Smits Fenne M, Geuze Elbert, Schutter Dennis J L G, van Honk Jack, Gladwin Thomas E
Brain Research & Innovation Centre, Ministry of Defence, Utrecht, the Netherlands.
Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands.
Psychol Med. 2021 Mar 24;52(16):1-11. doi: 10.1017/S0033291721000817.
Post-traumatic stress disorder (PTSD), anxiety, and impulsive aggression are linked to transdiagnostic neurocognitive deficits. This includes impaired inhibitory control over inappropriate responses. Prior studies showed that inhibitory control can be improved by modulating the right inferior frontal gyrus (IFG) with transcranial direct current stimulation (tDCS) in combination with inhibitory control training. However, its clinical potential remains unclear. We therefore aimed to replicate a tDCS-enhanced inhibitory control training in a clinical sample and test whether this reduces stress-related mental health symptoms.
In a preregistered double-blind randomized-controlled trial, 100 active-duty military personnel and post-active veterans with PTSD, anxiety, or impulsive aggression symptoms underwent a 5-session intervention where a stop-signal response inhibition training was combined with anodal tDCS over the right IFG for 20 min at 1.25 mA. Inhibitory control was evaluated with the emotional go/no-go task and implicit association test. Stress-related symptoms were assessed by self-report at baseline, post-intervention, and after 3-months and 1-year follow-ups.
Active relative to sham tDCS neither influenced performance during inhibitory control training nor on assessment tasks, and did also not significantly influence self-reported symptoms of PTSD, anxiety, impulsive aggression, or depression at post-assessment or follow-up.
Our results do not support the idea that anodal tDCS over the right IFG at 1.25 mA enhances response inhibition training in a clinical sample, or that this tDCS-training combination can reduce stress-related symptoms. Applying different tDCS parameters or combining tDCS with more challenging tasks might provide better conditions to modulate cognitive functioning and stress-related symptoms.
创伤后应激障碍（PTSD）、焦虑和冲动攻击与跨诊断神经认知缺陷有关。这包括对不适当反应的抑制控制受损。先前的研究表明，通过经颅直流电刺激（tDCS）调节右侧额下回（IFG）并结合抑制控制训练，可以改善抑制控制。然而，其临床潜力仍不明确。因此，我们旨在在临床样本中重复tDCS增强的抑制控制训练，并测试这是否能减轻与压力相关的心理健康症状。
在一项预先注册的双盲随机对照试验中，100名患有PTSD、焦虑或冲动攻击症状的现役军人和退伍军人接受了为期5节的干预，其中停止信号反应抑制训练与1.25 mA的阳极tDCS在右侧IFG上进行20分钟相结合。通过情绪go/no-go任务和内隐联想测验评估抑制控制。在基线、干预后、3个月和1年随访时通过自我报告评估与压力相关的症状。
与假tDCS相比，主动tDCS既不影响抑制控制训练期间的表现，也不影响评估任务的表现，在评估后或随访时也未显著影响PTSD、焦虑、冲动攻击或抑郁的自我报告症状。
我们的结果不支持以下观点，即1.25 mA的右侧IFG阳极tDCS可增强临床样本中的反应抑制训练，或这种tDCS训练组合可减轻与压力相关的症状。应用不同的tDCS参数或将tDCS与更具挑战性的任务相结合可能会为调节认知功能和与压力相关的症状提供更好的条件。
