Please select the arm or intervention descriptions that belong to the clinical trial below.
Title: Treatment of Major Depressive Disorder Post Stroke With Transcranial Direct Current Stimulation (TDCS): Randomized, Double-Blind, Clinical Trial
Brief Summary: Stroke is one of the main public health problems in America Latina. It can be associated with several neuropsychiatric complications, which include a broad spectrum of emotional distress and cognitive, results in important clinical implications for the prognosis of these patients. Depression is a common complication, affecting around 5-72% of patients and is associated with various cognitive deficits and also with increased mortality - up to 50% more deaths compared to non-depressed patients. Treatment of depression after stroke is important not only to improve depressive symptoms but can also be beneficial for cognitive deficits, activities of daily living. and leads to increased survival for these patients. There are different treatments for depression after stroke, all showing inconclusive results, even though antidepressants have been effective in some groups of patients, tolerability and treatment adherence were not very good-so it is necessary that new therapeutic modalities are presented with good tolerability. In this sense, transcranial direct current stimulation (tDCS) is an interesting technique that can provide interesting results, which proved to be effective for depression in some studies. This study proposes to investigate the effect of tDCS for the treatment of major depressive disorder after stroke. The proposed design is a clinical trial, randomized, double-blind, placebo-controlled study in a subsample of participants in the prospective cohort of stroke: Study of Morbidity and Mortality of stroke. They will be allocated to one of the groups: sham or active tDCS group. Participants will receive ten consecutive days of active or sham stimulation and return at the end of two weeks to evaluate the improvement in depression, cognition and functionality. As objectives, the investigators expect to see a clinical improvement of depression through scales like Hamilton, Beck and MADRS(Montgomery-Asberg Depression Rating Scale), and expect improvement on cognitive tests as MoCA (Montreal Cognitive Assessment), MMSE (mini mental scale exam), FAB (frontal assessment battery) and trail test. Another goal is to see improvement in markers related to depression as BDNF, cortisol, interleukins and heart rate variability. With all this, the investigators hope to offer a new treatment, and effective with few side effects to treat depression after stroke.


Options:
A: Arm Label: Dialogue-based psychosocial intervention; Type: EXPERIMENTAL; Interventions: Behavioral: Dialogue-based psychosocial rehabilitation | Arm Label: Usual care Control group; Type: NO_INTERVENTION; Interventions: N/A | Intervention Type: BEHAVIORAL; Name: Dialogue-based psychosocial rehabilitation; Assigned to Arm(s): Dialogue-based psychosocial intervention
B: Arm Label: escitalopram; Type: EXPERIMENTAL; Interventions: Drug: Escitalopram | Arm Label: placebo; Type: PLACEBO_COMPARATOR; Interventions: Drug: sugar pill | Intervention Type: DRUG; Name: Escitalopram; Assigned to Arm(s): escitalopram | Intervention Type: DRUG; Name: sugar pill; Assigned to Arm(s): placebo
C: Arm Label: In-person behavioral intervention; Type: EXPERIMENTAL; Interventions: Behavioral: Brief pleasurable events/behavioral therapy | Arm Label: Telephone behavioral intervention; Type: EXPERIMENTAL; Interventions: Behavioral: Brief pleasurable events/behavioral therapy | Arm Label: Standard care; Type: ACTIVE_COMPARATOR; Interventions: Other: Standard care | Intervention Type: BEHAVIORAL; Name: Brief pleasurable events/behavioral therapy; Assigned to Arm(s): In-person behavioral intervention, Telephone behavioral intervention | Intervention Type: OTHER; Name: Standard care; Assigned to Arm(s): Standard care
D: Arm Label: Sham Stimulation; Type: SHAM_COMPARATOR; Interventions: Device: Transcranial Direct Current Stimulation | Arm Label: Active Stimulation; Type: ACTIVE_COMPARATOR; Interventions: Device: Transcranial Direct Current Stimulation | Intervention Type: DEVICE; Name: Transcranial Direct Current Stimulation; Assigned to Arm(s): Active Stimulation, Sham Stimulation

Answer: D