JMIR Publications

ABSTRACT

Background:

Depression during the perinatal period poses significant risks to both maternal and infant health. While transcranial direct current stimulation (tDCS) has shown promise as a safe and well-tolerated intervention for perinatal depression, empirical evidence remains limited, and no prior study has integrated clinical outcomes with continuous objective behavioral monitoring.

Objective:

This pilot study aimed to evaluate the feasibility and preliminary effects of home-based transcranial direct current stimulation (tDCS) combined with wearable monitoring in women with perinatal depression, and to explore the correlation between behavioral and clinical measures.

Methods:

Thirty-eight perinatal women completed a 4-week self-administered tDCS protocol targeting the left dorsolateral prefrontal cortex (DLPFC) with 30-minute daily sessions. Participants continuously wore a wrist-worn device (Fitbit Inspire 2) that passively collected data on step count, distance, calorie expenditure, and heart rate. Depressive symptoms were assessed at baseline, Week 2, and Week 4 using the Montgomery-Åsberg Depression Rating Scale (MADRS) and Beck Depression Inventory (BDI). Linear mixed-effects models and nonparametric tests were used to evaluate changes over time, and correlations between behavioral and clinical variables were analyzed.

Results:

Significant reductions were observed in depressive symptoms from baseline to postintervention. MADRS scores decreased from a mean of 21.3 (SD 5.2) at baseline to 12.3 (SD 8.5) at Week 4 (P<.001), and BDI scores decreased from 24.8 (SD 11.4) to 16.1 (SD 11.2) (P<.001). Physical activity markers increased significantly: step count increased from 2366.8 to 6278.7 steps per day (P<.001), distance from 1564.6 to 4105.9 m per day (P<.001), and calorie expenditure from 1130.6 to 1834.9 kcal per day (P<.001). Resting heart rate decreased from 85.9 to 80.4 beats per minute (P<.01). Exploratory correlation analyses revealed that BDI score reductions, but not MADRS changes, correlated significantly with increases in physical activity indicators (steps: r=0.401, P=.019 at Week 2; r=0.351, P=.039 at Week 4).

Conclusions:

Four weeks of home-based, self-administered tDCS were feasible, well tolerated, and associated with improvements in depressive symptoms and objective behavioral activity among perinatal women. Self-reported symptom changes showed stronger correlations with behavioral outcomes than clinician-rated scores. Although the lack of a control group precludes causal inference, these findings support the feasibility of integrating wearable monitoring with tDCS protocols and warrant further validation in randomized sham-controlled trials. Clinical Trial: Not applicable (exploratory pilot study)