Brain Stimulation Trial Raises Questions for Future Depression Care

Jerusalem, 22 October, 2026 (TPS-IL) — Could treating depression at home be as simple as using a device and playing a computer game? A clinical trial by Israeli, Latvian and German researchers suggests the approach is feasible but has yet to show that it works better than a control treatment. Adults with major depression who used brain stimulation while playing a cognitive training game improved no more than participants who received sham stimulation and a control game.

The findings highlight a key challenge for technology-based mental health care: making treatment accessible at home does not mean it is effective.

The DiSCoVeR trial was led by Prof. Mor Nahum of the Hebrew University of Jerusalem, with researchers from Hadassah Medical Center, LMU Munich in Germany, and Riga Stradins University in Latvia. Of 111 adults enrolled at hospitals in Jerusalem, Munich and Riga, 109 were included in the main analysis.

The treatment combined transcranial direct current stimulation (tDCS), which delivers a weak electrical current through electrodes on the scalp, with a computer game designed to train attention, memory and decision-making.

Participants received either active brain stimulation alongside the cognitive training game or sham stimulation, which mimicked the procedure without delivering the active current, alongside a control game without the same cognitive training exercises.

After one to five initial in-person sessions, participants continued treatment at home. They were asked to complete 30 sessions, each lasting 30 minutes, over six weeks.

Feasible, but Not More Effective

The researchers found that patients could largely stick to the routine: 86 participants, or about 79% of those included in the main analysis, completed at least 20 sessions. Across the trial, 2,499 of 2,791 planned sessions were completed.

However, the experimental treatment did not produce greater improvement in depression symptoms. On the Montgomery-Åsberg Depression Rating Scale, a standard measure of depression severity, scores improved by an average of 7.3 points in the active-treatment group and 8.2 points in the control group. The difference was not statistically significant. Similar results were found at the 10-week follow-up.

“Both groups improved substantially, and that is the finding I keep returning to,” Nahum said.

“We still have a great deal to learn about what is actually driving improvement in depression: the neuromodulation, the cognitive training, expectations, engagement, ongoing care, or simply the structure of returning to a treatment every day,” she added. “Our study cannot answer that, but it shows why carefully designed control conditions are essential if we want to find out.”

Improvement in both groups does not establish that either intervention caused the changes. The study could not determine whether symptoms improved because of treatment routines, expectations, ongoing medical care, natural fluctuations in depression or other factors.

Adverse events occurred in both groups, with no statistically significant difference in rates or severity. Two participants in the active-treatment group were hospitalized, one for acute suicidal thoughts and the other for worsening depression. Researchers considered both events unlikely to be related to treatment.

Participants who believed they had received the control treatment tended to show less improvement, regardless of their actual assignment. The researchers cautioned that this association does not establish whether expectations influenced recovery or whether participants guessed their treatment group based on their progress.

The findings were published in the peer-reviewed journal JAMA Network Open.