The impact of transcranial Direct Current stimulation on rumination: A systematic review of the sham-controlled studies in healthy and clinical samples

Abstract

Introduction: Broadly considered a transdiagnostic feature of psychological disorders, rumination is associated with lower treatment response, slower recovery rates, and higher relapse rates. Accordingly, research has focused on the development of interventions to alleviate rumination. Recently, transcranial Direct Current Stimulation (tDCS) has emerged as a promising tool to do so. Methods: We performed a systematic review of sham-controlled tDCS studies targeting rumination among healthy participants or patients with psychiatric disorders, investigating the effectiveness of tDCS in reducing rumination, and assessing the research quality of this nascent field. Results: We identified nine studies, with five reporting a significant impact of tDCS on rumination. We also outlined a few tDCS parameters (e.g., stimulation duration, electrode size) and research methods' features (e.g., within- versus between-research designs) characterizing those positive-finding studies. However, these studies were characterized by substantial heterogeneity (e.g., methodological flaws, lack of open science practices), precluding any definite statement about the best way to target rumination via tDCS. Moreover, several strong methodological limitations were also present across those studies. Discussion: Although our systematic review identifies the strengths and weaknesses of the available research about the impact of tDCS on rumination, it calls for strong efforts to improve this nascent field's current methodological caveats. We discuss how open science practices can help to usher this field forward.

Keywords

• Rumination
• Transcranial Direct Current Stimulation
• Neuromodulation
• dlPFC
• Translational neuroscience
• Transdiagnostic psychiatry