Augmentation of Fear Extinction by Transcranial Direct Current Stimulation (tDCS).
Augmentation of Fear Extinction by Transcranial Direct Current Stimulation (tDCS).
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DOI：
10.3389/fnbeh.2018.00076
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发表时间：
2018
影响因子：
3
通讯作者：
Herrmann MJ
中科院分区：
文献类型：
--
作者：
Dittert N;Hüttner S;Polak T;Herrmann MJ
创伤后应激障碍（PTSD; DSM-V309. 82）和焦虑障碍（DSM-V300. xx）是广泛存在的精神障碍，但其治疗效果仍不令人满意。非侵入性脑刺激技术，如经颅直流电刺激（tDCS），可能是改善消退学习的一种选择，这是焦虑症基于焦虑症治疗的主要功能因素。为了检验这一假设，我们使用了一个恐惧条件反射范式与女性面孔作为条件刺激（CS）和95分贝的女性尖叫声作为非条件刺激（UCS）。我们的目的是进行tDCS的腹内侧前额叶皮层（vmPFC），这主要是在控制的注意力过程。因此，我们大约在EEG位置F7和F8处应用两个4 x 4 cm电极，并使用1.5 mA的直流电。20分钟的刺激在采集和消退之间的10分钟休息期间开始，并进行整体预防试验。健康受试者在两个双盲过程中随机分为两个假刺激组和两个真实刺激组，电流方向相反。为了测量恐惧反应，我们使用皮肤电导反应（SCR）和主观评级。我们对SCR进行了广义估计方程模型，以评估tDCS和电流方向对所有显示成功调节的受试者（N = 84）的消退过程的影响。结果表明，tDCS加速早期灭绝过程，CS+/CS-歧视的损失显着更快。在tDCS verum组中，对CS+的反应显著降低以及对CS-的反应增加导致了辨别力丧失，而假手术组在此期间未显示出显著的反应变化。因此，我们假设vmPFC的tDCS可以用来成功地增强早期灭绝过程。但在临床试验之前，需要进一步研究以评估CS-反应增加的原因。如果这种负面副作用可以避免，tDCS可能是一种改善焦虑治疗的工具。
Although posttraumatic stress disorder (PTSD; DSM-V 309.82) and anxiety disorders (DSM-V 300.xx) are widely spread mental disorders, the effectiveness of their therapy is still unsatisfying. Non-invasive brain-stimulation techniques like transcranial direct current stimulation (tDCS) might be an option to improve extinction learning, which is a main functional factor of exposure-based therapy for anxiety disorders. To examine this hypothesis, we used a fear conditioning paradigm with female faces as conditioned stimuli (CS) and a 95-dB female scream as unconditioned stimulus (UCS). We aimed to perform a tDCS of the ventromedial prefrontal cortex (vmPFC), which is mainly involved in the control of extinction-processes. Therefore, we applied two 4 × 4 cm electrodes approximately at the EEG-positions F7 and F8 and used a direct current of 1.5 mA. The 20-min stimulation was started during a 10-min break between acquisition and extinction and went on overall extinction-trials. The healthy participants were randomly assigned in two double-blinded process into two sham stimulation and two verum stimulation groups with opposite current flow directions. To measure the fear reactions, we used skin conductance responses (SCR) and subjective ratings. We performed a generalized estimating equations model for the SCR to assess the impact of tDCS and current flow direction on extinction processes for all subjects that showed a successful conditioning (N = 84). The results indicate that tDCS accelerates early extinction processes with a significantly faster loss of CS+/CS– discrimination. The discrimination loss was driven by a significant decrease in reaction toward the CS+ as well as an increase in reaction toward the CS– in the tDCS verum groups, whereas the sham groups showed no significant reaction changes during this period. Therefore, we assume that tDCS of the vmPFC can be used to enhance early extinction processes successfully. But before it should be tested in a clinical context further investigation is needed to assess the reason for the reaction increase on CS–. If this negative side effect can be avoided, tDCS may be a tool to improve exposure-based anxiety therapies.
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影响因子：
2.7
作者：
Hikind, Noam;Maroun, Mouna
通讯作者：
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影响因子：
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作者：
Bach DR;Flandin G;Friston KJ;Dolan RJ
通讯作者：
Dolan RJ
DOI：
10.1007/s00406-014-0540-6
发表时间：
2014-11-01
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通讯作者：
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通讯作者：
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作者：
BENSHAKHAR, G
通讯作者：
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