¹The Catholic University of Korea, Department of Psychiatry, Seoul, Korea, Republic of

Background: Transcranial direct current stimulation (tDCS) has demonstrated antidepressant efficacy comparable to established neuromodulation techniques and pharmacotherapy in major depressive disorder. However, most clinical evidence is based on clinic-based administration, which limits accessibility and adherence, particularly for treatments requiring frequent sessions. Home-based, self-administered tDCS may overcome these barriers by leveraging the portability and favorable safety profile of tDCS, yet clinical evidence supporting its effectiveness remains limited. This multicenter trial was designed to evaluate whether patient-administered tDCS delivered at home can meaningfully improve depressive symptoms in patients with major depressive disorder.

Aims & Objectives: The primary aim of this study was to evaluate the clinical effectiveness of home-based, self-administered tDCS in patients with major depressive disorder. Specifically, we sought to assess changes in depressive symptom severity over a six-week treatment period using validated self-report and clinician-rated scales. Secondary objectives included examining treatment adherence, symptom trajectory over time, and the safety and tolerability of unsupervised tDCS administered in a real-world home setting.

Method: This single-arm, multicenter clinical trial enrolled patients with major depressive disorder. Participants were trained to self-administer tDCS at home and received treatment once daily for 30 minutes, 5–7 days per week, over six weeks. Stimulation was delivered to the dorsolateral prefrontal cortex at 1.5–2.0 mA. Depressive and anxiety symptoms were assessed at baseline and at 2, 4, and 6 weeks using validated self-report and clinician-rated scales. Treatment adherence and adverse events were systematically monitored.

Results: A total of 61 participants were included in the full analysis. Depressive symptoms significantly improved over the six-week treatment period, with mean scores on validated depression scales decreasing from baseline at weeks 2, 4, and 6 (all p < 0.001). Remission was achieved by 57.4% of participants in the full-analysis group and 62.8% in the per-protocol group. Anxiety symptoms also showed significant improvement. Treatment adherence was not significantly associated with remission rates. Most adverse events were mild and transient, indicating good tolerability of home-based, self-administered tDCS.

Discussion & Conclusions: This multicenter study suggests that home-based, self-administered transcranial direct current stimulation may be an effective and well-tolerated acute treatment for patients with major depressive disorder. Significant improvements in depressive and anxiety symptoms were observed over six weeks without serious adverse events. Although the single-arm design limits causal inference, the findings support the feasibility and potential clinical utility of unsupervised tDCS in real-world settings. Home-based tDCS may expand access to neuromodulation treatments and serve as a scalable option for patients with limited ability to attend frequent clinic visits.