Neuropsychological Perspectives on FDA-Approved At-Home Brain Stimulation for Depression: Integrating Music-Based Auditory Stimulation

Major Depressive Disorder (MDD) is being increasingly viewed as a network-level pathology of the brain involving dysfunctional neural connections, neuroplasticity impairments, as well as a lack of executive control of emotional processes. In December 2024, the U.S. FDA approved the at-home transcranial direct current stimulation device (tDCS) 'Flow Neuroscience’s FL-100' for the treatment of moderate to severe depressive disorders in adults. The advent of this non-pharmacological approach represents a paradigmatic shift in circuit-level therapies for depression. In this paper, we investigate the neuropsychological basis of the FDA’s approval of the FL-100 device within a modern conceptualization of depression involving disruptions in the regulatory circuitry of the prefrontal and limbic systems of the brain. In addition, this study advances a theoretically well-grounded multi-modal approach to integrate transcranial stimulation using music-driven auditory stimulation as a primary state-dependent amplifier of the electromagnetic impacts of FL-100 stimulation of underlying emotional, reward, as well as executive neural networks of the brain, as supported by empirical evidence in cognitive neuroscience, affective neuropsychology, as well as research in non-invasive brain stimulation techniques.