Transcranial direct current stimulation targeting the medial prefrontal cortex modulates functional connectivity and enhances safety learning in obsessive-compulsive disorder: Results from two pilot studies.
Transcranial direct current stimulation targeting the medial prefrontal cortex modulates functional connectivity and enhances safety learning in obsessive-compulsive disorder: Results from two pilot studies.
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针对内侧前额叶皮质的经颅直流电刺激调节功能连接并增强强迫症的安全学习：来自两项试点研究的结果
DOI：
10.1002/da.23212
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发表时间：
2022-01
影响因子：
7.4
通讯作者：
Pittenger C
中科院分区：
文献类型：
--
作者：
Adams TG;Cisler JM;Kelmendi B;George JR;Kichuk SA;Averill CL;Anticevic A;Abdallah CG;Pittenger C
基于暴露的心理治疗是治疗强迫症（OCD）和焦虑精神病理学的支柱。内侧前额叶皮层（mPFC）和由mPFC锚定的默认模式网络（DMN）促进安全学习。靶向mPFC的神经调节可能会增加治疗安全性学习，并增强对基于胰岛素的治疗的反应。为了表征mPFC神经调节对功能连接的影响，17名社区志愿者在额极阳极多灶经颅直流电刺激（tDCS）前后20分钟完成了静息状态fMRI扫描。为了检查tDCS对治疗安全性学习的影响，24例强迫症患者完成了一项初步随机临床试验;他们被随机分配（双盲，50：50）接受活性或假额极tDCS，然后完成体内暴露和反应预防（ERP）挑战。在ERP挑战过程中主观情绪困扰的变化被用来指示治疗安全性学习。在社区志愿者中，tDCS后额极与额中回和额上级回的功能连接增加，而与前额叶和基底神经节的连接减少（ps<.001，校正）; tDCS后DMN和显著性网络之间的功能连接也减少（ps<.001，校正）。接受活性tDCS的OCD患者在ERP激发期间比接受假tDCS的患者表现出更快的治疗安全性学习（ps<0.05）。额极tDCS可以调节mPFC和DMN的功能连接，并可以加速治疗安全性学习。虽然受小样本的限制，但这些发现激发了进一步探索额极tDCS对与基于焦虑的心理治疗相关的神经和行为目标的影响。
Exposed-based psychotherapy is a mainstay of treatment for obsessive-compulsive disorder (OCD) and anxious psychopathology. The medial prefrontal cortex (mPFC) and the default mode network (DMN), which is anchored by the mPFC, promote safety learning. Neuromodulation targeting the mPFC might augment therapeutic safety learning and enhance response to exposure-based therapies. To characterize the effects of mPFC neuromodulation on functional connectivity, 17 community volunteers completed resting-state fMRI scans before and after 20 minutes of frontopolar anodal multifocal transcranial direct current stimulation (tDCS). To examine the effects of tDCS on therapeutic safety learning, 24 patients with OCD completed a pilot randomized clinical trial; they were randomly assigned (double-blind, 50:50) to receive active or sham frontopolar tDCS before completing an in vivo exposure and response prevention (ERP) challenge. Changes in subjective emotional distress during the ERP challenge were used to index therapeutic safety learning. In community volunteers, frontal pole functional connectivity with the middle and superior frontal gyri increased, while connectivity with the anterior insula and basal ganglia decreased (ps<.001, corrected) after tDCS; functional connectivity between DMN and salience network also decreased after tDCS (ps<.001, corrected). OCD patients who received active tDCS exhibited more rapid therapeutic safety learning (ps<.05) during the ERP challenge than patients who received sham tDCS. Frontopolar tDCS may modulate mPFC and DMN functional connectivity and can accelerate therapeutic safety learning. Though limited by small samples, these findings motivate further exploration of the effects of frontopolar tDCS on neural and behavioral targets associated with exposure-based psychotherapies.
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影响因子：
6.8
作者：
Chib VS;Yun K;Takahashi H;Shimojo S
通讯作者：
Shimojo S
影响因子：
7.4
作者：
Berry, Angela C.;Rosenfield, David;Smits, Jasper A. J.
通讯作者：
Smits, Jasper A. J.
影响因子：
1.7
作者：
Dadashi, Mohsen;Asl, Vida Yousefi;Morsali, Yousef
通讯作者：
Morsali, Yousef
影响因子：
4.7
作者：
Feusner JD;Moody T;Lai TM;Sheen C;Khalsa S;Brown J;Levitt J;Alger J;O'Neill J
通讯作者：
O'Neill J
影响因子：
3
作者：
Dittert N;Hüttner S;Polak T;Herrmann MJ
通讯作者：
Herrmann MJ