Department of Psychology, Clinical Psychology and Psychotherapy, Ludwig-Maximilians-Universität München, Germany; Department of Psychology, Clinical Psychology and Psychotherapy, University of Tübingen, Germany.
Department of Psychology, Clinical Psychology and Psychotherapy, University of Tübingen, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität, Humboldt-Universität zu Berlin, And Berlin Institute of Health, Campus Benjamin Franklin, Germany.
Neuropsychologia. 2021 Jun 18;156:107850. doi: 10.1016/j.neuropsychologia.2021.107850. Epub 2021 Apr 1.
Deficient cognitive control (CC) over emotional distraction is a central characteristic of borderline personality disorder (BPD). Reduced activation of the left dorsolateral prefrontal cortex (dlPFC) has been linked to this deficit. This study investigates whether it is possible to ameliorate CC deficits via anodal tDCS over the left dlPFC in BPD. Furthermore, we investigate whether the extent of CC impairment influences how well one responds to tDCS.
The effect of a single-session tDCS (1 mA for 20 min, reference electrode on the contralateral mastoid bone) to the left dlPFC (F3) on the CC of patients with BPD (N = 20) and healthy control participants (HCs, N = 20) was examined in a double-blinded, balanced randomized, sham-controlled crossover trial. A delayed response working memory task with negative, neutral and positive pictures presented during the delay period was conducted to assess CC. Stimulation was applied simultaneously with the task.
Negative pictures caused prolonged response times as compared to a control condition in patients with BPD and HCs. Anodal tDCS to the left dlPFC did not significantly reduce this interference effect in the overall sample. Further analyses showed, however, that participants with impaired CC profited the most from anodal tDCS. In the subgroup of participants who actually showed an interference effect we found the expected significant amelioration of CC under tDCS.
The present study demonstrates that anodal tDCS applied to the left dlPFC improves deficient CC. Thereby, base-level performance moderates tDCS effects. Hence, tDCS might be suitable to support behavioral trainings to enhance CC specifically in people whose impairments in CC are comparably high.
情绪分心的认知控制（CC）不足是边缘型人格障碍（BPD）的一个核心特征。左背外侧前额叶皮层（dlPFC）的激活减少与这种缺陷有关。这项研究调查了通过左 dlPFC 的阳极经颅直流电刺激（tDCS）是否可以改善 BPD 中的 CC 缺陷。此外，我们还调查了 CC 损伤的程度如何影响人们对 tDCS 的反应。
在一项双盲、平衡、随机、假对照交叉试验中，检查了单次 tDCS（1 mA 持续 20 分钟，参考电极置于对侧乳突骨）对 BPD 患者（N=20）和健康对照组（HCs，N=20）左 dlPFC（F3）的 CC 影响。使用延迟反应工作记忆任务，在延迟期间呈现负性、中性和正性图片，以评估 CC。刺激与任务同时进行。
与对照组相比，BPD 患者和 HCs 的负性图片会导致反应时间延长。左 dlPFC 的阳极 tDCS 并没有显著降低整体样本的这种干扰效应。然而，进一步的分析表明，CC 受损的参与者从阳极 tDCS 中获益最多。在实际上表现出干扰效应的参与者亚组中，我们发现 tDCS 下 CC 得到了预期的显著改善。
本研究表明，应用于左 dlPFC 的阳极 tDCS 可改善 CC 缺陷。因此，基础水平的表现调节了 tDCS 的效果。因此，tDCS 可能适合支持行为训练，以增强 CC，特别是在 CC 损伤相对较高的人群中。
