{
  "abstract": "Introduction Major depressive disorder (MDD) is the most common comorbidity among individuals with borderline personality disorder (BPD), affecting over 85% of patients and leading to high recurrence rates and resistance to treatment. Traditional pharmacological and psychotherapeutic interventions often show limited efficacy in this population, highlighting the need for innovative treatment strategies. Emerging evidence suggests that the dorsolateral prefrontal cortex (DLPFC) plays a crucial role in the pathophysiology of both MDD and BPD. In addition, non-invasive brain stimulation, particularly transcranial Direct Current Stimulation (tDCS), has shown promising results in alleviating depression and improving BPD symptoms when targeting the DLPFC. The development of home-based tDCS presents new opportunities for accessible and cost-effective interventions. However, no study has specifically investigated its effects on MDD in the context of BPD.Methods and analysis This double-blind randomised controlled trial will assess the feasibility and explore the efficacy of home-based tDCS in reducing depressive symptoms in BPD patients who are experiencing moderate to severe depressive episodes. A total of 60 participants will be randomised, following a 2-week online psychoeducation, to receive either active or sham tDCS in 14 sessions over 1 week. The primary outcome is the feasibility of home-based tDCS in remote and urban areas. The secondary aim is to obtain a preliminary assessment of the efficacy of 14 home-based tDCS sessions in reducing depressive symptoms in BPD patients with moderate to severe depressive episodes and BPD symptoms. Exploratory analyses will evaluate the impact of tDCS on neuropsychological functioning, physical activity and substance use. Sociodemographic variables will be considered in predicting treatment response. All assessments will be conducted at baseline, post-treatment and during follow-ups through 3 months after treatment ends.Ethics and dissemination This study has received approval from the Research Ethics Committee of the Centre intégré universitaire de santé et de services sociaux de l’Est-de-l’Île-de-Montréal (CIUSSS-EMTL) (approval number: MP-12-2025-4050). All participants will provide informed consent prior to inclusion. Findings will be disseminated through peer-reviewed publications, conference presentations and knowledge translation activities targeting clinicians, researchers and mental health stakeholders.Trial registration number NCT06972368.",
  "authors": [
    {
      "affiliations": [
        "Département de psychiatrie et d’addictologie, Université de Montréal, Montreal, Quebec, Canada",
        "Département de psychiatrie et d’addictologie, CR-IUSMM, Montreal, Quebec, Canada",
        "Centre de Recherche CERVO, Québec City, Québec, Canada",
        "CIUSSS de l’Est-de-l’Île-de-Montréal, Institut Universitaire en Santé Mentale de Montréal, Montreal, Quebec, Canada"
      ],
      "name": "Lionel Cailhol"
    },
    {
      "affiliations": [
        "Département de psychiatrie et d’addictologie, Université de Montréal, Montreal, Quebec, Canada",
        "Département de psychiatrie et d’addictologie, CR-IUSMM, Montreal, Quebec, Canada"
      ],
      "name": "Kamilia Soltani"
    },
    {
      "affiliations": [
        "Department of Psychiatry, McGill University, Montreal, Quebec, Canada",
        "Douglas Research Centre, Montreal, Quebec, Canada",
        "Douglas Mental Health University Institute, Montreal, Quebec, Canada"
      ],
      "name": "David Benrimoh"
    },
    {
      "affiliations": [
        "ADDIPSY, Groupe Santé Basque Développement, Lyon, France",
        "Centre de Recherche en Épidémiologie et Santé des Populations, Villejuif, France"
      ],
      "name": "Martin Blay"
    },
    {
      "affiliations": [
        "Centre de Recherche CERVO, Québec City, Québec, Canada",
        "Department of Psychiatry, Laval University, Québec City, Québec, Canada",
        "IUSMQ, Québec City, Québec, Canada"
      ],
      "name": "Sebastien Brodeur"
    },
    {
      "affiliations": [
        "PSYR2, CH Le Vinatier, Bron, France"
      ],
      "name": "Jérôme Brunelin"
    },
    {
      "affiliations": [
        "CISSS des Laurentides, Saint-Jérôme, Quebec, Canada"
      ],
      "name": "Caroline Dussault"
    },
    {
      "affiliations": [
        "Centre de Recherche CERVO, Québec City, Québec, Canada",
        "Department of Psychiatry, Laval University, Québec City, Québec, Canada"
      ],
      "name": "Roxane Hoyer"
    },
    {
      "affiliations": [
        "CIUSSS de l’Est-de-l’Île-de-Montréal, Institut Universitaire en Santé Mentale de Montréal, Montreal, Quebec, Canada"
      ],
      "name": "Jillian Mills"
    },
    {
      "affiliations": [
        "Département de psychiatrie et d’addictologie, Université de Montréal, Montreal, Quebec, Canada",
        "CIUSSS de l’Est-de-l’Île-de-Montréal, Institut Universitaire en Santé Mentale de Montréal, Montreal, Quebec, Canada"
      ],
      "name": "Simon Poirier"
    },
    {
      "affiliations": [
        "Département de psychiatrie et d’addictologie, Université de Montréal, Montreal, Quebec, Canada",
        "Département de psychiatrie et d’addictologie, CR-IUSMM, Montreal, Quebec, Canada"
      ],
      "name": "Stephane Potvin"
    },
    {
      "affiliations": [
        "Department of Psychiatry, Laval University, Québec City, Québec, Canada",
        "IUSMQ, Québec City, Québec, Canada"
      ],
      "name": "David Roy"
    },
    {
      "affiliations": [
        "Centre de Recherche CERVO, Québec City, Québec, Canada",
        "Department of Psychiatry, Laval University, Québec City, Québec, Canada",
        "IUSMQ, Québec City, Québec, Canada"
      ],
      "name": "Olivier Roy"
    },
    {
      "affiliations": [
        "Department of Psychology, University of Toronto, Toronto, Ontario, Canada"
      ],
      "name": "Anthony Ruocco"
    },
    {
      "affiliations": [
        "Centre de Recherche CERVO, Québec City, Québec, Canada",
        "Faculty of Education, Université Laval, Québec, Québec, Canada"
      ],
      "name": "Claudia Savard"
    },
    {
      "affiliations": [
        "Département de psychiatrie et d’addictologie, CR-IUSMM, Montreal, Quebec, Canada",
        "Department of Kinesiology, Université du Québec à Rimouski, Rimouski, Quebec, Canada"
      ],
      "name": "Samuel St-Amour"
    },
    {
      "affiliations": [
        "Centre de Recherche CERVO, Québec City, Québec, Canada",
        "Department of Psychiatry, Laval University, Québec City, Québec, Canada",
        "GIGA Consciousness Research Unit and Coma Science Group Liège, Université de Liège, Liège, Belgium",
        "International Consciousness Science Institute, Hangzhou Dianzi University, Hangzhou, Zhejiang, China"
      ],
      "name": "Steven Laureys"
    }
  ],
  "title": "Enhanced home-based transcranial direct-current stimulation (tDCS) for depression comorbid with borderline personality disorder (BPD): study protocol for a pilot double-blinded randomised controlled trial (TENTADIS)",
  "uid": "2411fcf6-3883-5bf4-b1d7-57753231dbac"
}