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Cited by 63Transcranial Magnetic Stimulation StudiesMemory and Neural MechanismsPosttraumatic Stress Disorder Research

Augmentation of Fear Extinction by Transcranial Direct Current Stimulation (tDCS)

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Dittert, Natalie, Hüttner, Sandrina, Polak, Thomas, Herrmann, Martin J.·2018·Frontiers in Behavioral Neuroscience
DOI 10.3389/fnbeh.2018.00076PMC PMC5996916
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Abstract

Although posttraumatic stress disorder (PTSD; DSM-V 309.82) and anxiety disorders (DSM-V 300.xx) are widely spread mental disorders, the effectiveness of their therapy is still unsatisfying. Non-invasive brain-stimulation techniques like transcranial direct current stimulation (tDCS) might be an option to improve extinction learning, which is a main functional factor of exposure-based therapy for anxiety disorders. To examine this hypothesis, we used a fear conditioning paradigm with female faces as conditioned stimuli (CS) and a 95-dB female scream as unconditioned stimuli (UCS). We aimed to perform a tDCS of the ventromedial prefrontal cortex (vmPFC), which is mainly involved in the control of extinction-processes. Therefore, we applied two 4x4 cm electrodes approximately at the EEG-positions F7 and F8 and used a direct current of 1.5 mA. The 20-minute stimulation was started during a 10-minute break between acquisition and extinction and went on overall extinction-trials. The healthy participants were randomly assigned in a double-blinded process into a sham stimulation and two verum stimulation groups with opposite current flow directions. To measure the fear reactions, we used skin conductance responses (SCR) and subjective ratings. We performed a generalized estimating equations model for the SCR to assess the impact of tDCS and current flow direction on extinction processes for all subjects that showed a successful conditioning (N = 84). The results indicate that tDCS accelerates early extinction processes with a significantly faster loss of CS+/CS- discrimination. The discrimination loss was driven by a significant decrease in reaction towards the CS+ as well as an increase in reaction towards the CS- in the tDCS verum group, whereas the sham group showed no significant reaction changes during this period. Therefore, we assume that tDCS of the vmPFC can be used to enhance early extinction processes successfully. But before it should be tested in a clinical context further investigation is needed to assess the reason for the reaction increase on CS-. If this negative side effect can be avoided, tDCS may be a tool to improve exposure-based anxiety therapies.

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  • tDCS relative to sham stimulation resulted in faster early extinction learning.

    “Dittert et al. [100] administered tDCS via bitemporal electrodes aimed at the vmPFC prior to and during extinction and found that tDCS, relative to sham, stimulation resulted in faster early extinction learning.”

    From Prefrontal cortex, amygdala, and threat processing: implications for PTSD (2022) · cites this paper as [100]

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Cited by

Sorted by citations

Authors
Dittert, N., Hüttner, S., Polak, T., & Herrmann, M. J.
Affiliations
Universitätsklinikum Würzburg (DE)
Corresponding author
Herrmann, Martin J.
ORCID
Herrmann, Martin J.
Venue
Frontiers in Behavioral Neuroscience
Publisher
Frontiers Media SA
Published
2018-04-25
Volume
12
Pages
76-76
ISSN
1662-5153 (ISSN-L)
DOI
10.3389/fnbeh.2018.00076
PMC
PMC5996916
OpenAlex
W2800113521
Cited by
63
References
17
Citations by year
2026: 3 · 2025: 8 · 2024: 10 · 2023: 9 · 2022: 5 · 2021: 8 · 2020: 6 · 2019: 13 · 2018: 1
FWCI
3.15
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Behavioral Neuroscience (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Online Publication Service of Würzburg University (Würzburg University) (submittedVersion, cc-by)
Funders
Deutsche Forschungsgemeinschaft (SFB TRR58, C06, C07)
Topics
  • Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Memory and Neural Mechanisms
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
Keywords
transcranial direct current stimulation, fear extinction, ventromedial prefrontal cortex, fear conditioning, anxiety disorders, post-traumatic stress disorder, exposure therapy, skin conductance response, non-invasive brain stimulation, current direction

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