多疗程经颅直流电刺激对压力调节和情绪工作记忆的影响：一项针对健康军事人员的随机对照试验

Effects of Multisession Transcranial Direct Current Stimulation on Stress Regulation and Emotional Working Memory: A Randomized Controlled Trial in Healthy Military Personnel.

作者信息

Smits Fenne M, Geuze Elbert, de Kort Guido J, Kouwer Karlijn, Geerlings Lisa, van Honk Jack, Schutter Dennis J L G

机构信息

Brain Research & Innovation Centre, Ministry of Defence, Utrecht, The Netherlands; Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands.

出版信息

Neuromodulation. 2023 Jun;26(4):817-828. doi: 10.1016/j.neurom.2022.05.002. Epub 2022 Aug 1.

DOI:10.1016/j.neurom.2022.05.002

PMID:35927162

Abstract

OBJECTIVES

Top-down stress regulation, important for military operational performance and mental health, involves emotional working memory and the dorsolateral prefrontal cortex (DLPFC). Multisession transcranial direct current stimulation (tDCS) applied over the DLPFC during working memory training has been shown to improve working memory performance. This study tested the hypothesis that combined tDCS with working memory training also improves top-down stress regulation. However, tDCS response differs between individuals. Resting-state electrophysiological brain activity was post hoc explored as a possible predictor of tDCS response. The predictive value of the ratio between slow-wave theta oscillations and fast-wave beta oscillations (theta/beta ratio) was examined, together with the previously identified tDCS response predictors age, education, and baseline working memory performance.

MATERIALS AND METHODS

Healthy military service members (n = 79) underwent three sessions of real or sham tDCS over the right DLPFC (anode: F4, cathode: behind C2) at 2 mA for 20 minutes during emotional working memory training (N-back task). At baseline and within a week after the tDCS training sessions, stress regulation was assessed by fear-potentiated startle responses and subjective fear in a threat-of-shock paradigm with instructed emotional downregulation. Results were analyzed in generalized linear mixed-effects models.

RESULTS

Threat-of-shock responses and emotional working memory performance showed no significant group-level effects of the real vs sham tDCS training intervention (p > 0.07). In contrast, when considering baseline theta/beta ratios or the other tDCS response predictors, exploratory results showed a trait-dependent beneficial effect of tDCS on emotional working memory training performance during the first session (p < 0.01).

CONCLUSIONS

No evidence was found for effectivity of the tDCS training intervention to improve stress regulation in healthy military personnel. The emotional working memory training results emphasize the importance of studying the effects of tDCS in relation to individual differences.

CLINICAL TRIAL REGISTRATION

This study was preregistered on September 16, 2019, at the Netherlands Trial Register (www.trialregister.nl) with ID: NL8028.

摘要

目的

自上而下的应激调节对军事作战表现和心理健康至关重要，涉及情绪工作记忆和背外侧前额叶皮层（DLPFC）。在工作记忆训练期间，对DLPFC施加多疗程经颅直流电刺激（tDCS）已被证明可改善工作记忆表现。本研究检验了以下假设：tDCS与工作记忆训练相结合也能改善自上而下的应激调节。然而，个体之间的tDCS反应存在差异。事后探索静息状态下的脑电生理活动作为tDCS反应的可能预测指标。研究了慢波θ振荡与快波β振荡之比（θ/β比值）的预测价值，以及先前确定的tDCS反应预测指标年龄、教育程度和基线工作记忆表现。

材料与方法

健康军人（n = 79）在情绪工作记忆训练（N-back任务）期间，接受了三次对右侧DLPFC（阳极：F4，阴极：C2后方）施加2 mA、持续20分钟的真刺激或假刺激tDCS。在基线时以及tDCS训练疗程结束后一周内，通过惊吓增强反应和在电击威胁范式中进行情绪下调指导下的主观恐惧来评估应激调节。结果在广义线性混合效应模型中进行分析。