Intensified electrical stimulation targeting lateral and medial prefrontal cortices for the treatment of social anxiety disorder: A randomized, double-blind, parallel-group, dose-comparison study
| Autor: | Amir-Homayun Hallajian, Meysam Refahi, Fereshteh Pourmohseni Koluri, Jaber Alizadehgoradel, Mohammad Ali Salehinejad, Elham Ghanavati, Eisa Jafari, Michael A. Nitsche, Carmelo M. Vicario, Ezzatollah Nikoozadehkordmirza, Mina Taherifard, Vahid Nejati |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
VMPFC Biophysics Prefrontal Cortex Neurosciences. Biological psychiatry. Neuropsychiatry Stimulation Dorsolateral prefrontal cortex (DLPFC) Transcranial direct current stimulation (tDCS) Attentional bias Medial prefrontal cortex Social anxiety disorder Audiology Transcranial Direct Current Stimulation Amygdala 050105 experimental psychology 03 medical and health sciences 0302 clinical medicine Double-Blind Method Quality of life medicine Humans 0501 psychology and cognitive sciences business.industry General Neuroscience 05 social sciences Social anxiety Phobia Social Cognition medicine.disease Electric Stimulation medicine.anatomical_structure Quality of Life Neurology (clinical) Hypoactivity business 030217 neurology & neurosurgery Anxiety disorder RC321-571 |
| Zdroj: | Brain Stimulation, Vol 14, Iss 4, Pp 974-986 (2021) Brain stimulation, 14(4):974-986 |
| ISSN: | 1935-861X |
| Popis: | Background Social Anxiety Disorder (SAD) is the most common anxiety disorder while remains largely untreated. Disturbed amygdala-frontal network functions are central to the pathophysiology of SAD, marked by hypoactivity of the lateral prefrontal cortex (PFC), and hypersensitivity of the medial PFC and the amygdala. The objective of this study was to determine whether modulation of the dorsolateral and medial PFC activity with a novel intensified stimulation protocol reduces SAD core symptoms, improves treatment-related variables, and reduces attention bias to threatening stimuli. Methods In this randomized, sham-controlled, double-blind trial, we assessed the efficacy of an intensified stimulation protocol (20 min, twice-daily sessions with 20 min intervals, 5 consecutive days) in two intensities (1 vs 2 mA) compared to sham stimulations. 45 patients with SAD were randomized in three tDCS arms (1-mA, 2-mA, sham). SAD symptoms, treatment-related variables (worries, depressive state, emotion regulation, quality of life), and attention bias to threatening stimuli (dot-probe paradigm) were assessed before and right after the intervention. SAD symptoms were also assessed at 2-month follow-up. Results Both 1-mA and 2-mA protocols significantly reduced fear/avoidance symptoms, worries and improved, emotion regulation and quality of life after the intervention compared to the sham group. Improving effect of the 2-mA protocol on avoidance symptoms, worries and depressive state was significantly larger than the 1-mA group. Only the 2-mA protocol reduced attention bias to threat-related stimuli, the avoidance symptom at follow-up, and depressive states, as compared to the sham group. Conclusions Modulation of lateral-medial PFC activity with intensified stimulation can improve cognitive control, motivation and emotion networks in SAD and might thereby result in therapeutic effects. These effects can be larger with 2-mA vs 1-mA intensities, though a linear relationship between intensity and efficacy should not be concluded. Our results need replication in larger trials. |
| Databáze: | OpenAIRE |
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