Transcranial Direct Current Stimulation (tDCS) for Depression during Pregnancy: Scientific Evidence and What Is Being Said in the Media - A Systematic Review

Major depression is the most frequent morbidity in pregnancy. The first-line therapies, psychopharmacologic treatment and psychotherapy, are either insufficient or may cause severe or teratogenic adverse events. As a result of its local limitation to the patient's brain, transcranial direct current stimulation (tDCS) could potentially be an ideal treatment for pregnant women with depression. A literature search was conducted in medical databases, globally published newspapers, search engines, and clinical trial registers to collect all articles on tDCS for the treatment of depression during pregnancy. The aim of this review was to investigate the scientific evidence of tDCS use for depression during pregnancy and to compare these results with the textual and emotional perception in the media as interventions during pregnancy are under particular surveillance. We detected 13 medical articles dealing with tDCS for depression in pregnancy. Overall, the scientific evidence as well as articles in the media for tDCS in pregnancy are sparse, but promising. Further studies are required in this specifically vulnerable population of pregnant women to generate evidence. It is likely that public interest will increase when the results of a pilot study in Canada are published

Cathodal tDCS Over Motor Cortex Does Not Improve Tourette Syndrome: Lessons Learned From a Case Series

Introduction: Current pathophysiological hypotheses of Gilles de la Tourette Syndrome (GTS) refer to temporally abnormal neuronal activation in cortico-striato-thalamo-cortical (CSTC) networks. Modifying cortical activity by non-invasive brain-stimulation appears to be a new treatment option in GTS. Background: Previous studies suggested therapeutic effects of cathodal transcranial direct current stimulation (tDCS) to pre-supplementary motor areas (SMA), however, treatment modalities concerning electrode placement, current intensity and stimulation-rate have not been systematically explored. Aim of this study was to assess efficacy of an alternative stimulation regime on GTS symptoms in a pilot study. To test a treatment protocol with tDCS twice a day, we administered 10 sessions over 5 days of bilateral cathodal tDCS (30 min, 2 mA) over the pre-SMA in three patients with severe GTS. Tic severity as well as obsessive-compulsive (OC) symptoms and affective scales were rated before and after tDCS treatment. Discussion: Only one out of three patients showed a 34.5% reduction in tic severity. The two other patients showed an increase in tic severity. All patients showed a mild increase in positive affect and a reduction in negative affect, OC symptom changes were heterogeneous. Our results do not support earlier findings of extensive therapeutic effects of cathodal tDCS on tics in patients with GTS and show that prediction of stimulation effects on a targeted brain area remains inaccurate. Concluding Remarks: Future research will have to focus on the determination of most effective stimulation modes regarding site, polarity and frequency of tDCS in GTS patients

Reporting bias in medical research - a narrative review

Reporting bias represents a major problem in the assessment of health care interventions. Several prominent cases have been described in the literature, for example, in the reporting of trials of antidepressants, Class I anti-arrhythmic drugs, and selective COX-2 inhibitors. The aim of this narrative review is to gain an overview of reporting bias in the medical literature, focussing on publication bias and selective outcome reporting. We explore whether these types of bias have been shown in areas beyond the well-known cases noted above, in order to gain an impression of how widespread the problem is. For this purpose, we screened relevant articles on reporting bias that had previously been obtained by the German Institute for Quality and Efficiency in Health Care in the context of its health technology assessment reports and other research work, together with the reference lists of these articles

Work-related behavior and experience patterns of music educators – a basis for intervention

Objectives Music educators are subjected to many physical and psychological stresses encountered in the workplace. These stresses could be counteracted by certain work-related behavior and experience patterns as personal resources to reduce the negative consequences of stress. The aim of the study was to determine the existing work-related behavioral and experiential patterns and the characteristics of the Work-Related Behavior and Experience Patterns (Arbeitsbezogenes Verhaltens- und Erlebensmuster – AVEM) questionnaire dimensions in the professional group of music educators according to age group. Material and Methods A total of 205 music educators (66.3% female) from various music schools in Germany participated in the online survey. The subjects were divided into 3 age groups (AG): AG I: ≤35 years, AG II: 36–45 years, AG III: ≥46 years. In addition to sociodemographic and occupational data, the standardized AVEM questionnaire was used according to Schaarschmidt and Fischer. The age and occupation-related data were evaluated in a correlation analysis with the expression of AVEM dimensions. Results A total of 71.4% of the music educators were ≥46 years old group. Another 12.8% belonged to AG II, and 15.8% belonged to AG III. The sex distribution in the 3 age groups was comparable (p = 0.261). The expression of all AVEM dimensions was within the reference range. The most pronounced dimension, with a stanine value of M±SD 5.2±2.15, was the willingness to spend. There was also no significant difference in the assignment to the 4 patterns in the 3 age groups (p = 0.669). Age showed a negative correlation with the experience of social support (ρ = –0.354). Conclusions The age-independent and high intervention-requiring expressions of the AVEM risk patterns A and B led to the recommendation of workplace prevention and health promotion measures. Therefore, it seems reasonable to promote appropriate stress management measures and resilience during studies