De Panfilis Chiara, Lisco Alessandro, Meehan Kevin B, Gerra Maria Lidia, Preti Emanuele, Riva Paolo, Romero Lauro Leonor Josefina
Unit of Neuroscience, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy.
Ospedale Maria Luigia, 43126 Monticelli Terme, Italy.
Brain Sci. 2025 May 20;15(5):530. doi: 10.3390/brainsci15050530.
Borderline Personality Disorder (BPD) is a debilitating mental health condition characterized by emotional dysregulation and interpersonal dysfunction, with perceived social rejection exacerbating these issues. Emerging evidence suggests that a single session of transcranial direct current stimulation (tDCS) over the right ventrolateral prefrontal cortex (rVLPFC) may decrease the unique tendency of BPD patients to feel rejected even when socially included during a laboratory task.
This protocol outlines a double-blind, sham-controlled study evaluating the longitudinal effects of repeated anodal tDCS over the right ventrolateral prefrontal cortex (rVLPFC) on rejection-related emotions (RRE) during real-life social interactions in individuals with BPD.
Sixty BPD patients will be randomized to receive real or sham tDCS across 10 daily sessions, coupled with an ecological momentary assessment (EMA) protocol capturing emotional and behavioral responses to real-life social interactions over four timepoints: baseline, during treatment, ten days post-treatment, and three months post-treatment. Primary outcomes include changes in RRE, with exploratory analyses examining feelings of social connection, aggressive tendencies, trust toward others, and interpersonal and affective dynamics. Multilevel modeling will assess temporal and group-level effects. Expected Results and Impact: This study aims to establish the efficacy of tDCS in reducing BPD patients' negative emotional response in real-life social situations and to determine whether such effects are maintained in time. The findings could advance the clinical application of tDCS as an adjunctive intervention to alleviate social-emotional impairments in BPD, addressing gaps in current treatment approaches and guiding future research into the neural mechanisms of social emotion regulation.
边缘型人格障碍（BPD）是一种使人衰弱的心理健康状况，其特征为情绪失调和人际功能障碍，而感知到的社会排斥会加剧这些问题。新出现的证据表明，对右侧腹外侧前额叶皮层（rVLPFC）进行单次经颅直流电刺激（tDCS）可能会降低BPD患者即使在实验室任务中被社会接纳时仍感到被排斥的独特倾向。
本方案概述了一项双盲、假刺激对照研究，评估对右侧腹外侧前额叶皮层（rVLPFC）重复进行阳极tDCS对BPD个体在现实生活社交互动中与排斥相关情绪（RRE）的纵向影响。
60名BPD患者将被随机分配，在为期10天的疗程中接受真实或假tDCS，并结合一项生态瞬时评估（EMA）方案，该方案在四个时间点捕捉对现实生活社交互动的情绪和行为反应：基线、治疗期间、治疗后10天和治疗后3个月。主要结局包括RRE的变化，探索性分析将考察社会联结感、攻击倾向、对他人的信任以及人际和情感动态。多层次建模将评估时间和组水平效应。预期结果和影响：本研究旨在确定tDCS在减少BPD患者在现实生活社交情境中负面情绪反应方面的疗效，并确定这种效果是否能长期维持。这些发现可能会推动tDCS作为一种辅助干预措施在临床上的应用，以减轻BPD患者的社会情感障碍，填补当前治疗方法的空白，并指导未来对社会情绪调节神经机制的研究。
