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Transcranial direct current stimulation (tDCS) is a promising non-invasive treatment for bipolar depression that is portable, safe, and suitable for use at home. We developed a home-based tDCS protocol with real-time remote supervision and examined its effect on QoL in bipolar depression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In an open\u2010label design, 44 participants (31 women) with bipolar depression of at least a moderate severity received 21 sessions of home\u2010based tDCS (2 mA, 30 min, F3 anode\/F4 cathode) over 6 weeks, with a follow-up visit conducted 5 months from baseline. QoL was assessed using the quality of life enjoyment and satisfaction questionnaire (Q-LES-Q) at baseline, week 2, end of treatment, and follow-up session. Baseline and post treatment scores were compared with healthy control participants (28 adults; 17 women).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At baseline and at the end of treatment, bipolar participants showed a significantly lower Q-LES-Q score than healthy controls (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Within the bipolar group, there was a significant improvement in total Q-LES-Q scores (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and across multiple domains by week 6 and remained elevated at follow-up. Changes in Q-LES-Q were no longer significant after adjustment for depressive symptoms.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A 6-week course of supervised home-based tDCS was associated with significant QoL improvements in bipolar depression, which appeared to be closely linked to reduction in depressive symptoms. Randomized, sham\u2010controlled trials are warranted to clarify the specific contribution of tDCS to improve QoL in bipolar depression.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11136-025-04135-2","type":"journal-article","created":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T08:54:46Z","timestamp":1767948886000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Home-based transcranial direct current stimulation (tDCS) for bipolar depression: effects on quality of life and functioning\u2014an open-label study"],"prefix":"10.1007","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-4516-5823","authenticated-orcid":false,"given":"Hakimeh","family":"Rezaei","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel D.","family":"Woodham","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali-Reza","family":"Ghazi-Noori","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elvira","family":"Bramon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Bauer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Allan H.","family":"Young","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cynthia H. 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Author CF acknowledges support from National Institute of Mental Health (R01MH134236), Milken Institute Baszucki Brain Research (BD00029), Rosetrees Trust (CF20212104), International Psychoanalytical Association (IPA158102845), and research grant funding from Flow Neuroscience. tDCS devices were provided by Flow Neuroscience. Author AY reports the following declaration of interests: Paid lectures and advisory boards for the following companies with drugs used in affective and related disorders: Flow Neuroscience, Novartis, Roche, Janssen, Takeda, Noema pharma, Compass, Astrazenaca, Boehringer Ingelheim, Eli Lilly, LivaNova, Lundbeck, Sunovion, Servier, Livanova, Janssen, Allegan, Bionomics, Sumitomo Dainippon Pharma, Sage, Neurocentrx. Principal Investigator for the following studies: (1) the Restore-Life VNS registry study funded by LivaNova; (2) ESKETINTRD3004: \u201cAn Open-label, Long-term, Safety and Efficacy Study of Intranasal Esketamine in Treatment-resistant Depression\u201d; (3) The Effects of Psilocybin on Cognitive Function in Healthy Participants; (4) The Safety and Efficacy of Psilocybin in Participants with Treatment-Resistant Depression (P-TRD); (5) A Double- Blind, Randomized, Parallel-Group Study with Quetiapine Extended Release as Comparator to Evaluate the Efficacy and Safety of Seltorexant 20 mg as Adjunctive Therapy to Antidepressants in Adult and Elderly Patients with Major Depressive Disorder with Insomnia Symptoms Who Have Responded Inadequately to Antidepressant Therapy. (Janssen); (6) An Open-label, Long-term, Safety and Efficacy Study of Aticaprant as Adjunctive Therapy in Adult and Elderly Participants with Major Depressive Disorder (MDD). (Janssen); (7) A Randomized, Double-blind, Multicentre, Parallel-group, Placebo-controlled Study to Evaluate the Efficacy, Safety, and Tolerability of Aticaprant 10 mg as Adjunctive Therapy in Adult Participants with Major Depressive Disorder (MDD) with Moderate-to-severe Anhedonia and Inadequate Response to Current Antidepressant Therapy; (8) A Study of Disease Characteristics and Real-life Standard of Care Effectiveness in Patients with Major Depressive Disorder (MDD) With Anhedonia and Inadequate Response to Current Antidepressant Therapy Including an SSRI or SNR. (Janssen). UK Chief Investigator for the following studies: (1) Novartis MDD study MIJ821A12201; (2) Compass; COMP006 & COMP007 studies. Grant funding (past and present): NIMH (USA); CIHR (Canada); NARSAD (USA); Stanley Medical Research Institute (USA); MRC (UK); Wellcome Trust (UK); Royal College of Physicians (Edin); BMA (UK); UBC-VGH Foundation (Canada); WEDC (Canada); CCS Depression Research Fund (Canada); MSFHR (Canada); NIHR (UK). Janssen (UK) EU Horizon 2020. Editor of Journal of Psychopharmacology and Deputy Editor, BJPsych Open. No shareholdings in pharmaceutical companies.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The study was conducted in accordance with the Code of Ethics of the World Medical Association (Declaration of Helsinki) and approved by the London Fulham Research Ethics Committee (21\/LO\/0910). All participants provided written informed consent for their participation. The privacy and rights of human subjects was observed at all times.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval and consent to participate"}},{"value":"Not applicable.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}}],"article-number":"33"}}