In an interview with HCPLive, 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 major depressive disorder (MDD) 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."
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
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.2 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
References
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. Mol Psychiatry. 2026;31(8):4632-4644. doi:10.1038/s41380-026-03560-0
