-masked, parallel-group, randomized clinical trial with follow-up at week 10, masking checks at 2 time points, and expectancy assessments was conducted at 3 university hospitals in Latvia, Germany, and Israel between June 22, 2021, and August 8, 2024. Participants included adults aged 18 to 65 years with MDD, 17-item Hamilton Depression Rating Scale scores of at least 13, and no or stable antidepressant medication.Intervention\n\nParticipants were randomly assigned 1:1 to active tDCS (2 mA; anode F3, cathode F4) plus a gamified CCT or sham tDCS plus a sham game. Participants were asked to complete 30 home treatment sessions (30 minutes each) over 6 weeks with software-assisted electrode positioning.Main outcomes and measures\n\nThe primary outcome was feasibility, defined as completing at least 20 of 30 sessions with greater than 50% probability. The secondary outcome was efficacy, measured as change in Montgomery-Åsberg Depression Rating Scale (MADRS) scores from baseline to week 6.Results\n\nOf 111 enrolled participants, 109 were included in the modified intention-to-treat sample (55 in the active group and 54 in the control group; mean [SD] age, 33.1 [10.6] years; 69 female [63.3%]). Feasibility criteria were met, with 86 participants (78.9%) completing at least 20 sessions (lower bound of 1-sided 95% CI, 71.5%). The MADRS scores improved significantly in both groups at week 6, indicating insufficient evidence to reject the null hypothesis of no difference in the mean change in MADRS score from baseline to 6 weeks between the 2 treatment groups (difference, 0.89 [95% CI, -1.37 to 3.15]; P = .44; Cohen d, 0.10 [95% CI, -0.15 to 0.34]). Results were similar at follow-up (week 10). Adverse events were balanced between groups.Conclusions and relevance\n\nThis RCT of home-based tDCS combined with CCT in adults with MDD was feasible and safe but did not demonstrate superior efficacy over the control condition. Future studies should refine the mechanistic alignment between stimulation and cognitive interventions to optimize treatment effects.Trial registration\n\nClinicalTrials.gov Identifier: NCT04953208.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Medizin, Ludwig-Maximilians-Universität München, Munich, Germany.",
    "DZPG (German Center for Mental Health), Partner Site Munich-Augsburg, Germany.",
    "Department of Statistics and Data Science, Faculty of Social Sciences, The Hebrew University of Jerusalem, Israel.",
    "Department of Psychological Methodology and Assessment, Ludwig-Maximilians-University, Munich, Germany.",
    "Charlotte Fresenius Hochschule, Munich, Germany.",
    "Department of Psychiatry and Narcology, Riga Stradins University, Riga, Latvia.",
    "National Centre of Mental Health, Riga, Latvia.",
    "Department of Psychiatry and Psychotherapy, TUM School of Medicine and Health, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.",
    "School of Occupational Therapy, Faculty of Medicine, The Hebrew University of Jerusalem, Israel.",
    "Neuro-X Institute, Ecole Polytechnique Fédérale de Lausanne, Geneva, Switzerland.",
    "Neuro-X Institute, Ecole Polytechnique Fédérale de Lausanne, Valais, Clinique Romande de Réadaptation, Sion, Switzerland.",
    "Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland.",
    "Neuro@campusbiotech, Geneva, Switzerland.",
    "Department of Psychiatry, Hadassah Medical Center, Jerusalem, Israel.",
    "NeuroImaging Core Unit Munich, LMU University Hospital, Munich, Germany.",
    "Signal Processing Laboratory 5, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland.",
    "CIBM Center for Biomedical Imaging, Lausanne, Switzerland.",
    "Radiology Department, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland.",
    "Department of Psychiatry, Faculty of Medicine, The Hebrew University of Jerusalem, Israel.",
    "Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 34,
  "authors": [
    {
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        0,
        1
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      "name": "Esther Dechantsreiter"
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        1,
        7
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      "name": "Ulrike Vogelmann"
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      "name": "Tamar Cohen"
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        8
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      "name": "Naamah Lerner"
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        0,
        1
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      "name": "Gerrit Burkhardt"
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      "name": "Aldo Soldini"
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        9,
        10
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      "name": "Fabienne Windel"
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      "name": "Marios Fanourakis"
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        11,
        12
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      "name": "Zeno Menestrina"
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    {
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        11,
        12
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      "name": "Arthur Nguyen"
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    {
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        11,
        12
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      "name": "Angela Pasqualotto"
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    {
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        9,
        10
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      "name": "Takuya Morishita"
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    {
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        8
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      "name": "Amir Dotan"
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    {
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        8
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      "name": "Shira Ahissar"
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        13
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      "name": "Alon Morash"
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      "name": "Jonas Björklund"
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      "name": "Lucia Bulubas"
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        14
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      "name": "Daniel Keeser"
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    {
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      "name": "Netta Assa"
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      "name": "Rémy Gardier"
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      "name": "Roser Viñals"
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        16,
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      "name": "Jean-Philippe Thiran"
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      "name": "Ronen Segman"
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      "name": "Omer Bonne"
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    {
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      "name": "Amit Lotan"
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        10,
        19
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      "name": "Friedhelm C Hummel"
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      "name": "Elmars Rancans"
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        11,
        12
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      "name": "Daphne Bavelier"
    },
    {
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        8
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      "name": "Mor Nahum"
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  "bibtex": "https://research.draconitic.com/paper/0edhzp5pb9ap6.bib",
  "cited_by": 0,
  "doi": "10.1001/jamanetworkopen.2026.39400",
  "fulltext_url": "https://europepmc.org/articles/PMC13681204",
  "id": "0edhzp5pb9ap6",
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  "landing_url": "https://europepmc.org/article/MED/42895746",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
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      "2808|Transcranial Magnetic Stimulation Studies"
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  "pdf_url": "https://jamanetwork.com/journals/jamanetworkopen/articlepdf/2855475/dechantsreiter_2026_oi_261067_1791821841.24451.pdf",
  "pmcid": "PMC13681204",
  "pmid": "42895746",
  "published": "2026-10-01",
  "publisher": "American Medical Association (AMA)",
  "ris": "https://research.draconitic.com/paper/0edhzp5pb9ap6.ris",
  "sources": [
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2808|Transcranial Magnetic Stimulation Studies",
      "subfield": "neurology"
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  ],
  "title": "Home Transcranial Direct Current Stimulation With Gamified Cognitive Control Training for Depression: A Randomized Clinical Trial.",
  "title_text": "Home Transcranial Direct Current Stimulation With Gamified Cognitive Control Training for Depression: A Randomized Clinical Trial.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:46Z",
  "url": "https://research.draconitic.com/paper/0edhzp5pb9ap6",
  "venue": "JAMA network open",
  "versions": []
}