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Nejati V, Estaji R. The impact of transcranial direct current stimulation on attention bias modification in children with ADHD. J Neural Transm (Vienna) 2024:10.1007/s00702-024-02775-1. [PMID: 38643330 DOI: 10.1007/s00702-024-02775-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 03/30/2024] [Indexed: 04/22/2024]
Abstract
Individuals with attention deficit-hyperactivity disorder (ADHD) struggle with the interaction of attention and emotion. The ventromedial prefrontal cortex (vmPFC) and dorsolateral prefrontal cortex (dlPFC) are assumed to be involved in this interaction. In the present study, we aimed to explore the effect of stimulation applied over the dlPFC and vmPFC on attention bias in individuals with ADHD. Twenty-three children with ADHD performed the emotional Stroop and dot probe tasks during transcranial direct current stimulation (tDCS) in 3 conditions: anodal dlPFC (F3)/cathodal vmPFC (Fp2), anodal vmPFC (Fp2)/cathodal dlPFC (F3), and sham stimulation. Findings suggest reduction of attention bias in both real conditions based on emotional Stroop task and not dot probe task. These results were independent of emotional states. The dlPFC and vmPFC are involved in attention bias in ADHD. tDCS can be used for attention bias modification in children with ADHD.
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Affiliation(s)
- Vahid Nejati
- Department of Psychology, Shahid Beheshti University, 1983969411, Tehran, Iran.
| | - Reza Estaji
- Department of Psychology, Shahid Beheshti University, 1983969411, Tehran, Iran
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Hu Q, Chen J, Ma J, Li Y, Xu Y, Yue C, Cong E. Causal effects of neuroticism on postpartum depression: a bidirectional mendelian randomization study. Arch Womens Ment Health 2024:10.1007/s00737-024-01466-w. [PMID: 38634868 DOI: 10.1007/s00737-024-01466-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 03/28/2024] [Indexed: 04/19/2024]
Abstract
PURPOSE Postpartum depression (PPD) brings adverse and serious consequences to both new parents and newborns. Neuroticism affects PPD, which remains controversial for confounding factors and reverse causality in cross-sectional research. Therefore, mendelian randomization (MR) study has been adopted to investigate their causal relationship. METHODS This study utilized large-scale genome-wide association study genetic pooled data from three major databases: the United Kingdom Biobank, the European Bioinformatics Institute, and the FinnGen databases. The causal analysis methods used inverse variance weighting (IVW). The weighted median, MR-Egger method, MR-PRESSO test, and the leave-one-out sensitivity test have been used to examine the results' robustness, heterogeneity, and horizontal pleiotropy. The fixed effect model yielded the results of meta-analysis. RESULTS In the IVW model, a meta-analysis of the MR study showed that neuroticism increased the risk of PPD (OR, 1.17; 95% CI, 1.11-1.25, p < 0.01). Reverse analysis showed that PPD could not genetically predict neuroticism. There was no significant heterogeneity or horizontal pleiotropy bias in this result. CONCLUSION Our study suggests neuroticism is the risk factor for PPD from a gene perspective and PPD is not the risk factor for neuroticism. This finding may provide new insights into prevention and intervention strategies for PPD according to early detection of neuroticism.
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Affiliation(s)
- Qianying Hu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wanping Road, Shanghai, 200030, China
- School of Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China
| | - Jianhua Chen
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wanping Road, Shanghai, 200030, China
| | - Jingjing Ma
- School of Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China
| | - Yuting Li
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wanping Road, Shanghai, 200030, China
| | - Yifeng Xu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wanping Road, Shanghai, 200030, China.
| | - Chaoyan Yue
- Obstetrics and Gynecology Hospital of Fudan University, Fang Xie Road, No419, Shanghai, Shanghai, China.
| | - Enzhao Cong
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wanping Road, Shanghai, 200030, China.
- School of Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China.
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Li C, Tao M, Chen D, Wei Q, Xiong X, Zhao W, Tan W, Yang J, Han Y, Zhang H, Zhang S, Liu H, Cao JL. Transcranial Direct Current Stimulation for Anxiety During Laparoscopic Colorectal Cancer Surgery: A Randomized Clinical Trial. JAMA Netw Open 2024; 7:e246589. [PMID: 38635271 DOI: 10.1001/jamanetworkopen.2024.6589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/19/2024] Open
Abstract
Importance Perioperative anxiety is prevalent among patients undergoing surgical treatment of cancer and often influences their prognosis. Transcranial direct current stimulation (tDCS) has shown potential in the treatment of various anxiety-related disorders, but data on the impact of tDCS on perioperative anxiety are limited. Objective To evaluate the effect of tDCS in reducing perioperative anxiety among patients undergoing laparoscopic colorectal cancer (CRC) resection. Design, Setting, And Participants This randomized clinical trial was conducted from March to August 2023 at the Affiliated Hospital of Xuzhou Medical University. Patients aged 18 years or older undergoing elective laparoscopic radical resection for CRC were randomly assigned to either the active tDCS group or the sham tDCS group. Intention-to-treat data analysis was performed in September 2023. Interventions Patients were randomly assigned to receive 2 sessions of either active tDCS or sham tDCS over the left dorsolateral prefrontal cortex on the afternoon of the day before the operation and in the morning of the day of operation. Main Outcomes and Measures The main outcome was the incidence of perioperative anxiety from the day of the operation up to 3 days after the procedure, as measured using the Hospital Anxiety and Depression Scale-Anxiety (HADS-A) subscale (range: 0-21, with higher scores indicating more anxiety). Secondary outcomes included postoperative delirium (assessed by the Confusion Assessment Method or Confusion Assessment Method intensive care unit scale); pain (assessed by the 10-point Numeric Rating Scale [NRS], with scores ranging from 0 [no pain] to 10 [worst pain]); frailty (assessed by the Fatigue, Resistance, Ambulation, Illness and Loss of Weight [FRAIL] Index, with scores ranging from 0 [most robust] to 5 [most frail]; and sleep quality (assessed by the Pittsburgh Sleep Quality Index [PSQI], with scores ranging from 0 to 21 and higher scores indicating worse sleep quality) after the 2 sessions of the tDCS intervention. Results A total of 196 patients (mean [SD] age, 63.5 [11.0] years; 124 [63.3%] men) were recruited and randomly assigned to the active tDCS group (98 patients) or the sham tDCS group (98 patients). After the second tDCS intervention on the day of the operation, the incidence of perioperative anxiety was 38.8% in the active tDCS group and 70.4% in the sham tDCS group (relative risk, 0.55 [95% CI, 0.42-0.73]; P < .001). Patients in the active tDCS group vs the sham tDCS group were less likely to have postoperative delirium (8.2% vs 25.5%) and, at 3 days after the operation, had lower median (IQR) pain scores (NRS, 1.0 [1.0-1.0] vs 2.0 [2.0-2.0]), better median (IQR) sleep quality scores (PSQI, 10.5 [10.0-11.0] vs 12.0 [11.0-13.0]), and lower median (IQR) FRAIL Index (2.0 [1.0-2.0] vs 2.0 [2.0-3.0]). Conclusions and Relevance Findings of this randomized clinical trial indicate that administration of 2 preoperative sessions of tDCS was associated with a decreased incidence of perioperative anxiety in patients undergoing elective CRC resection. Active tDCS was also associated with better anxiety scores, pain levels, and sleep quality as well as reduced postoperative delirium and frailty. The findings suggest that tDCS may be a novel strategy for improving perioperative anxiety in patients undergoing CRC resection. Trial Registration Chinese Clinical Trial Register Identifier: ChiCTR2300068859.
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Affiliation(s)
- Chunyan Li
- Department of Anesthesiology, the Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- National Medical Products Administration Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, China
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, China
- Jiangsu Key Laboratory of Applied Technology of Anesthesia and Analgesia, Xuzhou Medical University, Xuzhou, China
| | - Mingshu Tao
- Department of Anesthesiology, the Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- National Medical Products Administration Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, China
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, China
- Jiangsu Key Laboratory of Applied Technology of Anesthesia and Analgesia, Xuzhou Medical University, Xuzhou, China
| | - Dexian Chen
- Department of Anesthesiology, the Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- National Medical Products Administration Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, China
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, China
- Jiangsu Key Laboratory of Applied Technology of Anesthesia and Analgesia, Xuzhou Medical University, Xuzhou, China
| | - Qi Wei
- Department of Anesthesiology, the Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- National Medical Products Administration Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, China
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, China
- Jiangsu Key Laboratory of Applied Technology of Anesthesia and Analgesia, Xuzhou Medical University, Xuzhou, China
| | - Xingyu Xiong
- Department of Anesthesiology, the Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- National Medical Products Administration Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, China
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, China
- Jiangsu Key Laboratory of Applied Technology of Anesthesia and Analgesia, Xuzhou Medical University, Xuzhou, China
| | - Wenxin Zhao
- Department of Anesthesiology, the Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- National Medical Products Administration Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, China
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, China
- Jiangsu Key Laboratory of Applied Technology of Anesthesia and Analgesia, Xuzhou Medical University, Xuzhou, China
| | - Wen Tan
- Department of Anesthesiology, the Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- National Medical Products Administration Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, China
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, China
- Jiangsu Key Laboratory of Applied Technology of Anesthesia and Analgesia, Xuzhou Medical University, Xuzhou, China
| | - Jie Yang
- Department of Anesthesiology, the Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- National Medical Products Administration Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, China
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, China
- Jiangsu Key Laboratory of Applied Technology of Anesthesia and Analgesia, Xuzhou Medical University, Xuzhou, China
| | - Yuan Han
- Department of Anesthesiology, Eye & ENT Hospital of Fudan University, Shanghai, China
| | - Hongxing Zhang
- Department of Anesthesiology, the Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- National Medical Products Administration Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, China
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, China
- Jiangsu Key Laboratory of Applied Technology of Anesthesia and Analgesia, Xuzhou Medical University, Xuzhou, China
| | - Song Zhang
- Department of Anesthesiology, Renji Hospital and Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - He Liu
- Department of Anesthesiology & Clinical Research Center for Anesthesia and Perioperative Medicine, Huzhou Central Hospital, Huzhou, China
- Department of Anesthesiology & Clinical Research Center for Anesthesia and Perioperative Medicine, The Fifth School of Clinical Medicine of Zhejiang Chinese Medical University, Huzhou, China
- Department of Anesthesiology & Clinical Research Center for Anesthesia and Perioperative Medicine, The Affiliated Huzhou Hospital, Zhejiang University School of Medicine, Huzhou, China
- Department of Anesthesiology & Clinical Research Center for Anesthesia and Perioperative Medicine, The Affiliated Central Hospital, Huzhou University School of Medicine, Huzhou, China
| | - Jun-Li Cao
- National Medical Products Administration Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, China
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, China
- Jiangsu Key Laboratory of Applied Technology of Anesthesia and Analgesia, Xuzhou Medical University, Xuzhou, China
- Huzhou Key Laboratory of Basic Research and Clinical Translation for Neuromodulation, The Fifth School of Clinical Medicine of Zhejiang Chinese Medical University, Huzhou, China
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Zhang J, Wang Y, Mao Y, Leong C, Yuan Z. Shared Minds, Shared Feedback: tracing the influence of parental feedback on shared neural patterns. Cereb Cortex 2024; 34:bhad489. [PMID: 38163444 DOI: 10.1093/cercor/bhad489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 11/27/2023] [Accepted: 11/28/2023] [Indexed: 01/03/2024] Open
Abstract
Parental feedback affects children in multiple ways. However, little is known about how children, family, and feedback types affect parental feedback neural mechanisms. The current study used functional near-infrared spectroscopy-based hyperscanning to observe 47 mother-daughter pairs's (mean age of mothers: 35.95 ± 3.99 yr old; mean age of daughters: 6.97 ± 0.75 yr old) brain synchronization in a jigsaw game under various conditions. Between parental negative feedback and praise conditions, mother-daughter brain in supramarginal gyrus, left dorsolateral prefrontal cortex, right inferior frontal gyrus, and right primary somatic (S1) differed. When criticized, conformity family-communication-patterned families had much worse brain synchronization in S1, left dorsolateral prefrontal cortex, and right Wernicke's region than conversational families. Resilient children had better mother-child supramarginal gyrus synchronicity under negative feedback. This study supports the importance of studying children's neurological development in nurturing environments to assess their psychological development.
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Affiliation(s)
- Juan Zhang
- Faculty of Education, University of Macau, Avenida da Universidade, Taipa, Macau, China
- Centre for Cognitive and Brain Sciences, University of Macau, Avenida da Universidade, Taipa, Macau, China
| | - Yihui Wang
- Faculty of Education, University of Macau, Avenida da Universidade, Taipa, Macau, China
- Centre for Cognitive and Brain Sciences, University of Macau, Avenida da Universidade, Taipa, Macau, China
| | - Yidi Mao
- Faculty of Education, University of Macau, Avenida da Universidade, Taipa, Macau, China
- Centre for Cognitive and Brain Sciences, University of Macau, Avenida da Universidade, Taipa, Macau, China
| | - Chantat Leong
- Centre for Cognitive and Brain Sciences, University of Macau, Avenida da Universidade, Taipa, Macau, China
- Faculty of Health Sciences, University of Macau, Avenida da Universidade, Taipa, Macau, China
| | - Zhen Yuan
- Centre for Cognitive and Brain Sciences, University of Macau, Avenida da Universidade, Taipa, Macau, China
- Faculty of Health Sciences, University of Macau, Avenida da Universidade, Taipa, Macau, China
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5
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Chan HHY, Siu PLK, Choy CT, Chan UK, Zhou J, Wong CH, Lee YW, Chan HW, Tsui JCC, Loo SKF, Tsui SKW. Novel Multi-Strain E3 Probiotic Formulation Improved Mental Health Symptoms and Sleep Quality in Hong Kong Chinese. Nutrients 2023; 15:5037. [PMID: 38140296 PMCID: PMC10745623 DOI: 10.3390/nu15245037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/05/2023] [Accepted: 12/06/2023] [Indexed: 12/24/2023] Open
Abstract
Mental health issues have emerged as a significant concern in public health, given their association with physical and psychological comorbidities and the resultant socioeconomic burdens. Recent studies have highlighted the interplay between gut microbes and brain functions through the gut-brain axis. To investigate this further, we conducted a targeted 16S rRNA sequencing and comprehensive bioinformatic analysis among Southern Chinese individuals to explore the role of the gut microbiome in depression, anxiety, and sleep disturbance. We analyzed the differences in the gut microbiome profile of 68 participants with sleep disturbance and mood symptoms before and after an 8-week course of a novel oral E3 multi-strain probiotics formula. The results revealed a significant improvement in subjective sleep quality (PSQI: mean 8.79 at baseline vs. 7.10 at week 8, p < 0.001), depressive symptoms (PHQ9: mean 6.17 at baseline vs. 4.76 at week 8, p < 0.001), and anxious symptoms (GAD7: mean 4.90 at baseline vs. 3.76 at week 8, p < 0.001). Additionally, there were notable differences in beta diversity (weighted UniFrac; p = 0.045) and increased Firmicutes/Bacteroidetes (F/B) ratio (p = 4 × 10-4) were observed in the gut microbiome analysis. Furthermore, the relative abundance of Bifidobacterium bifidum (p < 0.001), Lactobacillus acidophilus (p < 0.001), Lactobacillus helveticus (p < 0.001) and Lactobacillus plantarum (p < 0.001) were significantly increased after the 8-week probiotic supplementation. Our study suggests that the gut microbial landscape varies between responders and non-responders at multiple levels, including genera, species, functional, and network interaction. Notably, the use of probiotics in populations with depressive or anxious symptoms and poor sleeping quality remodeled the gut microbiome and demonstrated improved mood and sleep quality.
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Affiliation(s)
- Helen Hoi Yin Chan
- Microbiome Research Centre, BioMed Laboratory Company Limited, Hong Kong, China (P.L.K.S.); (U.K.C.); (J.Z.); (C.H.W.); (Y.W.L.); (H.W.C.); (J.C.C.T.)
| | - Pui Ling Kella Siu
- Microbiome Research Centre, BioMed Laboratory Company Limited, Hong Kong, China (P.L.K.S.); (U.K.C.); (J.Z.); (C.H.W.); (Y.W.L.); (H.W.C.); (J.C.C.T.)
| | - Chi Tung Choy
- Microbiome Research Centre, BioMed Laboratory Company Limited, Hong Kong, China (P.L.K.S.); (U.K.C.); (J.Z.); (C.H.W.); (Y.W.L.); (H.W.C.); (J.C.C.T.)
| | - Un Kei Chan
- Microbiome Research Centre, BioMed Laboratory Company Limited, Hong Kong, China (P.L.K.S.); (U.K.C.); (J.Z.); (C.H.W.); (Y.W.L.); (H.W.C.); (J.C.C.T.)
| | - Junwei Zhou
- Microbiome Research Centre, BioMed Laboratory Company Limited, Hong Kong, China (P.L.K.S.); (U.K.C.); (J.Z.); (C.H.W.); (Y.W.L.); (H.W.C.); (J.C.C.T.)
| | - Chi Ho Wong
- Microbiome Research Centre, BioMed Laboratory Company Limited, Hong Kong, China (P.L.K.S.); (U.K.C.); (J.Z.); (C.H.W.); (Y.W.L.); (H.W.C.); (J.C.C.T.)
| | - Yuk Wai Lee
- Microbiome Research Centre, BioMed Laboratory Company Limited, Hong Kong, China (P.L.K.S.); (U.K.C.); (J.Z.); (C.H.W.); (Y.W.L.); (H.W.C.); (J.C.C.T.)
| | - Ho Wang Chan
- Microbiome Research Centre, BioMed Laboratory Company Limited, Hong Kong, China (P.L.K.S.); (U.K.C.); (J.Z.); (C.H.W.); (Y.W.L.); (H.W.C.); (J.C.C.T.)
| | - Joseph Chi Ching Tsui
- Microbiome Research Centre, BioMed Laboratory Company Limited, Hong Kong, China (P.L.K.S.); (U.K.C.); (J.Z.); (C.H.W.); (Y.W.L.); (H.W.C.); (J.C.C.T.)
| | - Steven King Fan Loo
- Microbiome Research Centre, BioMed Laboratory Company Limited, Hong Kong, China (P.L.K.S.); (U.K.C.); (J.Z.); (C.H.W.); (Y.W.L.); (H.W.C.); (J.C.C.T.)
- Hong Kong Institute of Integrative Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
- Dermatology Centre, CUHK Medical Centre, The Chinese University of Hong Kong, Hong Kong, China
| | - Stephen Kwok Wing Tsui
- Microbiome Research Centre, BioMed Laboratory Company Limited, Hong Kong, China (P.L.K.S.); (U.K.C.); (J.Z.); (C.H.W.); (Y.W.L.); (H.W.C.); (J.C.C.T.)
- School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
- Centre for Microbial Genomics and Proteomics, The Chinese University of Hong Kong, Hong Kong, China
- Hong Kong Bioinformatics Centre, The Chinese University of Hong Kong, Hong Kong, China
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Wang Y, Zhang J, Li Y, Qi S, Zhang F, Ball LJ, Duan H. Preventing prefrontal dysfunction by tDCS modulates stress-induced creativity impairment in women: an fNIRS study. Cereb Cortex 2023; 33:10528-10545. [PMID: 37585735 DOI: 10.1093/cercor/bhad301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 07/25/2023] [Accepted: 07/26/2023] [Indexed: 08/18/2023] Open
Abstract
Stress is a major external factor threatening creative activity. The study explored whether left-lateralized activation in the dorsolateral prefrontal cortex manipulated through transcranial direct current stimulation could alleviate stress-induced impairment in creativity. Functional near-infrared spectroscopy was used to explore the underlying neural mechanisms. Ninety female participants were randomly assigned to three groups that received stress induction with sham stimulation, stress induction with true stimulation (anode over the left and cathode over the right dorsolateral prefrontal cortex), and control manipulation with sham stimulation, respectively. Participants underwent the stress or control task after the transcranial direct current stimulation manipulation, and then completed the Alternative Uses Task to measure creativity. Behavioral results showed that transcranial direct current stimulation reduced stress responses in heart rate and anxiety. The functional near-infrared spectroscopy results revealed that transcranial direct current stimulation alleviated dysfunction of the prefrontal cortex under stress, as evidenced by higher activation of the dorsolateral prefrontal cortex and frontopolar cortex, as well as stronger inter-hemispheric and intra-hemispheric functional connectivity within the prefrontal cortex. Further analysis demonstrated that the cortical regulatory effect prevented creativity impairment induced by stress. The findings validated the hemispheric asymmetry hypothesis regarding stress and highlighted the potential for brain stimulation to alleviate stress-related mental disorders and enhance creativity.
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Affiliation(s)
- Yifan Wang
- Key Laboratory of Modern Teaching Technology, Ministry of Education, Shaanxi Normal University, Xi'an 041000, China
| | - Jiaqi Zhang
- Key Laboratory of Modern Teaching Technology, Ministry of Education, Shaanxi Normal University, Xi'an 041000, China
| | - Yadan Li
- Key Laboratory of Modern Teaching Technology, Ministry of Education, Shaanxi Normal University, Xi'an 041000, China
| | - Senqing Qi
- Key Laboratory of Modern Teaching Technology, Ministry of Education, Shaanxi Normal University, Xi'an 041000, China
| | - Fengqing Zhang
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA 19104, USA
| | - Linden J Ball
- School of Psychology & Computer Science, University of Central Lancashire, Preston PR1 2HE, UK
| | - Haijun Duan
- Key Laboratory of Modern Teaching Technology, Ministry of Education, Shaanxi Normal University, Xi'an 041000, China
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7
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Marotta A, Braga M, Fiorio M. Trait-related neural basis of attentional bias to emotions: a tDCS study. COGNITIVE, AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2023; 23:1291-1302. [PMID: 37537308 PMCID: PMC10545638 DOI: 10.3758/s13415-023-01122-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/20/2023] [Indexed: 08/05/2023]
Abstract
Negative emotional stimuli can strongly bias attention, particularly in individuals with high levels of dispositional negative affect (NA). The current study investigated whether the prefrontal cortex (PFC), a brain region involved in the top-down regulation of emotional processing, plays a different role in controlling attention to emotions, depending on the individual NA. Sham and anodal transcranial direct current stimulation (tDCS) was delivered over the right or left PFC while assessing attentional bias (AB) to emotions (happy, angry, sad faces) in individuals with higher and lower trait NA. When tDCS was inactive (sham), individuals with higher trait NA showed AB toward angry and away from sad faces, while individuals with lower trait NA presented with no AB. Right anodal-tDCS abolished the AB toward angry faces and induced an AB toward sad faces in individuals with higher trait NA, while no effect was found in individuals with lower trait NA. Left anodal-tDCS abolished any AB in individuals with higher trait NA and induced an AB away from happy faces in individuals with lower trait NA. These findings confirm a critical role of trait NA in AB to emotions and demonstrate a different involvement of PFC in emotional processing based on dispositional affect.
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Affiliation(s)
- Angela Marotta
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Via Felice Casorati, 43-37131 Verona, Italy
| | - Miriam Braga
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Via Felice Casorati, 43-37131 Verona, Italy
| | - Mirta Fiorio
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Via Felice Casorati, 43-37131 Verona, Italy
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Guo T, Schwieter JW, Liu H. fMRI reveals overlapping and non-overlapping neural bases of domain-general and emotional conflict control. Psychophysiology 2023; 60:e14355. [PMID: 37254582 DOI: 10.1111/psyp.14355] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 04/05/2023] [Accepted: 05/17/2023] [Indexed: 06/01/2023]
Abstract
The present study uses functional magnetic resonance image (fMRI) to examine the overlapping and specific neural correlates of contextualized emotional conflict control and domain-general conflict control. During a performance on emotional and domain-general conflict tasks, conjunction analyses showed that neural areas distributed in the frontoparietal network were engaged in both processes, supporting the notion that similar neural mechanisms are implemented in these two types of control. Importantly, disjunction analyses revealed a broader neural recruitment of emotional conflict control compared to domain-general conflict control as shown by the possible lateralization of the lateral prefrontal cortex (lPFC), such that emotional conflict control significantly involved the left lPFC while domain-general conflict control seemly involved the right lPFC. Results of generalized psychophysiological interaction (gPPI) analyses further demonstrated that emotional conflict control, compared to domain-general conflict control, elicited broader synergistic activities in individuals' brain networks. Together, these findings offer novel and compelling neural evidence that furthers our understanding of the complex relationship between domain-general and emotional conflict control.
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Affiliation(s)
- Tingting Guo
- Research Center of Brain and Cognitive Neuroscience, Liaoning Normal University, Dalian, China
- Key Laboratory of Brain and Cognitive Neuroscience, Liaoning Province, Dalian, China
| | - John W Schwieter
- Language Acquisition, Cognition, and Multilingualism Laboratory, Bilingualism Matters @ Wilfrid Laurier University, Waterloo, Ontario, Canada
- Department of Linguistics and Languages, McMaster University, Hamilton, Ontario, Canada
| | - Huanhuan Liu
- Research Center of Brain and Cognitive Neuroscience, Liaoning Normal University, Dalian, China
- Key Laboratory of Brain and Cognitive Neuroscience, Liaoning Province, Dalian, China
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Szeremeta EM, Sutton D, Marinovic W, Clarke PJF. The effects of left prefrontal stimulation on selective attention and emotional reactivity for positive and negative information. Biol Psychol 2023; 182:108640. [PMID: 37453731 DOI: 10.1016/j.biopsycho.2023.108640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 07/10/2023] [Accepted: 07/12/2023] [Indexed: 07/18/2023]
Abstract
Transcranial direct current stimulation targeting lateral prefrontal areas may attenuate attentional vigilance for negative content and reduce emotional reactivity. However, little research to date has examined how such stimulation may affect attention towards and emotional reactivity to positive emotional content. The aim of this study was to examine whether anodal tDCS targeting the left dorsolateral prefrontal cortex would affect attentional bias towards either or both negative and positive content, and similarly, how it would impact emotional reactivity to negative and positive emotional content among healthy individuals. Unselected participants (N = 101) were recruited (Mage = 22.57, SD = 5.60; 66.33% female) and allocated to either an active or sham tDCS condition. Attentional bias was measured using an eye-tracking task involving negative-neutral and positive-neutral image pairs, followed by an emotional reactivity assessment task involving negative and positive video content (self-report and heart rate variability). Results showed no evidence that tDCS influenced attentional patterns towards either positive or negative information, nor was there evidence that tDCS influenced self-reported anxious mood or physiological arousal. However, participants in the active tDCS condition reported higher positive mood in response to both the positive and negative videos compared to those in the sham condition and also higher arousal in response to positive content and lower arousal in response to negative content, with those in the sham tDCS condition showing the reverse pattern of effects. As such, tDCS effects on emotional reactivity to positive and negative content were restricted to self-report measures.
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Affiliation(s)
- Elise M Szeremeta
- Cognition and Emotion Research Group, Curtin University, Perth, WA, Australia
| | - Dane Sutton
- Cognition and Emotion Research Group, Curtin University, Perth, WA, Australia
| | - Welber Marinovic
- Cognition and Emotion Research Group, Curtin University, Perth, WA, Australia
| | - Patrick J F Clarke
- Cognition and Emotion Research Group, Curtin University, Perth, WA, Australia.
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10
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Chang SH, Chen HY, Shaw FZ, Shyu BC. Early- and late-phase changes of brain activity and early-phase neuromodulation in the posttraumatic stress disorder rat model. Neurobiol Stress 2023; 26:100554. [PMID: 37576348 PMCID: PMC10415797 DOI: 10.1016/j.ynstr.2023.100554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 06/21/2023] [Accepted: 07/03/2023] [Indexed: 08/15/2023] Open
Abstract
Posttraumatic stress disorder (PTSD) is a complex syndrome that may occur after life-threatening events. Fear memory abnormalities may play vital roles in the pathogenesis of PTSD. Previous work has found that fear memories are not rigid; the retrieval of fear memories may change over time. Furthermore, prior studies suggest that theta wave (4 Hz) activity is highly correlated with fear expression in an animal model. However, the relationship between pathological fear memory and potential brain wave features in PTSD remains largely uncharacterized. Here, we hypothesized that after traumatic stress exposure, the longitudinal dynamics of abnormal fears in PTSD animal models could be reflected by the measurement of local field potentials (LFPs). Using a well-established modified single-prolonged stress and footshock (SPS & FS) PTSD rat model, animals were restrained for 2 h and subsequently subjected to 20 min of forced swimming, then exposed to diethyl ether until they lost consciousness and placed in a conditioning chamber for fear conditioning. To characterize the temporal changes, we characterized freezing behavior brain wave features during the conditioning chamber re-exposure in the early (10 and 30 min; 2, 4, and 6 h) and late (day 1, 3, 7, and 14) phases after traumatic stress exposure. Our results indicate that SPS & FS rats showed co-morbid PTSD phenotypes including significantly higher levels of anxiety-, depression-, and anhedonia-like behaviors, and impaired fear extinction. Delta wave (0.5-4 Hz) suppression in the medial prefrontal cortex, amygdala, and ventral hippocampus occurred 10 and 30 min after traumatic stress, followed by continuous delta wave activity from 2 h to day 14, correlating with fear levels. tDCS reduced delta activity and alleviated PTSD-like phenotypes in the SPS & FS group. In this study, profiling abnormal fears with brain wave correlates may improve our understanding of time-dependent pathological fear memory retrieval in PTSD and facilitate the development of effective intervention strategies.
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Affiliation(s)
- Shao-Han Chang
- Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
- Department of Psychology, National Cheng Kung University, Tainan, Taiwan
- Taiwan International Graduate Program in Interdisciplinary Neuroscience, National Cheng Kung University and Academia Sinica, Taipei, Taiwan
| | - Huan-Yuan Chen
- Inflammation Core Facility, Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
| | - Fu-Zen Shaw
- Department of Psychology, National Cheng Kung University, Tainan, Taiwan
| | - Bai-Chuang Shyu
- Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
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11
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Tsai YC, Li CT, Juan CH. A review of critical brain oscillations in depression and the efficacy of transcranial magnetic stimulation treatment. Front Psychiatry 2023; 14:1073984. [PMID: 37260762 PMCID: PMC10228658 DOI: 10.3389/fpsyt.2023.1073984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 04/11/2023] [Indexed: 06/02/2023] Open
Abstract
Repetitive transcranial magnetic stimulation (rTMS) and intermittent theta burst stimulation (iTBS) have been proven effective non-invasive treatments for patients with drug-resistant major depressive disorder (MDD). However, some depressed patients do not respond to these treatments. Therefore, the investigation of reliable and valid brain oscillations as potential indices for facilitating the precision of diagnosis and treatment protocols has become a critical issue. The current review focuses on brain oscillations that, mostly based on EEG power analysis and connectivity, distinguish between MDD and controls, responders and non-responders, and potential depression severity indices, prognostic indicators, and potential biomarkers for rTMS or iTBS treatment. The possible roles of each biomarker and the potential reasons for heterogeneous results are discussed, and the directions of future studies are proposed.
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Affiliation(s)
- Yi-Chun Tsai
- Institute of Cognitive Neuroscience, College of Health Sciences and Technology, National Central University, Taoyuan City, Taiwan
| | - Cheng-Ta Li
- Institute of Cognitive Neuroscience, College of Health Sciences and Technology, National Central University, Taoyuan City, Taiwan
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Brain Science, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
- Division of Psychiatry, Faculty of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
| | - Chi-Hung Juan
- Institute of Cognitive Neuroscience, College of Health Sciences and Technology, National Central University, Taoyuan City, Taiwan
- Cognitive Intelligence and Precision Healthcare Center, National Central University, Taoyuan City, Taiwan
- Department of Psychology, Kaohsiung Medical University, Kaohsiung, Taiwan
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12
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Zhang R, Zhao W, Qi Z, Xu T, Zhou F, Becker B. Angiotensin II Regulates the Neural Expression of Subjective Fear in Humans: A Precision Pharmaco-Neuroimaging Approach. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2023; 8:262-270. [PMID: 36174930 DOI: 10.1016/j.bpsc.2022.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/23/2022] [Accepted: 09/19/2022] [Indexed: 02/05/2023]
Abstract
BACKGROUND Rodent models and pharmacological neuroimaging studies in humans have been used to test novel pharmacological agents to reduce fear. However, these strategies are limited with respect to determining process-specific effects on the actual subjective experience of fear, which represents the key symptom that motivates patients to seek treatment. In this study, we used a novel precision pharmacological functional magnetic resonance imaging approach based on process-specific neuroaffective signatures to determine effects of the selective angiotensin II type 1 receptor (AT1R) antagonist losartan on the subjective experience of fear. METHODS In a double-blind, placebo-controlled, randomized pharmacological functional magnetic resonance imaging design, healthy participants (N = 87) were administered 50 mg losartan or placebo before they underwent an oddball paradigm that included neutral, novel, and fear oddballs. Effects of losartan on brain activity and connectivity as well as on process-specific multivariate neural signatures were examined. RESULTS AT1R blockade selectively reduced neurofunctional reactivity to fear-inducing visual oddballs in terms of attenuating dorsolateral prefrontal activity and amygdala-ventral anterior cingulate communication. Neurofunctional decoding further demonstrated fear-specific effects in that AT1R blockade reduced the neural expression of subjective fear but not of threat or nonspecific negative affect and did not influence reactivity to novel oddballs. CONCLUSIONS These results show a specific role of the AT1R in regulating the subjective fear experience and demonstrate the feasibility of a precision pharmacological functional magnetic resonance imaging approach to the affective characterization of novel receptor targets for fear in humans.
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Affiliation(s)
- Ran Zhang
- Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China; Ministry of Education, Key Laboratory for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Weihua Zhao
- Ministry of Education, Key Laboratory for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Ziyu Qi
- Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China; Ministry of Education, Key Laboratory for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Ting Xu
- Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China; Ministry of Education, Key Laboratory for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Feng Zhou
- Faculty of Psychology, Southwest University, ChongQing, China; Key Laboratory of Cognition and Personality, Ministry of Education, ChongQing, China.
| | - Benjamin Becker
- Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China; Ministry of Education, Key Laboratory for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China.
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13
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Li J, Ma H, Yang H, Yu H, Zhang N. Cognitive bias modification for adult's depression: A systematic review and meta-analysis. Front Psychol 2023; 13:968638. [PMID: 36743641 PMCID: PMC9894684 DOI: 10.3389/fpsyg.2022.968638] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 12/07/2022] [Indexed: 01/20/2023] Open
Abstract
Objects This study aimed to elucidate the effect of cognitive bias modification on depression. Methods This research included 10 randomized studies searching four major databases: PubMed, Embase, PsycINFO, and Cochrane Library, with a total sample size of 467. Moreover, they were examined for quality and possible publication bias. Results Cognitive bias modification (CBM) had statistically significant results, g = -0.64, 95% CI = [-0.97-0.32]. The interpretation of cognitive bias modification shows the highest effect size, g = -1.45, 95% CI = [-2.05-0.88]. When the training place is located in the laboratory, the training effect is significant, g = -1.11, 95% CI = [-1.62-0.61]. The difference is statistically significant when the training environment was changed to home, g = -0.28, 95% CI = [-0.51-0.05]. CBM has a statistical effect on moderate-to-severe depression, g = -0.70, 95% CI = [-1.04-0.36]. Conclusion We found that CBM had a moderate therapeutic effect on depression, whether the setting was at home or in the lab. Especially when the interpretation of cognitive bias modification (CBM-I) was used, we got the highest effect value. Furthermore, CBM has a statistical effect on moderate-to-severe depression.
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14
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Zhang D, Liu J, Fan L, Liu Q. Quantitative description of the relationship between the enhancement of distraction-suppression and brain local state alteration after transcranial direct current stimulation. Front Neurosci 2022; 16:984893. [PMID: 36148150 PMCID: PMC9485618 DOI: 10.3389/fnins.2022.984893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 08/18/2022] [Indexed: 11/29/2022] Open
Abstract
Anodal transcranial direct current stimulation (tDCS) over the left dorsal lateral prefrontal cortex (lDLPFC) can improve distraction suppression ability, possibly by distantly regulating the connection properties of several large-scale brain networks and local brain state changes. However, little is known about the local state alteration that tDCS can induce in distant but task-related regions and the relationship between performance enhancement and local state alteration in potentially related regions, resulting in inefficient and uncertain tDCS regulation. We aimed to examine the alteration of brain local state before and after tDCS and its relationship with performance enhancement. With the within-subject design, the participants received anodal (1.5 mA) and sham tDCS at F3 (lDLPFC) for 20 min. The visual search task and resting-state functional magnetic resonance imaging (rsfMRI) were performed before and after stimulation. Anodal tDCS significantly enhanced distraction suppression. The amplitude of low-frequency fluctuation (ALFF) in the left parietal region significantly decreased, the decrement significantly positively correlated with performance enhancement after anodal tDCS. As well, the regional homogeneity (ReHo) in the left precuneus significantly increased, and the increasement significantly positively correlated with performance enhancement. Anodal tDCS over the lDLPFC can distantly modulate the local state of the brain and improve the distraction suppression ability. These two aspects are closely related and provide a direct and efficient approach to enhancing performance.
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Affiliation(s)
- Di Zhang
- Research Center of Brain and Cognitive Neuroscience, Liaoning Normal University, Dalian, China
| | - Jiaojiao Liu
- Research Center of Brain and Cognitive Neuroscience, Liaoning Normal University, Dalian, China
| | - Li Fan
- Research Center of Brain and Cognitive Neuroscience, Liaoning Normal University, Dalian, China
| | - Qiang Liu
- Research Center of Brain and Cognitive Neuroscience, Liaoning Normal University, Dalian, China
- Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu, China
- *Correspondence: Qiang Liu,
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15
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Todd J, Austin H, Clarke P, Notebaert L. Chronic Pain, Insomnia and their Mutual Maintenance: A Call for Cognitive Bias Research. THE JOURNAL OF PAIN 2022; 23:1530-1542. [PMID: 35472519 DOI: 10.1016/j.jpain.2022.03.241] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 03/04/2022] [Accepted: 03/24/2022] [Indexed: 06/14/2023]
Abstract
Chronic pain and insomnia are highly comorbid: Approximately 50% of those with chronic pain experience insomnia or clinically significant sleep disturbances, and 50% of those with insomnia experience chronic pain. Further, these conditions can be extremely disabling, particularly when they co-occur. There is increasing recognition of the need to tackle both chronic pain and insomnia together, as evidenced by growing empirical research in this area. Cognitive processing biases have been independently implicated in both chronic pain and in insomnia. Given their trans-diagnostic status, cognitive biases may therefore have a role in explaining the co-occurrence and mutual maintenance of these conditions. These biases also represent novel, potentially modifiable targets for treatment. However, the role of cognitive biases has not been adequately explored in comorbid chronic pain and insomnia. Here, we describe the state of cognitive bias research in chronic pain and insomnia, considering evidence for the roles of attentional bias, interpretation bias, expectancy bias, and memory bias. In reviewing the literature, it is apparent that similar cognitive biases operate in insomnia and chronic pain, with preliminary, albeit sparse, evidence of pain-related cognitive biases influencing sleep-related outcomes. On the basis of current findings and separate theoretical models, we present a novel, testable cognitive model of comorbid chronic pain and insomnia, to guide future research in this area. Key recommendations for the future of this relatively new field are provided. PERSPECTIVE: Chronic pain and insomnia are highly co-morbid, suggesting an overlap in causal mechanisms. Empirical research, although sparse, suggests that cognitive biases may play a role in their development and mutual maintenance. Our novel cognitive model generates research avenues of clinical importance for treating co-morbid chronic pain and insomnia.
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Affiliation(s)
- Jemma Todd
- School of Psychology, University of Sydney, Sydney, New South Wales, Australia; School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia.
| | - Henry Austin
- School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia; Cardio Respiratory Sleep, Nedlands, Western Australia, Australia
| | - Patrick Clarke
- School of Psychology, Curtin University, Perth, Western Australia, Australia
| | - Lies Notebaert
- School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia
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16
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Aksu S, Soyata AZ, Mursalova Z, Eskicioğlu G, Tükel R. Transcranial direct current stimulation does not improve clinical and neurophysiological outcomes in panic disorder: A randomized sham-controlled trial. Psychiatry Clin Neurosci 2022; 76:384-392. [PMID: 35587504 DOI: 10.1111/pcn.13378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 05/08/2022] [Accepted: 05/16/2022] [Indexed: 11/28/2022]
Abstract
AIM Emerging evidence suggests that transcranial direct current stimulation (tDCS) has anxiolytic effects and may enhance emotional processing of threat and reduce threat-related attentional bias. Panic disorder (PD) is considered to be a fear network disorder along with prefrontal activity alterations. We aim to assess the effect of tDCS on clinical and physiological parameters in PD for the first time. METHODS In this triple-blind randomized sham-controlled pilot study, 30 individuals with PD were allocated into active and sham groups to receive 10 sessions of tDCS targeting the dorsolateral prefrontal cortex bilaterally at 2 mA for 20-min duration over 2 weeks. The clinical severity, threat-related attentional bias, interoceptive accuracy, and emotional recognition were assessed before, immediately after, and 1 month after tDCS. RESULTS Active tDCS, in comparison to sham, did not elicit more favorable clinical and neuropsychological/physiological outcomes in PD. CONCLUSION The present study provides the first clinical and neurobehavioral results of prefrontal tDCS in PD and indicates that prefrontal tDCS was not superior to sham in PD.
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Affiliation(s)
- Serkan Aksu
- Department of Physiology, Faculty of Medicine, Muğla Sıtkı Koçman University, Muğla, Turkey.,Department of Physiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | | | - Zhala Mursalova
- Department of Psychiatry, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Gaye Eskicioğlu
- Department of Psychology, Istanbul University, Istanbul, Turkey
| | - Raşit Tükel
- Department of Psychiatry, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
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17
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Kou J, Zhang Y, Zhou F, Gao Z, Yao S, Zhao W, Li H, Lei Y, Gao S, Kendrick KM, Becker B. Anxiolytic Effects of Chronic Intranasal Oxytocin on Neural Responses to Threat Are Dose-Frequency Dependent. PSYCHOTHERAPY AND PSYCHOSOMATICS 2022; 91:253-264. [PMID: 35086102 DOI: 10.1159/000521348] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 11/29/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Anxiety disorders are prevalent mental conditions characterized by exaggerated anxious arousal and threat reactivity. Animal and human studies suggest an anxiolytic potential of the neuropeptide oxytocin (OT), yet, while a clinical application will require chronic administration protocols, previous human studies have exclusively focused on single-dose (acute) intranasal OT effects. OBJECTIVE To facilitate the translation of the potential anxiolytic mechanism of OT into clinical application, we determined whether the anxiolytic effects of OT are maintained with repeated (chronic) administration or are influenced by dose frequency and trait anxiety. METHODS In a pre-registered double-blind randomized placebo-controlled pharmaco-fMRI trial the acute (single dose) as well as chronic effects of two different dose frequencies of OT (OT administered daily for 5 days or every other day) on emotional reactivity were assessed in n = 147 individuals with high versus low trait anxiety (ClinicalTrials.gov ID: NCT03085654). RESULTS OT produced valence, dose frequency, and trait anxiety-specific effects, such that the low-frequency (intermittent) chronic dosage specifically attenuated a neural reactivity increase in amygdala-insula-prefrontal circuits observed in the high anxious placebo-treated subjects in response to threatening but not positive stimuli. CONCLUSIONS The present trial provides the first evidence that low-dose frequency chronic intranasal OT has the potential to alleviate exaggerated neural threat reactivity in subjects with elevated anxiety levels, suggesting a treatment potential for anxiety disorders.
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Affiliation(s)
- Juan Kou
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China.,Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu, China
| | - Yingying Zhang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China.,Department of Molecular Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Feng Zhou
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Zhao Gao
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Shuxia Yao
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Weihua Zhao
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Hong Li
- Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu, China
| | - Yi Lei
- Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu, China
| | - Shan Gao
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Keith M Kendrick
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Benjamin Becker
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
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18
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Antal A, Luber B, Brem AK, Bikson M, Brunoni AR, Cohen Kadosh R, Dubljević V, Fecteau S, Ferreri F, Flöel A, Hallett M, Hamilton RH, Herrmann CS, Lavidor M, Loo C, Lustenberger C, Machado S, Miniussi C, Moliadze V, Nitsche MA, Rossi S, Rossini PM, Santarnecchi E, Seeck M, Thut G, Turi Z, Ugawa Y, Venkatasubramanian G, Wenderoth N, Wexler A, Ziemann U, Paulus W. Non-invasive brain stimulation and neuroenhancement. Clin Neurophysiol Pract 2022; 7:146-165. [PMID: 35734582 PMCID: PMC9207555 DOI: 10.1016/j.cnp.2022.05.002] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 04/19/2022] [Accepted: 05/18/2022] [Indexed: 12/15/2022] Open
Abstract
The available data frame with a wide parameter space of tES does not allow an overarching protocol recommendation. Established engineering risk-management procedures with regard to manufacturing should be followed. Consensus among experts is that tES for neuroenhancement is safe as long as tested protocols are followed.
Attempts to enhance human memory and learning ability have a long tradition in science. This topic has recently gained substantial attention because of the increasing percentage of older individuals worldwide and the predicted rise of age-associated cognitive decline in brain functions. Transcranial brain stimulation methods, such as transcranial magnetic (TMS) and transcranial electric (tES) stimulation, have been extensively used in an effort to improve cognitive functions in humans. Here we summarize the available data on low-intensity tES for this purpose, in comparison to repetitive TMS and some pharmacological agents, such as caffeine and nicotine. There is no single area in the brain stimulation field in which only positive outcomes have been reported. For self-directed tES devices, how to restrict variability with regard to efficacy is an essential aspect of device design and function. As with any technique, reproducible outcomes depend on the equipment and how well this is matched to the experience and skill of the operator. For self-administered non-invasive brain stimulation, this requires device designs that rigorously incorporate human operator factors. The wide parameter space of non-invasive brain stimulation, including dose (e.g., duration, intensity (current density), number of repetitions), inclusion/exclusion (e.g., subject’s age), and homeostatic effects, administration of tasks before and during stimulation, and, most importantly, placebo or nocebo effects, have to be taken into account. The outcomes of stimulation are expected to depend on these parameters and should be strictly controlled. The consensus among experts is that low-intensity tES is safe as long as tested and accepted protocols (including, for example, dose, inclusion/exclusion) are followed and devices are used which follow established engineering risk-management procedures. Devices and protocols that allow stimulation outside these parameters cannot claim to be “safe” where they are applying stimulation beyond that examined in published studies that also investigated potential side effects. Brain stimulation devices marketed for consumer use are distinct from medical devices because they do not make medical claims and are therefore not necessarily subject to the same level of regulation as medical devices (i.e., by government agencies tasked with regulating medical devices). Manufacturers must follow ethical and best practices in marketing tES stimulators, including not misleading users by referencing effects from human trials using devices and protocols not similar to theirs.
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Affiliation(s)
- Andrea Antal
- Department of Neurology, University Medical Center, Göttingen, Germany
- Corresponding author at: Department of Neurology, University Medical Center, Göttingen, Robert Koch Str. 40, 37075 Göttingen, Germany.
| | - Bruce Luber
- Noninvasive Neuromodulation Unit, Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Anna-Katharine Brem
- University Hospital of Old Age Psychiatry, University of Bern, Bern, Switzerland
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Marom Bikson
- Biomedical Engineering at the City College of New York (CCNY) of the City University of New York (CUNY), NY, USA
| | - Andre R. Brunoni
- Departamento de Clínica Médica e de Psiquiatria, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Service of Interdisciplinary Neuromodulation (SIN), Laboratory of Neurosciences (LIM-27), Institute of Psychiatry, Hospital das Clínicas da Faculdade de Medicina da USP, São Paulo, Brazil
| | - Roi Cohen Kadosh
- School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, UK
| | - Veljko Dubljević
- Science, Technology and Society Program, College of Humanities and Social Sciences, North Carolina State University, Raleigh, NC, USA
| | - Shirley Fecteau
- Department of Psychiatry and Neurosciences, Faculty of Medicine, Université Laval, CERVO Brain Research Centre, Centre intégré universitaire en santé et services sociaux de la Capitale-Nationale, Quebec City, Quebec, Canada
| | - Florinda Ferreri
- Unit of Neurology, Unit of Clinical Neurophysiology, Study Center of Neurodegeneration (CESNE), Department of Neuroscience, University of Padua, Padua, Italy
- Department of Clinical Neurophysiology, Kuopio University Hospital, University of Eastern Finland, Kuopio, Finland
| | - Agnes Flöel
- Department of Neurology, Universitätsmedizin Greifswald, 17475 Greifswald, Germany
- German Centre for Neurodegenerative Diseases (DZNE) Standort Greifswald, 17475 Greifswald, Germany
| | - Mark Hallett
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Roy H. Hamilton
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - Christoph S. Herrmann
- Experimental Psychology Lab, Department of Psychology, Carl von Ossietzky Universität, Oldenburg, Germany
| | - Michal Lavidor
- Department of Psychology and the Gonda Brain Research Center, Bar Ilan University, Israel
| | - Collen Loo
- School of Psychiatry and Black Dog Institute, University of New South Wales; The George Institute; Sydney, Australia
| | - Caroline Lustenberger
- Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, 8092 Zurich, Switzerland
| | - Sergio Machado
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil
- Laboratory of Physical Activity Neuroscience, Neurodiversity Institute, Queimados-RJ, Brazil
| | - Carlo Miniussi
- Center for Mind/Brain Sciences – CIMeC and Centre for Medical Sciences - CISMed, University of Trento, Rovereto, Italy
| | - Vera Moliadze
- Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig Holstein, Kiel University, Kiel, Germany
| | - Michael A Nitsche
- Department Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors at TU, Dortmund, Germany
- Dept. Neurology, University Medical Hospital Bergmannsheil, Bochum, Germany
| | - Simone Rossi
- Siena Brain Investigation and Neuromodulation Lab (Si-BIN Lab), Unit of Neurology and Clinical Neurophysiology, Department of Medicine, Surgery and Neuroscience, University of Siena, Italy
| | - Paolo M. Rossini
- Department of Neuroscience and Neurorehabilitation, Brain Connectivity Lab, IRCCS-San Raffaele-Pisana, Rome, Italy
| | - Emiliano Santarnecchi
- Precision Neuroscience and Neuromodulation Program, Gordon Center for Medical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Margitta Seeck
- Department of Clinical Neurosciences, Hôpitaux Universitaires de Genève, Switzerland
| | - Gregor Thut
- Centre for Cognitive Neuroimaging, School of Psychology and Neuroscience, EEG & Epolepsy Unit, University of Glasgow, United Kingdom
| | - Zsolt Turi
- Department of Neuroanatomy, Institute of Anatomy and Cell Biology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Yoshikazu Ugawa
- Department of Human Neurophysiology, Fukushima Medical University, Fukushima, Japan
| | | | - Nicole Wenderoth
- Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, 8092 Zurich, Switzerland
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence And Technological Enterprise (CREATE), Singapore
| | - Anna Wexler
- Department of Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Ulf Ziemann
- Department of Neurology and Stroke, University of Tübingen, Germany
- Hertie Institute for Clinical Brain Research, University of Tübingen, Germany
| | - Walter Paulus
- Department of of Neurology, Ludwig Maximilians University Munich, Germany
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Duran JM, Sierra RO, Corredor K, Cardenas FP. Cathodal transcranial direct current stimulation on the prefrontal cortex applied after reactivation attenuates fear memories and prevent reinstatement after extinction. J Psychiatr Res 2021; 145:213-221. [PMID: 34929471 DOI: 10.1016/j.jpsychires.2021.12.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 12/04/2021] [Accepted: 12/11/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND In the last decade, pharmacological strategies targeting reconsolidation after memory retrieval have shown promising efforts to attenuate persistent memories and overcome fear recovery. However, most reconsolidation inhibiting agents have not been approved for human testing. While non-invasive neuromodulation can be considered an alternative approach to pharmacological treatments, there is a lack of evidence about the efficacy of these technologies when modifying memory traces via reactivation/reconsolidation mechanism. OBJECTIVE In this study, we evaluate the effect of cathodal (c-tDCS) and anodal (a-DCS) transcranial direct current stimulation applied after memory reactivation and extinction in rats. METHODS Male Wistar rats were randomly assigned into three groups: one sham group, one anodal tDCS group, and one cathodal tDCS group (500 μA, 20 min). Reconsolidation and extinction of fear memories were evaluated using a contextual fear conditioning. RESULTS Our results showed that c-tDCS and a-tDCS after memory reactivation can attenuate mild fear memories. However, only c-tDCS stimulation prevented both fear expression under strong fear learning and fear recovery after a reinstatement protocol without modification of learning rate or extinction retrieval. Nevertheless, the remote memories were resistant to modification through this type of neuromodulation. Our results are discussed considering the interaction between intrinsic excitability promoted by learning and memory retrieval and the electric field applied during tDCS. CONCLUSION These results point out some of the boundary conditions influencing the efficacy of tDCS in fear attenuation and open new ways for the development of noninvasive interventions aimed to control fear-related disorders via reconsolidation.
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Affiliation(s)
- Johanna M Duran
- Laboratory of Neuroscience and Behavior, Department of Psychology, Universidad de Los Andes, Colombia.
| | | | - Karen Corredor
- Laboratory of Neuroscience and Behavior, Department of Psychology, Universidad de Los Andes, Colombia
| | - Fernando P Cardenas
- Laboratory of Neuroscience and Behavior, Department of Psychology, Universidad de Los Andes, Colombia.
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Vergallito A, Gallucci A, Pisoni A, Punzi M, Caselli G, Ruggiero GM, Sassaroli S, Romero Lauro LJ. Effectiveness of noninvasive brain stimulation in the treatment of anxiety disorders: a meta-analysis of sham or behaviour-controlled studies. J Psychiatry Neurosci 2021; 46:E592-E614. [PMID: 34753789 PMCID: PMC8580831 DOI: 10.1503/jpn.210050] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 05/23/2021] [Accepted: 07/02/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The possibility of using noninvasive brain stimulation to treat mental disorders has received considerable attention recently. Repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) are considered to be effective treatments for depressive symptoms. However, no treatment recommendation is currently available for anxiety disorders, suggesting that evidence is still limited. We conducted a systematic review of the literature and a quantitative analysis of the effectiveness of rTMS and tDCS in the treatment of anxiety disorders. METHODS Following PRISMA guidelines, we screened 3 electronic databases up to the end of February 2020 for English-language, peer-reviewed articles that included the following: a clinical sample of patients with an anxiety disorder, the use of a noninvasive brain stimulation technique, the inclusion of a control condition, and pre/post scores on a validated questionnaire that measured symptoms of anxiety. RESULTS Eleven papers met the inclusion criteria, comprising 154 participants assigned to a stimulation condition and 164 to a sham or control group. We calculated Hedge's g for scores on disorder-specific and general anxiety questionnaires before and after treatment to determine effect size, and we conducted 2 independent random-effects meta-analyses. Considering the well-known comorbidity between anxiety and depression, we ran a third meta-analysis analyzing outcomes for depression scores. Results showed a significant effect of noninvasive brain stimulation in reducing scores on disorder-specific and general anxiety questionnaires, as well as depressive symptoms, in the real stimulation compared to the control condition. LIMITATIONS Few studies met the inclusion criteria; more evidence is needed to strengthen conclusions about the effectiveness of noninvasive brain stimulation in the treatment of anxiety disorders. CONCLUSION Our findings showed that noninvasive brain stimulation reduced anxiety and depression scores compared to control conditions, suggesting that it can alleviate clinical symptoms in patients with anxiety disorders.
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Affiliation(s)
| | | | - Alberto Pisoni
- From the Department of Psychology, University of Milano Bicocca, Milan, Italy (Vergallito, Pisoni, Punzi, Romero Lauro); the Neuromi, Milan, Italy (Vergallito, Gallucci, Pisoni, Romero Lauro); the Department of Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy (Gallucci); the Studi Cognitivi, Milan, Italy (Caselli, Ruggiero, Sassaroli); and the Faculty of Psychology, Sigmund Freud University, Milan, Italy (Caseli, Ruggiero, Sassaroli)
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21
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Overman MJ, Browning M, O'Shea J. Inducing Affective Learning Biases with Cognitive Training and Prefrontal tDCS: A Proof-of-Concept Study. COGNITIVE THERAPY AND RESEARCH 2021; 45:869-884. [PMID: 34720259 PMCID: PMC8550254 DOI: 10.1007/s10608-020-10146-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2020] [Indexed: 11/27/2022]
Abstract
Background Cognitive models of mood disorders emphasize a causal role of negative affective biases in depression. Computational work suggests that these biases may stem from a belief that negative events have a higher information content than positive events, resulting in preferential processing of and learning from negative outcomes. Learning biases therefore represent a promising target for therapeutic interventions. In this proof-of-concept study in healthy volunteers, we assessed the malleability of biased reinforcement learning using a novel cognitive training paradigm and concurrent transcranial direct current stimulation (tDCS). Methods In two studies, young healthy adults completed two sessions of negative (n = 20) or positive (n = 20) training designed to selectively increase learning from loss or win outcomes, respectively. During training active or sham tDCS was applied bilaterally to dorsolateral prefrontal cortex. Analyses tested for changes both in learning rates and win- and loss-driven behaviour. Potential positive/negative emotional transfer of win/loss learning was assessed by a facial emotion recognition task and mood questionnaires. Results Negative and positive training increased learning rates for losses and wins, respectively. With negative training, there was also a trend for win (but not loss) learning rates to decrease over successive task blocks. After negative training, there was evidence for near transfer in the form of an increase in loss-driven choices when participants performed a similar (untrained) task. There was no change in far transfer measures of emotional face processing or mood. tDCS had no effect on any aspect of behaviour. Discussion and Conclusions Negative training induced a mild negative bias in healthy adults as reflected in loss-driven choice behaviour. Prefrontal tDCS had no effect. Further research is needed to assess if this training procedure can be adapted to enhance learning from positive outcomes and whether effects translate to affective disorders. Electronic supplementary material The online version of this article (10.1007/s10608-020-10146-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Margot Juliëtte Overman
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, OX3 9DU England
| | - Michael Browning
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX England.,Oxford Health NHS Foundation Trust, Warneford Hospital, Warneford Lane, Oxford, OX3 7JX England
| | - Jacinta O'Shea
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, OX3 9DU England.,Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX England.,Oxford Centre for Human Brain Activity (OHBA), Wellcome Centre for Integrative Neuroimaging, Department of Psychiatry, University of Oxford, Oxford, OX3 7JX England
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22
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Allaert J, Erdogan M, Sanchez-Lopez A, Baeken C, De Raedt R, Vanderhasselt MA. Prefrontal tDCS Attenuates Self-Referential Attentional Deployment: A Mechanism Underlying Adaptive Emotional Reactivity to Social-Evaluative Threat. Front Hum Neurosci 2021; 15:700557. [PMID: 34483865 PMCID: PMC8416079 DOI: 10.3389/fnhum.2021.700557] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 07/12/2021] [Indexed: 11/13/2022] Open
Abstract
Social-evaluative threat (SET) - a situation in which one could be negatively evaluated by others - elicits profound (psycho)physiological reactivity which, if chronically present and not adaptively regulated, has deleterious effects on mental and physical health. Decreased self-awareness and increased other-awareness are understood to be an adaptive response to SET. Attentional deployment - the process of selectively attending to certain aspects of emotional stimuli to modulate emotional reactivity - is supported by fronto-parietal and fronto-limbic networks, with the dorsolateral prefrontal cortex being a central hub. The primary aim of the current study was to investigate the effects of active (versus sham) prefrontal transcranial direct current stimulation (tDCS) on self and other-attentional deployment during the exposure to a SET context. Seventy-four female participants received active or sham tDCS and were subsequently exposed to a rigged social feedback paradigm. In this paradigm a series of social evaluations were presented together with a photograph of the supposed evaluator and a self- photograph of the participant, while gaze behavior (time to first fixation, total fixation time) and skin conductance responses (SCRs; a marker of emotional reactivity) were measured. For half of the evaluations, participants could anticipate the valence (negative or positive) of the evaluation a priori. Analyses showed that participants receiving active tDCS were (a) slower to fixate on their self-photograph, (b) spent less time fixating on their self-photograph, and (c) spent more time fixating on the evaluator photograph. During unanticipated evaluations, active tDCS was associated with less time spent fixating on the evaluation. Furthermore, among those receiving active tDCS, SCRs were attenuated as a function of slower times to fixate on the self-photograph. Taken together, these results suggest that in a context of SET, prefrontal tDCS decreases self-attention while increasing other-attention, and that attenuated self-referential attention specifically may be a neurocognitive mechanism through which tDCS reduces emotional reactivity. Moreover, the results suggest that tDCS reduces vigilance toward stimuli that possibly convey threatening information, corroborating past research in this area.
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Affiliation(s)
- Jens Allaert
- Ghent Experimental Psychiatry Lab, Department of Head and Skin, Ghent University, University Hospital Ghent (UZ Ghent), Ghent, Belgium
- Psychopathology and Affective Neuroscience Laboratory, Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Maide Erdogan
- Research in Developmental Disorders Lab, Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Alvaro Sanchez-Lopez
- Department of Clinical Psychology, Universidad Complutense de Madrid, Madrid, Spain
| | - Chris Baeken
- Ghent Experimental Psychiatry Lab, Department of Head and Skin, Ghent University, University Hospital Ghent (UZ Ghent), Ghent, Belgium
- Department of Psychiatry, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Rudi De Raedt
- Psychopathology and Affective Neuroscience Laboratory, Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Marie-Anne Vanderhasselt
- Ghent Experimental Psychiatry Lab, Department of Head and Skin, Ghent University, University Hospital Ghent (UZ Ghent), Ghent, Belgium
- Psychopathology and Affective Neuroscience Laboratory, Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
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Jafari E, Alizadehgoradel J, Pourmohseni Koluri F, Nikoozadehkordmirza E, Refahi M, Taherifard M, Nejati V, Hallajian AH, Ghanavati E, Vicario CM, Nitsche MA, Salehinejad MA. Intensified electrical stimulation targeting lateral and medial prefrontal cortices for the treatment of social anxiety disorder: A randomized, double-blind, parallel-group, dose-comparison study. Brain Stimul 2021; 14:974-986. [PMID: 34167918 DOI: 10.1016/j.brs.2021.06.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 06/06/2021] [Accepted: 06/09/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Social Anxiety Disorder (SAD) is the most common anxiety disorder while remains largely untreated. Disturbed amygdala-frontal network functions are central to the pathophysiology of SAD, marked by hypoactivity of the lateral prefrontal cortex (PFC), and hypersensitivity of the medial PFC and the amygdala. The objective of this study was to determine whether modulation of the dorsolateral and medial PFC activity with a novel intensified stimulation protocol reduces SAD core symptoms, improves treatment-related variables, and reduces attention bias to threatening stimuli. METHODS In this randomized, sham-controlled, double-blind trial, we assessed the efficacy of an intensified stimulation protocol (20 min, twice-daily sessions with 20 min intervals, 5 consecutive days) in two intensities (1 vs 2 mA) compared to sham stimulations. 45 patients with SAD were randomized in three tDCS arms (1-mA, 2-mA, sham). SAD symptoms, treatment-related variables (worries, depressive state, emotion regulation, quality of life), and attention bias to threatening stimuli (dot-probe paradigm) were assessed before and right after the intervention. SAD symptoms were also assessed at 2-month follow-up. RESULTS Both 1-mA and 2-mA protocols significantly reduced fear/avoidance symptoms, worries and improved, emotion regulation and quality of life after the intervention compared to the sham group. Improving effect of the 2-mA protocol on avoidance symptoms, worries and depressive state was significantly larger than the 1-mA group. Only the 2-mA protocol reduced attention bias to threat-related stimuli, the avoidance symptom at follow-up, and depressive states, as compared to the sham group. CONCLUSIONS Modulation of lateral-medial PFC activity with intensified stimulation can improve cognitive control, motivation and emotion networks in SAD and might thereby result in therapeutic effects. These effects can be larger with 2-mA vs 1-mA intensities, though a linear relationship between intensity and efficacy should not be concluded. Our results need replication in larger trials.
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Affiliation(s)
- Eisa Jafari
- Department of Psychology, Payame Noor University, Tehran, Iran
| | - Jaber Alizadehgoradel
- Department of Psychology, Faculty of Humanities, University of Zanjan, Zanjan, Iran.
| | | | | | - Meysam Refahi
- Department of Psychology, Payame Noor University, Tehran, Iran
| | - Mina Taherifard
- Department of Psychology, Mohaghegh-Ardabili University, Ardabil, Iran
| | - Vahid Nejati
- Department of Psychology, Shahid Beheshti University, Tehran, Iran
| | | | - Elham Ghanavati
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
| | - Carmelo M Vicario
- Department of Cognitive Science, University of Messina, Messina, Italy
| | - Michael A Nitsche
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany; Department of Neurology, University Medical Hospital Bergmannsheil, Bochum, Germany
| | - Mohammad Ali Salehinejad
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany.
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Gilbert JR, Galiano CS, Nugent AC, Zarate CA. Ketamine and Attentional Bias Toward Emotional Faces: Dynamic Causal Modeling of Magnetoencephalographic Connectivity in Treatment-Resistant Depression. Front Psychiatry 2021; 12:673159. [PMID: 34220581 PMCID: PMC8249755 DOI: 10.3389/fpsyt.2021.673159] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 05/25/2021] [Indexed: 12/11/2022] Open
Abstract
The glutamatergic modulator ketamine rapidly reduces depressive symptoms in individuals with treatment-resistant major depressive disorder (TRD) and bipolar disorder. While its underlying mechanism of antidepressant action is not fully understood, modulating glutamatergically-mediated connectivity appears to be a critical component moderating antidepressant response. This double-blind, crossover, placebo-controlled study analyzed data from 19 drug-free individuals with TRD and 15 healthy volunteers who received a single intravenous infusion of ketamine hydrochloride (0.5 mg/kg) as well as an intravenous infusion of saline placebo. Magnetoencephalographic recordings were collected prior to the first infusion and 6-9 h after both drug and placebo infusions. During scanning, participants completed an attentional dot probe task that included emotional faces. Antidepressant response was measured across time points using the Montgomery-Asberg Depression Rating Scale (MADRS). Dynamic causal modeling (DCM) was used to measure changes in parameter estimates of connectivity via a biophysical model that included realistic local neuronal architecture and receptor channel signaling, modeling connectivity between the early visual cortex, fusiform cortex, amygdala, and inferior frontal gyrus. Clinically, ketamine administration significantly reduced depressive symptoms in TRD participants. Within the model, ketamine administration led to faster gamma aminobutyric acid (GABA) and N-methyl-D-aspartate (NMDA) transmission in the early visual cortex, faster NMDA transmission in the fusiform cortex, and slower NMDA transmission in the amygdala. Ketamine administration also led to direct and indirect changes in local inhibition in the early visual cortex and inferior frontal gyrus and to indirect increases in cortical excitability within the amygdala. Finally, reductions in depressive symptoms in TRD participants post-ketamine were associated with faster α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) transmission and increases in gain control of spiny stellate cells in the early visual cortex. These findings provide additional support for the GABA and NMDA inhibition and disinhibition hypotheses of depression and support the role of AMPA throughput in ketamine's antidepressant effects. Clinical Trial Registration: https://clinicaltrials.gov/ct2/show/NCT00088699?term=NCT00088699&draw=2&rank=1, identifier NCT00088699.
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Affiliation(s)
- Jessica R. Gilbert
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States
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25
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Postpartum Stress and Neural Regulation of Emotion among First-Time Mothers. COGNITIVE AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2021; 21:1066-1082. [PMID: 34128217 DOI: 10.3758/s13415-021-00914-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/29/2021] [Indexed: 12/17/2022]
Abstract
Early parenting relies on emotion regulation capabilities, as mothers are responsible for regulating both their own emotional state and that of their infant during a time of new parenting-related neural plasticity and potentially increased stress. Previous research highlights the importance of frontal cortical regions in facilitating effective emotion regulation, but few studies have investigated the neural regulation of emotion among postpartum women. The current study employed a functional neuroimaging (fMRI) approach to explore the association between perceived stress, depressive symptoms, and the neural regulation of emotion in first-time mothers. Among 59 postpartum mothers, higher perceived stress during the postpartum period was associated with less self-reported use of cognitive reappraisal in everyday life, and greater use of emotion suppression. While viewing standardized aversive images during the Emotion Regulation Task (ERT), mothers were instructed to experience their natural emotional state (Maintain) or to decrease the intensity of their negative emotion by using cognitive reappraisal (Reappraise). Whole-brain analysis revealed a two-way interaction of perceived stress x condition in the right dorsolateral prefrontal cortex (DLPFC) at p < .05 cluster-wise corrected, controlling for postpartum months and scanner type. Higher levels of perceived stress were associated with heightened right DLPFC activity while engaging in cognitive reappraisal versus naturally responding to negative stimuli. Higher right DLPFC activity during Reappraise versus Maintain was further associated with elevated parenting stress. Findings suggest that stress and everyday reappraisal use is reflected in mothers' neural regulation of emotion and may have important implications for their adaptation to parenthood.
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McKinney C, Stearns M. Parental Psychopathology and Oppositional Defiant Problems in Emerging Adults: Moderated Mediation by Temperament and Gender. Child Psychiatry Hum Dev 2021; 52:439-449. [PMID: 32712741 DOI: 10.1007/s10578-020-01030-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Previous studies have indicated that prenatal maternal depressive symptoms predicted toddler temperament, which led to childhood irritability, an important component to ODD problems. In addition, children with ODD problems continue to have difficulties as they transition into emerging adulthood. The current study examined whether present-day emerging adult temperament mediated the relationship between perceived parental psychopathology (e.g., depressive, anxiety, and antisocial problems) and emerging adult ODD problems (e.g., affective and behavioral components). Further, emerging adult and parent gender was examined as a moderator (i.e., moderated mediation). The current study asked a sample of 973 emerging adults to report upon the psychological problems of their parents as well as their own temperament and ODD problems. Negative affect and effortful control mediated the relationship between maternal anxiety problems and female affective and behavioral ODD problems. Similarly, effortful control mediated the relationship between paternal antisocial problems and male behavioral ODD problems. Significant indirect effects occurred for the mother-daughter and father-son dyads only, suggesting moderated mediation by child and parent gender. Thus, temperament may be one process which explains the relationship between parental psychopathology and emerging adult ODD problems, and this process differed by parent and child gender.
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27
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tDCS-Augmented in vivo exposure therapy for specific fears: A randomized clinical trial. J Anxiety Disord 2021; 78:102344. [PMID: 33418483 DOI: 10.1016/j.janxdis.2020.102344] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 10/01/2020] [Accepted: 12/06/2020] [Indexed: 12/14/2022]
Abstract
Exposure therapy is highly effective for anxiety-related disorders, but there is a need for enhancement. Recent trials of adjunctive neuromodulation have shown promise, warranting evaluation of transcranial direct current stimulation (tDCS) as an augmentation. In a double-blind, placebo-controlled trial, contamination- and animal-phobic participants (N = 49) were randomized to active tDCS (1.7 mA, 20 min; n = 27), or sham tDCS (1.7 mA, 30 s; n = 22), followed by 30 min of in-vivo exposure. Active tDCS targeted excitation of the left mPFC and inhibition of the right dlPFC; polarity was counterbalanced for controls. We predicted tDCS would result in accelerated and better maintained gains, contingent on the subsequent in-session response, and baseline negative prognostic indicators. Consistent with predictions, tDCS promoted engagement and reductions in threat appraisals during exposure, and greater reductions in distress and threat appraisals through 1-month, although effects did not uniformly generalize. tDCS was most beneficial given high phobic severity, anxiety sensitivity, and a suboptimal early response. tDCS may promote engagement and response among individuals who are resistant or refractory to standard treatment. tDCS should be applied to more severe anxiety-related disorders, with parameters yoked to individual differences to improve outcomes in exposure-based interventions.
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28
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Nord CL. Predicting Response to Brain Stimulation in Depression: a Roadmap for Biomarker Discovery. Curr Behav Neurosci Rep 2021; 8:11-19. [PMID: 33708470 PMCID: PMC7904553 DOI: 10.1007/s40473-021-00226-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/28/2021] [Indexed: 11/22/2022]
Abstract
PURPOSE OF REVIEW Clinical response to brain stimulation treatments for depression is highly variable. A major challenge for the field is predicting an individual patient's likelihood of response. This review synthesises recent developments in neural predictors of response to targeted brain stimulation in depression. It then proposes a framework to evaluate the clinical potential of putative 'biomarkers'. RECENT FINDINGS Largely, developments in identifying putative predictors emerge from two approaches: data-driven, including machine learning algorithms applied to resting state or structural neuroimaging data, and theory-driven, including task-based neuroimaging. Theory-driven approaches can also yield mechanistic insight into the cognitive processes altered by the intervention. SUMMARY A pragmatic framework for discovery and testing of biomarkers of brain stimulation response in depression is proposed, involving (1) identification of a cognitive-neural phenotype; (2) confirming its validity as putative biomarker, including out-of-sample replicability and within-subject reliability; (3) establishing the association between this phenotype and treatment response and/or its modifiability with particular brain stimulation interventions via an early-phase randomised controlled trial RCT; and (4) multi-site RCTs of one or more treatment types measuring the generalisability of the biomarker and confirming the superiority of biomarker-selected patients over randomly allocated groups.
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Affiliation(s)
- Camilla L. Nord
- MRC Cognition and Brain Sciences Unit, University of Cambridge, 15 Chaucer Road, Cambridge, CB2 7EF UK
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Suen PJC, Doll S, Batistuzzo MC, Busatto G, Razza LB, Padberg F, Mezger E, Bulubas L, Keeser D, Deng ZD, Brunoni AR. Association between tDCS computational modeling and clinical outcomes in depression: data from the ELECT-TDCS trial. Eur Arch Psychiatry Clin Neurosci 2021; 271:101-110. [PMID: 32279145 PMCID: PMC8100980 DOI: 10.1007/s00406-020-01127-w] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 03/30/2020] [Indexed: 12/19/2022]
Abstract
Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation intervention investigated for the treatment of depression. Clinical results have been heterogeneous, partly due to the variability of electric field (EF) strength in the brain owing to interindividual differences in head anatomy. Therefore, we investigated whether EF strength was correlated with behavioral changes in 16 depressed patients using simulated electric fields in real patient data from a controlled clinical trial. We hypothesized that EF strength in the dorsolateral prefrontal cortex (DLPFC) and anterior cingulate cortex (ACC), brain regions implicated in depression pathophysiology, would be associated with changes in depression, mood and anxiety scores. SimNIBS were used to simulate individual electric fields based on the MRI structural T1-weighted brain scans of depressed subjects. Linear regression models showed, at the end of the acute treatment phase, that simulated EF strength was inversely associated with negative affect in the bilateral ACC (left: β = - 160.463, CI [- 291.541, - 29.385], p = 0.021; right: β = - 189.194, CI [- 289.479, - 88.910], p = 0.001) and DLPFC (left: β = - 93.210, CI [- 154.960, - 31.461], p = 0.006; right: β = - 82.564, CI [- 142.867, - 22.262], p = 0.011) and with depression scores in the left ACC (β = - 156.91, CI [- 298.51, - 15.30], p = 0.033). No association between positive affect or anxiety scores, and simulated EF strength in the investigated brain regions was found. To conclude, our findings show preliminary evidence that EF strength simulations might be associated with further behavioral changes in depressed patients, unveiling a potential mechanism of action for tDCS. Further studies should investigate whether individualization of EF strength in key brain regions impact clinical response.
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Affiliation(s)
- Paulo J. C. Suen
- Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Sarah Doll
- Department of Psychology, University of Münster, Münster, Germany
| | | | - Geraldo Busatto
- Center for Interdisciplinary Research on Applied Neurosciences (NAPNA) and Laboratory of Psychiatric Neuroimaging, Department and Institute of Psychiatry, University of Sao Paulo, Sao Paulo, Brazil
| | - Lais B. Razza
- Laboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry, Faculdade de Medicina da Universidade de São Paulo, Service of Interdisciplinary Neuromodulation, Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBioN), Instituto de Psiquiatria, R Dr Ovidio Pires de Campos 785, 2o andar, Ala Sul, São Paulo, CEP 05403-000, Brazil
| | - Frank Padberg
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Eva Mezger
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Lucia Bulubas
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany,International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany
| | - Daniel Keeser
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany,Department of Clinical Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Zhi-De Deng
- Noninvasive Neuromodulation Unit, Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Andre R. Brunoni
- Laboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry, Faculdade de Medicina da Universidade de São Paulo, Service of Interdisciplinary Neuromodulation, Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBioN), Instituto de Psiquiatria, R Dr Ovidio Pires de Campos 785, 2o andar, Ala Sul, São Paulo, CEP 05403-000, Brazil,Department of Internal Medicine, Faculdade de Medicina da Universidade de São Paulo and Hospital Universitário, Universidade de São Paulo, Av. Prof Lineu Prestes 2565, São Paulo 05508-000, Brazil
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Huang Y, Shen L, Huang J, Xu X, Wang Y, Jin H. Efficacy and Safety of tDCS and tACS in Treatment of Major Depressive Disorder: A Randomized, Double-Blind, Factorial Placebo-Controlled Study Design. Neuropsychiatr Dis Treat 2021; 17:1459-1468. [PMID: 34012266 PMCID: PMC8128494 DOI: 10.2147/ndt.s295945] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 04/27/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Transcranial direct current stimulation (tDCS) and transcranial alternating current stimulation (tACS) are regarded as promising antidepressant treatments. OBJECTIVE To compare the efficacy and safety of tDCS, tACS, escitalopram, and placebo/sham stimulation controls. DESIGN Randomized, parallel, double-blind, placebo-controlled study. METHODS Sample sizes were calculated based on data from previous similar studies. Eligible non-treatment-resistant-depressive outpatient subjects with moderate-to-severe depression (HRDS ≥17) are randomized to receive (1) tDCS + placebo; (2) tACS + placebo; (3) escitalopram + placebo; or (4) sham stimulation + placebo. The intensity of electricity is 2 mA, lasting for 30 minutes over two consecutive working days (10 sessions in total). The medication lasts for 6 weeks. The primary outcome measure was the response rates within 6 weeks (week 6 is also the endpoint of the study), and secondary outcome measures included changes in other clinical measurements. Safety and acceptability are measured by adverse event rates and dropout rates. Exploring outcome consist of the performance of cognitive battery as well as neurophysiology results. CONCLUSION To the best of our knowledge, the present study is the first double-blind controlled study comparing tDCS, tACS, and clinically used antidepressants, which will provide further evidence for their efficacy and safety in possible clinical applications.
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Affiliation(s)
- Yuxin Huang
- Department of Outpatient, Shanghai Mental Health Center, Shanghai, People's Republic of China
| | - Linjie Shen
- Department of Outpatient, Shanghai Mental Health Center, Shanghai, People's Republic of China
| | - Jia Huang
- Department of Outpatient, Shanghai Mental Health Center, Shanghai, People's Republic of China
| | - Xianrong Xu
- School of Public Health, Hangzhou Normal University, Hnagzhou, Zhejiang Province, People's Republic of China
| | - Yong Wang
- Department of Outpatient, Shanghai Mental Health Center, Shanghai, People's Republic of China
| | - Hua Jin
- Department of Outpatient, Shanghai Mental Health Center, Shanghai, People's Republic of China
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31
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Godlewska BR, Harmer CJ. Cognitive neuropsychological theory of antidepressant action: a modern-day approach to depression and its treatment. Psychopharmacology (Berl) 2021; 238:1265-1278. [PMID: 31938879 PMCID: PMC8062380 DOI: 10.1007/s00213-019-05448-0] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 12/27/2019] [Indexed: 12/12/2022]
Abstract
Depression is a leading cause of disability worldwide and improving its treatment is a core research priority for future programmes. A change in the view of psychological and biological processes, from seeing them as separate to complementing one another, has introduced new perspectives on pathological mechanisms of depression and treatment mode of action. This review presents a theoretical model that incorporated this novel approach, the cognitive neuropsychological hypothesis of antidepressant action. This model proposes that antidepressant treatments decrease the negative bias in the processing of emotionally salient information early in the course of antidepressant treatment, which leads to the clinically significant mood improvement later in treatment. The paper discusses the role of negative affective biases in the development of depression and response to antidepressant treatments. It also discusses whether the model can be applied to other antidepressant interventions and its potential translational value, including treatment choice, prediction of response and drug development.
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Affiliation(s)
- Beata R Godlewska
- Department of Psychiatry, Psychopharmacology Research Unit, University Department of Psychiatry (PPRU), University of Oxford, Oxford, UK.
- Department of Psychiatry, Psychopharmacology and Emotion Research Laboratory (PERL), University of Oxford, Oxford, UK.
- Oxford Health Foundation Trust, University Department of Psychiatry, Warneford Hospital, Oxford, OX3 7JX, UK.
| | - Catherine J Harmer
- Department of Psychiatry, Psychopharmacology and Emotion Research Laboratory (PERL), University of Oxford, Oxford, UK
- Oxford Health Foundation Trust, University Department of Psychiatry, Warneford Hospital, Oxford, OX3 7JX, UK
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32
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Keen L, George L, Williams G, Blanden G, Ramirez M. Assessing the validity of the Self-Report Webexec Questionnaire: Self-report vs performance neurocognitive inferences. APPLIED NEUROPSYCHOLOGY-ADULT 2020; 29:1030-1038. [PMID: 33949904 DOI: 10.1080/23279095.2020.1843041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The Webexec is a self-reported neuropsychological measure, which previous research suggests is associated with personality and executive functions. Though the Webexec could be useful for brief neuropsychological assessment, there is limited literature examining its validity. The current study's purpose was to determine Webexec's validity and association with mood symptomatology in two Historically Black College or University (HBCU) undergraduate student samples. Study 1 employed a neurocognitive battery for convergent validity testing, while the second study utilized psychological measures to determine the Webexec's association with mood-based symptomatology. Study 1 included 149 participants, with a mean age of 20.08 (SD = 1.75) years. Participants completed a demographic questionnaire, the Webexec, and a neuropsychological battery. The neuropsychological battery measured verbal fluency, visual scanning, and working memory. The Webexec was positively associated with working memory (r = 0.18, p = 0.03), but no other neuropsychological measures. Study 2 utilized an online survey with 799 HBCU participants. Results suggest Webexec was associated with depressive symptomatology (r = 0.41, p = 0.01), anxiety symptomatology (r = 0.39, p = 0.01), and impulsivity (r = 0.21, p = 0.01). Taken together, results from both studies suggest the Webexec is not consistently associated with performance measures of executive function and maybe more consistent with self-reported psychological symptoms.
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Affiliation(s)
- Larry Keen
- Department of Psychology, Virginia State University, Petersburg, VA, USA
| | - Lauren George
- Department of Psychology, Virginia State University, Petersburg, VA, USA
| | - Georgia Williams
- Department of Psychology, Virginia State University, Petersburg, VA, USA
| | - Gwenna Blanden
- Department of Psychology, Virginia State University, Petersburg, VA, USA
| | - Mara Ramirez
- Department of Psychology, Virginia State University, Petersburg, VA, USA
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33
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Mehrsafar AH, Rosa MAS, Zadeh AM, Gazerani P. A feasibility study of application and potential effects of a single session transcranial direct current stimulation (tDCS) on competitive anxiety, mood state, salivary levels of cortisol and alpha amylase in elite athletes under a real-world competition. Physiol Behav 2020; 227:113173. [DOI: 10.1016/j.physbeh.2020.113173] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 07/15/2020] [Accepted: 09/04/2020] [Indexed: 01/29/2023]
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34
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tDCS as a treatment for anxiety and related cognitive deficits. Int J Psychophysiol 2020; 158:172-177. [PMID: 33129848 DOI: 10.1016/j.ijpsycho.2020.10.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 08/07/2020] [Accepted: 10/16/2020] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Anxiety is characterized by psychological, physiological, and cognitive complaints. Current treatments have significant limitations, and often overlook any potential benefits to common cognitive symptoms, notably attention and executive function issues. The current study aimed to investigate the use of transcranial direct current stimulation (tDCS) on both common anxiety symptoms and executive function abilities in a college aged sample. METHOD As this is one of the first large scale anxiety studies utilizing tDCS, participants were given a single session of tDCS (anodal, cathodal, or sham) for 20 min at 2 mA over the left dorsolateral prefrontal cortex (lDLPFC). Participants also completed a series of self-reported anxiety measures and measures of executive functioning (Rey-O Copy and Wisconsin Card Sorting Task). RESULTS While there were no differences in anxiety between tDCS groups, a trend was noted demonstrating better performance on Rey-O Copy for the cathodal group. Anxiety increased pre to post for all groups. CONCLUSION Overall, results suggest that while anodal stimulation of the lDLPFC may benefit cognitive abilities for this population, targeting psychological symptoms of anxiety likely requires stimulation over other cortex, possibly right DLPFC. Further, the use of tDCS, whether active or sham, may be distressing to patients.
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35
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The effects of left DLPFC tDCS on emotion regulation, biased attention, and emotional reactivity to negative content. COGNITIVE AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2020; 20:1323-1335. [PMID: 33123862 DOI: 10.3758/s13415-020-00840-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/07/2020] [Indexed: 12/24/2022]
Abstract
The potentiation of neural activity in lateral prefrontal regions via transcranial direct current stimulation (tDCS) can reduce patterns of biased attention for threat and may facilitate intentional emotion regulation. The current study sought to determine whether left dorsolateral prefrontal cortex tDCS, in combination with intentional down-regulation of emotional responses would reduce negative appraisals of aversive content during emotional regulation (assessed during online tDCS), reduce patterns of biased attention and attention bias variability (assessed offline), and attenuate spontaneous (uninstructed) emotional reactivity to negative content (assessed offline) above tDCS or intentional down-regulation of emotions in isolation. Healthy participants (n = 116) were allocated to one of four experimental conditions involving either active or sham tDCS, combined with an either a down-regulate or maintain emotion regulation task. Attention bias/bias variability was assessed with an attentional probe task, and emotional reactivity was assessed in a negative video viewing task. tDCS did not affect the appraisals of negative stimuli during emotion regulation, and there were no effects on attention bias/bias variability. However, tDCS did attenuate emotional reactivity. Those receiving active stimulation showed smaller elevations in negative mood in response to viewing aversive video content compared with sham. The present findings are consistent with the potential of left frontal tDCS to attenuate negative emotional reactions to aversive content but provide no support for tDCS enhancement of emotion regulation, nor its impact on attention bias or attention bias variability.
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36
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Clarke PJF, Haridas SMP, Van Bockstaele B, Chen NTM, Salemink E, Notebaert L. Frontal tDCS and Emotional Reactivity to Negative Content: Examining the Roles of Biased Interpretation and Emotion Regulation. COGNITIVE THERAPY AND RESEARCH 2020. [DOI: 10.1007/s10608-020-10162-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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37
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Influence of theta-burst transcranial magnetic stimulation over the dorsolateral prefrontal cortex on emotion processing in healthy volunteers. COGNITIVE AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2020; 20:1278-1293. [PMID: 33000366 PMCID: PMC7716858 DOI: 10.3758/s13415-020-00834-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/13/2020] [Indexed: 02/07/2023]
Abstract
Repetitive transcranial magnetic stimulation is a potential treatment option for depression, with the newer intermittent theta-burst stimulation (iTBS) protocols providing brief intervention. However, their mechanism of action remains unclear. We investigated the hypothesis that iTBS influences brain circuits involved in emotion processing that are also affected by antidepressants. We predicted that iTBS would lead to changes in performance on emotion-processing tasks. We investigated the effects of intermittent TBS (iTBS) over the left dorsolateral prefrontal cortex (DLPFC) on the processing of emotional information (word recall and categorization, facial emotion recognition, and decision-making) in 28 healthy volunteers by contrasting these effects with those of sham stimulation. Each volunteer received iTBS and sham stimulation in a blinded crossover design and completed the emotion-processing tasks before and after stimulation. Compared to sham stimulation, iTBS increased positive affective processing for word recall, yet had an unexpected effect on facial emotion recognition for happy and sad faces. There was no evidence of an effect on decision-making or word categorization. We found support for our hypothesis that iTBS influences emotion processing, though some changes were not in the expected direction. These findings suggest a possible common mechanism of action between iTBS and antidepressants, and a complex neural circuitry involved in emotion processing that could potentially be tapped into via brain stimulation. Future research should investigate the neural correlates of emotion processing more closely to inform future iTBS protocols.
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38
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Liu S, Li X, Ma R, Cao H, Jing C, Wang Z, Chen D, Zhang J, Zhang Y, Feng J, Wu J. Cancer-associated changes of emotional brain network in non-nervous system metastatic non-small cell lung cancer patients: a structural connectomic diffusion tensor imaging study. Transl Lung Cancer Res 2020; 9:1101-1111. [PMID: 32953489 PMCID: PMC7481628 DOI: 10.21037/tlcr-20-273] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background Emotional distress frequently occur in cancer patients following diagnosis. Previous neuroimaging studies have demonstrated that depression and anxiety are associated with functional and structural brain abnormalities. However, little is known about the cancer-associated changes of emotional brain network in non-small cell lung cancer (NSCLC) patients. The aim of this study was to assess the topological features of brain structural network and emotions in non-nervous system metastatic NSCLC patients prior to chemotherapy. Methods Twenty-four treatment-naïve patients with non-nervous system metastatic NSCLC and 25 healthy controls (HC) matched for gender, age and education participated in this study. All subjects underwent diffusion tensor imaging (DTI), and were assessed with the 17 item hamilton depression rating scale (HAMD-17) and hamilton anxiety rating scale (HAMA). Properties of brain network were examined by the method of graph-theoretic analysis. The assessments included small-worldness, clustering coefficient and shortest path length. Results NSCLC patients had higher scores of HAMD-17 and HAMA when compared with HC. Additionally, we found a small-world topology of brain white matter network in both NSCLC and HC. NSCLC patients had significantly reduced clustering coefficient compared to healthy controls in the left hippocampus. Moreover, increased shortest path length were identified in NSCLC patients, which included the left middle frontal gyrus (orbital part), superior temporal gyrus and right Rolandic operculum, rectus gyrus, lenticular nucleus (putamen). However, no correlations were found between the impaired brain regions and HAMD-17, HAMA scores of NSCLC patients. Conclusions Our results indicated impaired topological characteristics in the brain structural network of non-nervous system metastatic NSCLC patients prior to chemotherapy, which might account for the cancer-related emotional distress. Our findings demonstrated that NSCLC might affect brain regions involved in the process of emotion, which identified the basis of emotional changes associated with cancer.
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Affiliation(s)
- Siwen Liu
- Research Center for Clinical Oncology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Xiaoyou Li
- Department of Oncology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Rong Ma
- Research Center for Clinical Oncology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Haixia Cao
- Research Center for Clinical Oncology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Changwen Jing
- Research Center for Clinical Oncology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Zhuo Wang
- Research Center for Clinical Oncology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Dan Chen
- Research Center for Clinical Oncology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Junying Zhang
- Research Center for Clinical Oncology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Yuan Zhang
- Research Center for Clinical Oncology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Jifeng Feng
- Research Center for Clinical Oncology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China.,Department of Oncology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Jianzhong Wu
- Research Center for Clinical Oncology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
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39
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Tabibnia G. An affective neuroscience model of boosting resilience in adults. Neurosci Biobehav Rev 2020; 115:321-350. [DOI: 10.1016/j.neubiorev.2020.05.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 05/09/2020] [Accepted: 05/10/2020] [Indexed: 12/11/2022]
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40
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Wright EC, Hostinar CE, Trainor BC. Anxious to see you: Neuroendocrine mechanisms of social vigilance and anxiety during adolescence. Eur J Neurosci 2020; 52:2516-2529. [PMID: 31782841 PMCID: PMC7255921 DOI: 10.1111/ejn.14628] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Revised: 10/05/2019] [Accepted: 11/22/2019] [Indexed: 12/14/2022]
Abstract
Social vigilance is a behavioral strategy commonly used in adverse or changing social environments. In animals, a combination of avoidance and vigilance allows an individual to evade potentially dangerous confrontations while monitoring the social environment to identify favorable changes. However, prolonged use of this behavioral strategy in humans is associated with increased risk of anxiety disorders, a major burden for human health. Elucidating the mechanisms of social vigilance in animals could provide important clues for new treatment strategies for social anxiety. Importantly, during adolescence the prevalence of social anxiety increases significantly. We hypothesize that many of the actions typically characterized as anxiety behaviors begin to emerge during this time as strategies for navigating more complex social structures. Here, we consider how the social environment and the pubertal transition shape neural circuits that modulate social vigilance, focusing on the bed nucleus of the stria terminalis and prefrontal cortex. The emergence of gonadal hormone secretion during adolescence has important effects on the function and structure of these circuits, and may play a role in the emergence of a notable sex difference in anxiety rates across adolescence. However, the significance of these changes in the context of anxiety is still uncertain, as not enough studies are sufficiently powered to evaluate sex as a biological variable. We conclude that greater integration between human and animal models will aid the development of more effective strategies for treating social anxiety.
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Affiliation(s)
- Emily C Wright
- Department of Psychology, University of California, Davis, CA, USA
| | | | - Brian C Trainor
- Department of Psychology, University of California, Davis, CA, USA
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41
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Farhat LC, Carvalho AF, Solmi M, Brunoni AR. Evidence-based Umbrella Review of Cognitive Effects of Prefrontal tDCS. Soc Cogn Affect Neurosci 2020; 17:43-60. [PMID: 32577732 PMCID: PMC8866814 DOI: 10.1093/scan/nsaa084] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 04/29/2020] [Accepted: 06/15/2020] [Indexed: 12/04/2022] Open
Abstract
Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique, which has been increasingly used as an investigational tool in neuroscience. In social and affective neuroscience research, the prefrontal cortex has been primarily targeted, since this brain region is critically involved in complex psychobiological processes subserving both Șhotș and Școldș domains. Although several studies have suggested that prefrontal tDCS can enhance neuropsychological outcomes, meta-analyses have reported conflicting results. Therefore, we aimed to assess the available evidence by performing an umbrella review of meta-analyses. We evaluated the effects of prefrontal active vs sham tDCS on different domains of cognition among healthy and neuropsychiatric individuals. A MeaSurement Tool to Assess Systematic Reviews 2 was employed to evaluate the quality of meta-analyses, and the GRADE system was employed to grade the quality of evidence of every comparison from each meta-analysis. PubMed/MEDLINE, PsycINFO and the Cochrane Database of Systematic Reviews were searched, and 11 meta-analyses were included resulting in 55 comparisons. Only 16 comparisons reported significant effects favoring tDCS, but 13 of them had either very low or low quality of evidence. Of the remaining 39 comparisons which reported non-significant effects, 38 had either very low or low quality of evidence. Meta-analyses were rated as having critically low and low quality. Among several reasons to explain these findings, the lack of consensus and reproducibility in tDCS research is discussed.
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Affiliation(s)
- Luis C Farhat
- Departamento de Psiquiatria da Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Andre F Carvalho
- Center for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,IMPACT Strategic Research Centre (Innovation in Mental and Physical Health and Clinical Treatment), Deakin University, Geelong, Vic., Australia
| | - Marco Solmi
- Padua Neuroscience Center, University of Padua, Padua, Italy.,Department of Neuroscience, University of Padua, Padua, Italy
| | - Andre R Brunoni
- Departamento de Psiquiatria da Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil.,Laboratory of Neurosciences (LIM-27), Department of Psychiatry, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.,Department of Internal Medicine, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
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42
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Stein DJ, Fernandes Medeiros L, Caumo W, Torres IL. Transcranial Direct Current Stimulation in Patients with Anxiety: Current Perspectives. Neuropsychiatr Dis Treat 2020; 16:161-169. [PMID: 32021208 PMCID: PMC6969693 DOI: 10.2147/ndt.s195840] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 12/21/2019] [Indexed: 02/05/2023] Open
Abstract
Anxiety is one of the most prevalent and debilitating psychiatric conditions worldwide. Pharmaco- and psycho-therapies have been employed in the treatment of human anxiety to date. Yet, either alone or in combination, unsatisfactory patient outcomes are prevalent, resulting in a considerable number of people whose symptoms fail to respond to conventional therapies with symptoms remaining after intervention. The demand for new therapies has given birth to several noninvasive brain stimulation techniques. Transcranial direct current stimulation (tDCS) has arisen as a promising tool and has been proven to be safe and well tolerated for the treatment of many diseases, including chronic pain, depression, and anxiety. Here, reports of the use of tDCS in anxiety disorders in human patients were reviewed and summarized. A literature search was conducted in mid-2019, to identify clinical studies that evaluated the use of tDCS for the treatment of anxiety behavior. The PubMed, Web of Science, and Scielo and PsycInfo databases were explored using the following descriptors: "anxiety", "anxious behavior", "tDCS", and "transcranial direct current stimulation". Among the selected articles, considerable variability in the type of tDCS treatment applied in interventions was observed. Evidence shows that tDCS may be more effective when used in combination with drugs and cognitive behavioral therapies; however future large-scale clinical trials are recommended to better clarify the real effects of this intervention alone, or in combination with others.
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Affiliation(s)
- Dirson João Stein
- Laboratório de Farmacologia da Dor e Neuromodulação, Investigações Pré-Clínicas, Centro de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil.,Programa de Pós-Graduação em Medicina: Ciências Médicas, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Liciane Fernandes Medeiros
- Laboratório de Farmacologia da Dor e Neuromodulação, Investigações Pré-Clínicas, Centro de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil.,Programa de Pós-Graduação em Ciências Biológicas: Farmacologia e Terapêutica, UFRGS, Porto Alegre, RS, Brazil.,Programa de Pós-Graduação em Saúde e Desenvolvimento Humano, Universidade La Salle, Canoas, RS, Brazil
| | - Wolnei Caumo
- Programa de Pós-Graduação em Medicina: Ciências Médicas, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Iraci Ls Torres
- Laboratório de Farmacologia da Dor e Neuromodulação, Investigações Pré-Clínicas, Centro de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil.,Programa de Pós-Graduação em Medicina: Ciências Médicas, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.,Programa de Pós-Graduação em Ciências Biológicas: Farmacologia e Terapêutica, UFRGS, Porto Alegre, RS, Brazil
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tDCS increases anxiety reactivity to intentional worry. J Psychiatr Res 2020; 120:34-39. [PMID: 31629997 DOI: 10.1016/j.jpsychires.2019.10.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 10/11/2019] [Accepted: 10/11/2019] [Indexed: 12/15/2022]
Abstract
While considerable experimental research has examined the impact of transcranial direct current stimulation (tDCS) on a range of cognitive processes associated with emotional pathology, the impact of tDCS on worry has been comparatively neglected. Given that anxiety pathology is characterised by motivated engagement in worry, and that frontal tDCS has the capacity to enhance goal-oriented cognition, it is important to examine whether tDCS would increase or ameliorate the cognitive and emotional effects of worry. In the current study we examined how tDCS influenced the anxiety response to worry, and the frequency of negative intrusive thoughts. We additionally examined whether stimulation delivered in isolation, or in combination with a mindful-focus task would augment the effects of tDCS. Ninety-seven (75 female) healthy participants received either active or sham anodal tDCS to the left dorsolateral prefrontal cortex, delivered either in isolation or concurrently with a mindful task (four conditions). The frequency of negative thought intrusions was assessed before and after a period of instructed worry, and state anxiety was assessed across the study. Active tDCS was associated with significantly greater elevation in anxiety in response to the worry induction. No effects were observed on the frequency of negative thought intrusions, and the combined delivery of tDCS with the concurrent mindful task did not alter the pattern of observed effects. While inviting replication in a high anxious sample, the present results highlight the possibility that tDCS may interact with motivated engagement in negative patterns of cognition, such as worry, to produce greater emotional reactivity.
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de Lima AL, Braga FMA, da Costa RMM, Gomes EP, Brunoni AR, Pegado R. Transcranial direct current stimulation for the treatment of generalized anxiety disorder: A randomized clinical trial. J Affect Disord 2019; 259:31-37. [PMID: 31437698 DOI: 10.1016/j.jad.2019.08.020] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 08/08/2019] [Accepted: 08/13/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Generalized anxiety disorder (GAD) is a common condition with current treatments being only moderately effective. Non-invasive brain stimulation techniques might provide a novel approach for treating GAD. Transcranial direct current stimulation (tDCS) has shown promising efficacy and tolerability for major depression but has not been investigated for GAD yet. Thus, we investigated the effects of tDCS on patients with GAD. METHODS We conducted a pilot, double-blind, randomized, sham-controlled trial on 30 GAD patients. Five sessions of tDCS (2 mA, 20 min, anode over the left dorsolateral prefrontal cortex and cathode over the right supraorbital cortex) were performed. Anxiety was the primary outcome and it was measured by the Hamilton Anxiety Rating Scale and the Beck Anxiety Inventory. Secondary outcomes were accessed by the Lipp Inventory of Stress Symptoms for Adults, Positive and Negative Affect Schedule, and the Beck Depression Inventory (BDI). Data were examined at baseline, after the 5th day of intervention, and at 1-week follow-up. RESULTS Thirty patients finished the study. There were no significant improvements in anxiety, mood symptoms of stress, affectivity or depression. Anodal stimulation of the left DLPFC showed significant improvements in physical symptoms of stress in GAD patients. LIMITATIONS Additional tDCS sessions could have resulted in larger tDCS effects. CONCLUSION Five sessions of anodal tDCS over the DLPFC did not improve the main outcomes for GAD patients, although physical symptoms of stress were improved. The role of tDCS in GAD should be explored in larger patient samples using different parameters.
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Affiliation(s)
- Ana Lucia de Lima
- Graduate Program in Rehabilitation Science, Federal University of Rio Grande do Norte, Rio Grande do Norte, Brazil
| | | | | | | | - André Russowsky Brunoni
- Department and Institute of Psychiatry, University of São Paulo, São Paulo, Brazil; Department of Internal Medicine, University of São Paulo, São Paulo, Brazil
| | - Rodrigo Pegado
- Graduate Program in Rehabilitation Science, Federal University of Rio Grande do Norte, Rio Grande do Norte, Brazil.
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DeLaRosa BL, Spence JS, Didehbani N, Tillman GD, Motes MA, Bass C, Kraut MA, Hart J. Neurophysiology of threat processing bias in combat-related post-traumatic stress disorder. Hum Brain Mapp 2019; 41:218-229. [PMID: 31584243 PMCID: PMC7268056 DOI: 10.1002/hbm.24800] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 08/18/2019] [Accepted: 09/08/2019] [Indexed: 01/08/2023] Open
Abstract
Post‐traumatic stress disorder (PTSD) is a debilitating condition that may develop after experiencing a traumatic event. Combat exposure increases an individual's chance of developing PTSD, making veterans especially susceptible to the disorder. PTSD is characterized by dysregulated emotional networks, memory deficits, and a hyperattentive response to perceived threatening stimuli. Recently, there have been a number of imaging studies that show structural and functional abnormalities associated with PTSD; however, there have been few studies utilizing electroencephalography (EEG). The goal of this study was to characterize **EEG brain dynamics in individuals with PTSD, in order to better understand the neurophysiological underpinnings of some of the salient features of PTSD, such as threat‐processing bias. Veterans of Operation Enduring Freedom/Iraqi Freedom completed an implicit visual threat semantic memory recognition task with stimuli that varied on both category (animals, items, nature, and people) and feature (threatening and nonthreatening) membership, including trauma‐related stimuli. Combat veterans with PTSD had slower reaction times for the threatening stimuli relative to the combat veterans without PTSD (VETC). There were trauma‐specific effects in frontal regions, with theta band EEG power reductions for the threatening combat scenes in the PTSD patients compared to the VETC group. Additionally, a moderate negative correlation was observed between trauma‐specific frontal theta power and hyperarousal symptoms as measured by clinically administered PTSD scale. These findings complement and extend current models of cortico‐limbic dysfunction in PTSD. The moderate negative correlation between frontal theta power and hyperarousal endorsements suggests the utility of these measures as therapeutic markers of symptomatology in PTSD patients.
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Affiliation(s)
- Bambi L DeLaRosa
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas, Texas
| | - Jeffrey S Spence
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas, Texas
| | - Nyaz Didehbani
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas, Texas
| | - Gail D Tillman
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas, Texas
| | - Michael A Motes
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas, Texas
| | - Christina Bass
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas, Texas
| | - Michael A Kraut
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas, Texas.,Department of Radiology, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - John Hart
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas, Texas.,Department of Neurology and Neurotherapeutics, The University of Texas Southwestern, Medical Center, Dallas, Texas
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Ganho-Ávila A, Gonçalves ÓF, Guiomar R, Boggio PS, Asthana MK, Krypotos AM, Almeida J. The effect of cathodal tDCS on fear extinction: A cross-measures study. PLoS One 2019; 14:e0221282. [PMID: 31532768 PMCID: PMC6750569 DOI: 10.1371/journal.pone.0221282] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 08/02/2019] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Extinction-based procedures are often used to inhibit maladaptive fear responses. However, because extinction procedures show efficacy limitations, transcranial direct current stimulation (tDCS) has been suggested as a promising add-on enhancer. OBJECTIVE In this study, we tested how cathodal tDCS over the right dorsolateral prefrontal cortex affects extinction and tried to unveil the processes at play that boost the effectiveness of extinction procedures and its translational potential to the treatment of anxiety disorders. METHODS We implemented a fear conditioning paradigm whereby 41 healthy women (mean age = 20.51 ± 5.0) were assigned to either cathodal tDCS (n = 27) or sham tDCS (n = 16). Fear responses were measured with self-reports, autonomic responses, and implicit avoidance tendencies. RESULTS Cathodal tDCS shows no statistically significant effect in extinction, according to self-reports, and seems to even negatively affect fear conditioned skin conductance responses. However, one to three months after the tDCS session and extinction, we found a group difference in the action tendencies towards the neutral stimuli (F (1, 41) = 12.04, p = .001, ηp2 = .227), with the cathodal tDCS group (as opposed to the sham group) showing a safety learning (a positive bias towards the CS-), with a moderate effect size. This suggests that cathodal tDCS may foster stimuli discrimination, leading to a decreased generalization effect. DISCUSSION Cathodal tDCS may have enhanced long-term distinctiveness between threatening cues and perceptively similar neutral cues through a disambiguation process of the value of the neutral stimuli-a therapeutic target in anxiety disorders. Future studies should confirm these results and extend the study of cathodal tDCS effect on short term avoidance tendencies.
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Affiliation(s)
- Ana Ganho-Ávila
- Proaction Laboratory, Cognitive and Behavior Center for Research and Intervention Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
- Neuropsychophysiology Lab, CiPsi, School of Psychology, University of Minho, Braga, Portugal
| | - Óscar F. Gonçalves
- Neuropsychophysiology Lab, CiPsi, School of Psychology, University of Minho, Braga, Portugal
- Spaulding Neuromodulation Center, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, United States of America
| | - Raquel Guiomar
- Proaction Laboratory, Cognitive and Behavior Center for Research and Intervention Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | - Paulo Sérgio Boggio
- Social and Cognitive Neuroscience Laboratory and Developmental Disorders Program, Center for Health and Biological Sciences, Mackenzie Presbyterian University, São Paulo, Brazil
| | - Manish Kumar Asthana
- Social and Cognitive Neuroscience Laboratory and Developmental Disorders Program, Center for Health and Biological Sciences, Mackenzie Presbyterian University, São Paulo, Brazil
- Department of Humanities and Social Sciences, Indian Institute of Technology, Roorkee, India
| | | | - Jorge Almeida
- Proaction Laboratory, Cognitive and Behavior Center for Research and Intervention Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
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Pan J, Zhu C, Liu X, Wang Y, Li J. Transcranial Direct Current Stimulation Modulates the Effect of Unreasonable Request in the Context of Peer Punishment. Front Hum Neurosci 2019; 13:255. [PMID: 31417380 PMCID: PMC6682667 DOI: 10.3389/fnhum.2019.00255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 07/09/2019] [Indexed: 11/14/2022] Open
Abstract
Making a request is a common occurrence during social interactions. In most social contexts, requesters may impose punishments and many behavioral studies have focused on the differential effects of reasonable and unreasonable requests during such interactions. However, few studies have explored whether reasonable or unreasonable requests involve differential neurocognitive mechanisms. In this study, we used transcranial direct current stimulation (tDCS) to investigate the mechanistic effects of request within the context of peer punishment. We used a modified ultimatum game (UG) task as well as a modified dictator game (DG) task. Both unreasonable and reasonable requests induced the proposer to increase their monetary offer for both tasks. Moreover, in the modified UG task, cathodal tDCS over the right dorsolateral prefrontal cortex (rDLPFC) significantly decreased the effect of an unreasonable request when compared to sham stimulation. Cathodal stimulation did not impact the effect of a reasonable request on the modified UG task. For the modified DG task, no tDCS effect for either an unreasonable or reasonable request was observed. These findings suggest that rDLPFC was only involved in decision-making processes during unreasonable requests when there was an opportunity for peer punishment. Moreover, our results indicate that reasonable and unreasonable requests involve differential neurocognitive mechanisms in the context of possible peer punishment.
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Affiliation(s)
- Jingjing Pan
- China Academy of Corporate Governance, Business School, Nankai University, Tianjin, China.,School of Economics, Shandong University, Jinan, China
| | - Chengkang Zhu
- China Academy of Corporate Governance, Business School, Nankai University, Tianjin, China.,School of Economics, Shandong University, Jinan, China
| | - Xiaoli Liu
- China Academy of Corporate Governance, Business School, Nankai University, Tianjin, China.,Reinhard Selten Laboratory, Nankai University, Tianjin, China
| | - Yiwen Wang
- China Center of Social Trust Research (CCSTR), Fuzhou University, Fuzhou, China
| | - Jianbiao Li
- School of Economics, Shandong University, Jinan, China.,Reinhard Selten Laboratory, Nankai University, Tianjin, China.,Department of Economic and Management, Nankai University Binhai College, Tianjin, China
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Sagliano L, Atripaldi D, De Vita D, D'Olimpio F, Trojano L. Non-invasive brain stimulation in generalized anxiety disorder: A systematic review. Prog Neuropsychopharmacol Biol Psychiatry 2019; 93:31-38. [PMID: 30876986 DOI: 10.1016/j.pnpbp.2019.03.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 02/28/2019] [Accepted: 03/07/2019] [Indexed: 12/26/2022]
Abstract
In the last years, several studies using non-invasive brain stimulation (NIBS) techniques demonstrated that the dorsolateral prefrontal cortex (DLPFC) plays a key role in the neurobiological bases of anxiety disorders. Both transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) applied primarily over the prefrontal cortex have been shown to modulate anxiety symptomatology and attention allocation in the generalized anxiety disorder. A literature search on PubMed and PsycINFO databases following PRISMA guidelines identified 4 TMS studies (one open-label study and three randomized trials with active/sham conditions) and one tDCS case report study that have applied NIBS in patients with GAD. All the studies targeted the DLPFC except one in which the parietal cortex has been stimulated. Overall, the findings would suggest that NIBS could ameliorate anxiety symptoms and that improvements remained stable in the follow-up. Although a limited number of NIBS studies has been conducted on patients with anxiety disorders, these techniques could represent promising tools for the study of neurofunctional basis of anxiety disorders. Further sham-controlled studies are needed to clarify the mechanisms of action of NIBS in order to optimize stimulation protocols and to verify their effectiveness for treating anxiety symptoms.
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Affiliation(s)
- Laura Sagliano
- Department of Psychology, University of Campania "Luigi Vanvitelli", Viale Ellittico 31, 81100 Caserta, Italy.
| | - Danilo Atripaldi
- Department of Psychology, University of Campania "Luigi Vanvitelli", Viale Ellittico 31, 81100 Caserta, Italy
| | - Dalila De Vita
- Department of Psychology, University of Campania "Luigi Vanvitelli", Viale Ellittico 31, 81100 Caserta, Italy
| | - Francesca D'Olimpio
- Department of Psychology, University of Campania "Luigi Vanvitelli", Viale Ellittico 31, 81100 Caserta, Italy
| | - Luigi Trojano
- Department of Psychology, University of Campania "Luigi Vanvitelli", Viale Ellittico 31, 81100 Caserta, Italy
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Xiong G, Li X, Dong Z, Cai S, Huang J, Li Q. Modulating Activity in the Prefrontal Cortex Changes Intertemporal Choice for Loss: A Transcranial Direct Current Stimulation Study. Front Hum Neurosci 2019; 13:167. [PMID: 31178709 PMCID: PMC6543463 DOI: 10.3389/fnhum.2019.00167] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 05/07/2019] [Indexed: 12/18/2022] Open
Abstract
Intertemporal choice refers to decisions involving tradeoffs between costs and benefits occurring at different times. Studies have found that weighting the time and benefits during decision-making involves a complex neural network that includes the dorsolateral prefrontal cortex (DLPFC). However, in contrast to literature regarding intertemporal choice for gains, studies have not provided causal evidence that the DLPFC is involved in intertemporal choice for losses. We examined whether bifrontal transcranial direct current stimulation (tDCS) applied over the right and left prefrontal cortex can alter the balance of intertemporal preference in the loss condition. A total of 60 participants performed delay discounting tasks for losses while receiving either right anodal/left cathodal, left anodal/right cathodal, or sham stimulation. The results showed that participants tended to choose larger delayed losses after receiving left anodal/right cathodal tDCS. Left anodal/right cathodal tDCS significantly decreased the discounting rate compared with the sham stimulation. These findings confirm that DLPFC activity is critical during intertemporal decision-making for losses.
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Affiliation(s)
- Guanxing Xiong
- School of Economics and Management, South China Normal University, Guangzhou, China.,Key Lab for Behavioral Economic Science & Technology, South China Normal University, Guangzhou, China
| | - Xi Li
- School of Economics and Management, South China Normal University, Guangzhou, China.,Key Lab for Behavioral Economic Science & Technology, South China Normal University, Guangzhou, China
| | - Zhiqiang Dong
- School of Economics and Management, South China Normal University, Guangzhou, China.,Key Lab for Behavioral Economic Science & Technology, South China Normal University, Guangzhou, China
| | - Shenggang Cai
- School of Economics and Management, South China Normal University, Guangzhou, China.,Key Lab for Behavioral Economic Science & Technology, South China Normal University, Guangzhou, China
| | - Jianye Huang
- School of Economics and Management, South China Normal University, Guangzhou, China.,Key Lab for Behavioral Economic Science & Technology, South China Normal University, Guangzhou, China
| | - Qian Li
- School of Economics and Management, South China Normal University, Guangzhou, China.,Key Lab for Behavioral Economic Science & Technology, South China Normal University, Guangzhou, China
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50
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Nuñez M, Zinbarg RE, Mittal VA. Efficacy and mechanisms of non-invasive brain stimulation to enhance exposure therapy: A review. Clin Psychol Rev 2019; 70:64-78. [PMID: 30986744 DOI: 10.1016/j.cpr.2019.04.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 02/15/2019] [Accepted: 04/03/2019] [Indexed: 12/19/2022]
Abstract
Though cognitive behavioral techniques are generally effective in the treatment of anxiety disorders, some people fail to benefit from exposure therapy or experience a return of fear after terminating exposure therapy. The burgeoning field of non-invasive brain stimulation provides a potential method of augmenting exposure therapy so that it is more effective. Successful exposure therapy is hypothesized to occur due to inhibition, and research suggests that brain stimulation can alter inhibitory learning and related processes. As such, one can reasonably posit that brain stimulation could be used to test the inhibitory learning theory of exposure therapy and to increase the efficacy of exposure therapy by inducing stronger inhibitory learning during exposures. Four known studies that pair brain stimulation with exposure therapy have yielded promising preliminary evidence in support of the therapeutic use of brain stimulation. In this review we describe research illustrating the mechanisms and efficacy of non-invasive brain stimulation to enhance the understanding of and outcomes produced by exposure therapy.
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Affiliation(s)
- Mia Nuñez
- Northwestern University, United States; Rogers Behavioral Health, United States.
| | - Richard E Zinbarg
- Northwestern University, United States; The Family Institute, Northwestern University, United States
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