Mindful Breathing and tDCS for Depression
Condition: Depression; Depressive Disorder
MeSH terms: Depression; Depressive Disorder
Study type: Interventional

Summary: 
      This study will investigate whether transcranial direct current stimulation (tDCS) targeting
      the dorsolateral prefrontal cortex (DLPFC) can enhance the therapeutic effect of mindful
      breathing training (MBT) for adolescent depression. The objective is to enhance connectivity
      between the DLPFC with the amygdala and Default Mode Network (DMN) circuits as well as to
      enhance emotion regulation abilities and decrease rumination to reduce symptoms of
      depression. This will aid in the development of novel treatments for depression.
    

Detailed description: 
      Aim 1: To demonstrate the feasibility of recruiting and randomizing adolescents with
      depression to a research protocol involving MBT and tDCS. The investigators expect that
      adolescents will be willing to enroll in a randomized trial involving MBT and tDCS.

      Aim 2: To test the tolerability of MBT and tDCS in adolescents. The investigators expect that
      MBT will be well-tolerated and that active tDCS will show no difference in tolerance compared
      to sham stimulation.

      Aim 3: To examine whether tDCS can enhance the effects of MBT. The investigators expect the
      MBT + tDCS group will show greater reduction in depressive symptoms compared to the MBT +
      sham stimulation group.

      Aim 4: To examine the mechanisms of MBT +/- tDCS treatment. The investigators expect that
      depression symptom improvement will be associated with decreased rumination, improvements in
      emotion regulation, increased task-based and resting state DLPFC-DMN and DLPFC-amygdala
      connectivity, as well as increased DLPFC activation and reduced amygdala activation during
      rumination and emotion processing tasks. The investigators also expect reduced alpha
      asymmetry and reduced LPP amplitude during emotion regulation and emotion processing. The
      investigators expect these changes will be greatest in the active tDCS + MBT group.
    

Intervention name(s): Transcranial Direct Current Stimulation; Mindful Breathing; Sham
Intervention type(s): Device; Behavioral; Other
Intervention description(s): A non-invasive neuromodulation technique that can modulate neural activity. Weak electrical current (~2mA) is applied to the scalp using anodal and cathodal electrode sponges, which increase or decrease cortical excitability respectively.; MBT is a mindfulness-based intervention that guides participants to pay attention to the present experience. Participants will be trained to become aware of mind-wandering, disengage, and shift attention back to the present experience. Participants will practice mindful breathing using a computerized application that they will be able to access on the web.; Weak electrical current (~2mA) is applied to the scalp using anodal and cathodal electrode sponges, which increase or decrease cortical excitability respectively. Sham stimulation will serve as a control condition with current applied only for the first and last 30 seconds of the 20-minute session.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary purpose: Treatment