Mohammad Ali Salehinejad, PhD, from the department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy at RWTH Aachen University.

Mohammad Ali Salehinejad, PhD

 Mohammad Ali Salehinejad, PhD, from the department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy at RWTH Aachen University, said computational modeling could allow an optimized multichannel transcranial direct current stimulation (tDCS) protocol for

 to scale toward home-based use without patient-specific MRI, provided clinicians supervise treatment.¹

"One of the current trends in cognitive neuroscience and psychiatry is to use individualized and personalized intervention for each patient. This means we need to record 1 MRI from each patient and adjust intervention based on the person's MRI, which is a very source-demanding approach not feasible in many clinics and clinical settings," Salehinejad said. "By computational modeling, we can optimize a protocol without needing individualized MRI or other source-demanding steps and provide a more effective intervention compared with conventional intervention."

Multichannel tDCS Shows Path to Scalable Use in MDD

The 4 mA multichannel montage, delivered through 7 electrodes and shaped with a template head model, produced a 75% response rate compared with 45% for conventional 2 mA tDCS in a randomized, sham-controlled trial of 71 adults with unipolar, nonpsychotic MDD.¹

Template-Based tDCS Targeting Versus Individualized MRI

Salehinejad said this template-based approach removes barriers and preserves much of the targeting benefit of the MRI-based tDCS. The multichannel protocol's faster and larger symptom reductions relative to conventional 2-electrode tDCS support the premise a non-individualized but optimized montage can outperform standard dosing without added imaging burden.¹ Salehinejad said this positions the protocol for settings where personalized MRI-based targeting remains impractical.

Durability and Path to Home-Based tDCS Use

Does optimized multichannel tDCS require individualized MRI targeting?


No. The protocol uses computational modeling on a template head model rather than patient-specific MRI, making it more feasible to deploy in clinics without imaging resources.

Can optimized multichannel tDCS be used at home?


Salehinejad said it can, but only with a clinician uploading the stimulation protocol to the device software and supervising treatment, given the higher current intensity involved.

How durable is the treatment response to multichannel tDCS?


Symptom improvement was sustained through the 3-month follow-up in the trial, and longer-term data are planned in future studies.

Symptom improvement with multichannel tDCS held through the 3-month follow-up in the trial, and Salehinejad said longer follow-up is a priority for future work. He noted trials in this space typically extend follow-up to 6 months, and future studies, including his own group's planned work, need longer observation windows to establish how long the therapeutic effect persists.

Salehinejad pointed to tDCS's portability as an advantage over repetitive transcranial magnetic stimulation (rTMS), particularly for home-based use, an approach that gained traction during the COVID-19 pandemic. He said the optimized multichannel protocol could be used at home if a clinician uploads the stimulation parameters to the device software and supervises treatment, since the higher current intensity should not be self-administered without oversight.

He also noted an FDA-cleared tDCS device already exists for depression, with approval based on a home-application trial.

Flow Neuroscience’s FL-100 The FDA approved Flow Neuroscience’s FL-100 tDCS system on December 11, 2025, which is the first at-home, prescription neuromodulation therapy authorized in the United States for adults with moderate to severe MDD.

"If you are looking for a portable, low-cost, and effective intervention which can be used at home, tDCS is a really good option," Salehinejad said. "This FDA approval for tDCS comes from a home-application trial, which means it can be used at home."

Read more about the trial data in part 1: 

Optimized Multichannel tDCS Beats Conventional Protocol in MDD

Salehinejad MA, Abdi M, Dadashi M, et al. Optimized multichannel 4 mA vs conventional transcranial direct current stimulation for major depressive disorder: A randomized sham-controlled trial. 

Halsey G. FDA Clears First At-Home Brain-Stimulation Device for Major Depression. Patient Care Online. Published December 11, 2025. Accessed September 10, 2026. 

https://www.patientcareonline.com/view/fda-clears-first-at-home-brain-stimulation-device-for-major-depression

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Mohammad Ali Salehinejad, PhD, explains how template-based targeting could extend optimized multichannel tDCS to broader clinical and home-based care.

An optimized multichannel transcranial direct current stimulation (tDCS) protocol delivering 4 mA (precisely 3.99 mA) total injected current produced significantly greater and faster reductions in depressive symptoms than conventional 2 mA tDCS or sham stimulation in a randomized, sham-controlled trial of patients with 

Prior home-based conventional tDCS trials have shown efficacy without the precision of individualized targeting.

 Fully personalized, MRI-based tDCS protocols improve targeting but remain resource-intensive and difficult to scale in routine care. The multichannel montage tested in this trial used computational modeling on a template head model rather than patient-specific imaging, pairing improved targeting with clinical feasibility.¹

"Both interventions showed clinical improvement, but the multichannel intervention showed earlier and stronger effect, which means the depression symptom was relieved earlier," said Mohammad Ali Salehinejad, PhD, from the department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy at RWTH Aachen University, in an interview with 

Multichannel tDCS Efficacy in Major Depressive Disorder

The trial randomized 71 adults with unipolar, nonpsychotic MDD who failed ≥ 1 antidepressant to have optimized multichannel tDCS (4 mA via 7 small electrodes), conventional tDCS (2 mA via 2 sponge electrodes), or sham stimulation. Sixty patients provided endpoint data (n = 20 per arm), and all participants received 30 daily sessions over 6 weeks.

Depressive symptoms were assessed via the Montgomery-Åsberg Depression Rating Scale (MADRS) and Hamilton Depression Rating Scale (HDRS) at baseline, sessions 10, 20, and 30, and at 1- and 3-month follow-up. Multichannel tDCS reduced MADRS scores by a mean of 21.50 points (95% CI, 17.77-25.22) by week 6, compared with 13.50 points (95% CI, 10.44-16.55) for conventional tDCS and 6.30 points (95% CI, 3.42-9.17) for sham (group×time interaction, 

Treatment response, defined as a ≥ 50% reduction in MADRS score, occurred in 75% (15/20) of the multichannel group compared with 45% (9/20) for conventional tDCS and 20% (4/20) for sham, yielding a number needed to treat of 2 (95% CI, 1-3) for multichannel tDCS versus sham. Symptom reduction with multichannel tDCS emerged as early as session 10, while conventional tDCS did not separate from sham until sessions 20 to 30.

Multichannel tDCS Safety, Blinding, and Cognitive Effects


It delivers 4 mA of total injected current through 7 small electrodes targeting the left and right dorsolateral prefrontal cortex, shaped by computational modeling for more precise field targeting than a 2-electrode conventional montage.

How does multichannel tDCS compare with conventional tDCS for MDD?


In this trial, multichannel tDCS produced significantly larger MADRS reductions and an earlier onset of response at session 10, while conventional 2 mA tDCS did not separate from sham until sessions 20 to 30.


No serious adverse events occurred, though the multichannel group reported more frequent transient effects, mainly itching, tingling, and skin redness, tied to its higher current density.

Beck Depression Inventory-II scores followed a similar pattern, decreasing significantly from session 10 in the multichannel group and from session 30 in the conventional group, with no significant change in sham. Multichannel tDCS also improved working memory, sustained attention, and executive function on CANTAB testing, effects not observed with conventional tDCS, and increased frontotemporal and prefrontal-central functional connectivity on EEG.

No serious adverse events occurred in any arm. The multichannel group reported more adverse effects per participant (5.05 ± 0.94) than conventional (2.50 ± 1.15) or sham (2.85 ± 1.04) tDCS, driven mainly by itching, tingling, burning, skin redness, and headache tied to the higher current density at the 7-electrode sites.

Blinding was unsuccessful in the multichannel arm, with 19 of 20 participants correctly identifying active stimulation, while the conventional arm showed chance-level guessing. Guessed treatment intensity was not correlated with symptom improvement within the multichannel arm (

"One possible solution to resolve this issue is to use [a] cream which makes the skin numb,” Salehinejad said. “We sometimes use this so that the people do not understand that they are receiving any stimulation.”

Woodham RD, Selvaraj S, Lajmi N, Hobday H, Sheehan G, Ghazi-Noori AR, Lagerberg PJ, Rizvi M, Kwon SS, Orhii P, Maislin D, Hernandez L, Machado-Vieira R, Soares JC, Young AH, Fu CHY. Home-based transcranial direct current stimulation treatment for major depressive disorder: a fully remote phase 2 randomized sham-controlled trial. Nat Med. 2025 Jan;31(1):87-95. doi: 10.1038/s41591-024-03305-y. Epub 2024 Oct 21. 

A study found 4 mA multichannel tDCS achieved a 75% MDD response rate versus 45% for conventional 2 mA stimulation, Mohammad Ali Salehinejad, PhD, says.

Mohammad Ali Salehinejad, PhD

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