Ahmed Mariam, Delisle Frédérique, Hanafi Lyna, Hudon Alexandre, Brunelin Jerome, Mondino Marine, Potvin Stéphane, Cailhol Lionel
From the Department of Psychiatry and Addictology, Université de Montréal (Ahmed, Hanafi, Hudon, Potvin, Cailhol); Centre de recherche de l'Institut universitaire en santé mentale de Montréal (Ahmed, Delisle, Hanafi, Hudon, Potvin, Cailhol); Department of Psychology, Université de Montréal (Delisle); Institut universitaire en santé mentale de Montréal, Centre intégré universitaire de santé et de services sociaux de l'est-de-l'île-de-Montréal (Hudon, Cailhol); Institut nationale de psychiatrie légale Philippe-Pinel, Montréal, Que. (Hudon); Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de recherche en neurosciences de Lyon CRNL U1028 UMR5292, PsyR2 Team (Brunelin, Mondino); Le vinatier psychiatrie universitaire Lyon Métropole, Bron, France (Brunelin, Mondino, Cailhol); CERVO Brain Research Centre, Québec, Que. (Cailhol)
From the Department of Psychiatry and Addictology, Université de Montréal (Ahmed, Hanafi, Hudon, Potvin, Cailhol); Centre de recherche de l'Institut universitaire en santé mentale de Montréal (Ahmed, Delisle, Hanafi, Hudon, Potvin, Cailhol); Department of Psychology, Université de Montréal (Delisle); Institut universitaire en santé mentale de Montréal, Centre intégré universitaire de santé et de services sociaux de l'est-de-l'île-de-Montréal (Hudon, Cailhol); Institut nationale de psychiatrie légale Philippe-Pinel, Montréal, Que. (Hudon); Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de recherche en neurosciences de Lyon CRNL U1028 UMR5292, PsyR2 Team (Brunelin, Mondino); Le vinatier psychiatrie universitaire Lyon Métropole, Bron, France (Brunelin, Mondino, Cailhol); CERVO Brain Research Centre, Québec, Que. (Cailhol).
J Psychiatry Neurosci. 2025 Aug 26;50(4):E299-E309. doi: 10.1503/jpn.250041. Print 2025 Jul-Aug.
Despite the effectiveness of specialized therapies, people with borderline personality disorder (BPD) continue to face substantial psychosocial challenges, which may be partially attributed to neuropsychological deficits arising from imbalances in the corticolimbic system. Transcranial direct current stimulation (tDCS) targeting the dorsolateral prefrontal cortex (DLPFC) could enhance impulse control, emotional regulation, and cognitive functions; thus, we sought to explore the effectiveness of tDCS combined with online cognitive training on cognitive functions, BPD symptoms, and psychosocial functioning among patients with BPD.
This open-label study recruited adults with BPD who were not undergoing psychotherapy. Participants completed informational psychoeducation sessions, followed by 10 daily sessions of 20-minute tDCS over 2 weeks. Stimulation involved a continuous 2-mA current with the anode over the left DLPFC and the cathode over the right DLPFC. During each session, participants simultaneously engaged in online cognitive training using the Lumosity app (aspredicted.org no. 206 001).
We included 29 participants. We noted significant improvements in cognitive functions, including the Towers of London task (Cohen = -0.38 to -0.78), the Corsi Block-Tapping direct and total scores ( = -0.41 and -0.42, respectively), and the Stroop Interference and Alternance tests ( = 0.80 and 0.94, respectively). Emotional dysregulation showed a substantial reduction ( = 0.44), while impulsivity did not change significantly. Symptoms of BPD decreased ( = 0.69), while general functioning ( = 0.33) and the internal component of BPD functioning improved ( = -0.51).
Although these preliminary findings are encouraging, further controlled studies are necessary to validate the efficacy and long-term effect of the intervention.
This combined approach appears to be well tolerated and produced promising short-term improvements in cognitive performance, BPD symptoms, and overall functioning. The results underscore the relevance of the left DLPFC in developing neuropsychologically integrative interventions for BPD.
尽管有专门的治疗方法，但边缘型人格障碍（BPD）患者仍面临重大的社会心理挑战，这可能部分归因于皮质边缘系统失衡导致的神经心理学缺陷。针对背外侧前额叶皮质（DLPFC）的经颅直流电刺激（tDCS）可以增强冲动控制、情绪调节和认知功能；因此，我们试图探讨tDCS联合在线认知训练对BPD患者认知功能、BPD症状和社会心理功能的有效性。
这项开放标签研究招募了未接受心理治疗的BPD成年患者。参与者完成了信息性心理教育课程，随后在2周内每天进行10次，每次20分钟的tDCS治疗。刺激采用持续2毫安电流，阳极置于左侧DLPFC，阴极置于右侧DLPFC。在每次治疗期间，参与者同时使用Lumosity应用程序（aspredicted.org编号206 001）进行在线认知训练。
我们纳入了29名参与者。我们注意到认知功能有显著改善，包括伦敦塔任务（科恩d=-0.38至-0.78）、 Corsi块点击直接得分和总分（分别为d=-0.41和-0.42），以及斯特鲁普干扰和交替测试（分别为d=0.80和0.94）。情绪失调有显著降低（d=0.44），而冲动性没有显著变化。BPD症状减轻（d=0.69），总体功能（d=0.33）和BPD功能的内部成分得到改善（d=-0.51）。
尽管这些初步结果令人鼓舞，但需要进一步的对照研究来验证干预措施的疗效和长期效果。
这种联合方法似乎耐受性良好，并在认知表现、BPD症状和整体功能方面产生了有希望的短期改善。结果强调了左侧DLPFC在开发针对BPD的神经心理学综合干预措施中的相关性。
