TY - JOUR
T1 - Effects of tDCS during inhibitory control training on performance and PTSD, aggression and anxiety symptoms
T2 - a randomized-controlled trial in a military sample
AU - Smits, Fenne M
AU - Geuze, Elbert
AU - Schutter, Dennis J L G
AU - van Honk, Jack
AU - Gladwin, Thomas E
N1 - Funding Information:
This work was supported by the Dutch Ministry of Defence.
Funding Information:
We are very thankful to all participants for their valuable contribution to this study, and our coworkers from the Dutch Military Mental Healthcare Organization and from the Brain Research & Innovation Centre for their help in participant recruitment and data acquisition. We also thank the anonymous reviewers for their constructive feedback on this manuscript.
Publisher Copyright:
© The Author(s), 2021. Published by Cambridge University Press.
PY - 2022/12/24
Y1 - 2022/12/24
N2 - BACKGROUND: Post-traumatic stress disorder (PTSD), anxiety, and impulsive aggression are linked to transdiagnostic neurocognitive deficits. This includes impaired inhibitory control over inappropriate responses. Prior studies showed that inhibitory control can be improved by modulating the right inferior frontal gyrus (IFG) with transcranial direct current stimulation (tDCS) in combination with inhibitory control training. However, its clinical potential remains unclear. We therefore aimed to replicate a tDCS-enhanced inhibitory control training in a clinical sample and test whether this reduces stress-related mental health symptoms.METHODS: In a preregistered double-blind randomized-controlled trial, 100 active-duty military personnel and post-active veterans with PTSD, anxiety, or impulsive aggression symptoms underwent a 5-session intervention where a stop-signal response inhibition training was combined with anodal tDCS over the right IFG for 20 min at 1.25 mA. Inhibitory control was evaluated with the emotional go/no-go task and implicit association test. Stress-related symptoms were assessed by self-report at baseline, post-intervention, and after 3-months and 1-year follow-ups.RESULTS: Active relative to sham tDCS neither influenced performance during inhibitory control training nor on assessment tasks, and did also not significantly influence self-reported symptoms of PTSD, anxiety, impulsive aggression, or depression at post-assessment or follow-up.CONCLUSIONS: Our results do not support the idea that anodal tDCS over the right IFG at 1.25 mA enhances response inhibition training in a clinical sample, or that this tDCS-training combination can reduce stress-related symptoms. Applying different tDCS parameters or combining tDCS with more challenging tasks might provide better conditions to modulate cognitive functioning and stress-related symptoms.
AB - BACKGROUND: Post-traumatic stress disorder (PTSD), anxiety, and impulsive aggression are linked to transdiagnostic neurocognitive deficits. This includes impaired inhibitory control over inappropriate responses. Prior studies showed that inhibitory control can be improved by modulating the right inferior frontal gyrus (IFG) with transcranial direct current stimulation (tDCS) in combination with inhibitory control training. However, its clinical potential remains unclear. We therefore aimed to replicate a tDCS-enhanced inhibitory control training in a clinical sample and test whether this reduces stress-related mental health symptoms.METHODS: In a preregistered double-blind randomized-controlled trial, 100 active-duty military personnel and post-active veterans with PTSD, anxiety, or impulsive aggression symptoms underwent a 5-session intervention where a stop-signal response inhibition training was combined with anodal tDCS over the right IFG for 20 min at 1.25 mA. Inhibitory control was evaluated with the emotional go/no-go task and implicit association test. Stress-related symptoms were assessed by self-report at baseline, post-intervention, and after 3-months and 1-year follow-ups.RESULTS: Active relative to sham tDCS neither influenced performance during inhibitory control training nor on assessment tasks, and did also not significantly influence self-reported symptoms of PTSD, anxiety, impulsive aggression, or depression at post-assessment or follow-up.CONCLUSIONS: Our results do not support the idea that anodal tDCS over the right IFG at 1.25 mA enhances response inhibition training in a clinical sample, or that this tDCS-training combination can reduce stress-related symptoms. Applying different tDCS parameters or combining tDCS with more challenging tasks might provide better conditions to modulate cognitive functioning and stress-related symptoms.
KW - Aggression
KW - PTSD
KW - anxiety
KW - inferior frontal gyrus
KW - inhibitory control
KW - transcranial direct current stimulation
UR - http://www.scopus.com/inward/record.url?scp=85146096608&partnerID=8YFLogxK
U2 - 10.1017/S0033291721000817
DO - 10.1017/S0033291721000817
M3 - Article
C2 - 33757606
SN - 0033-2917
VL - 52
SP - 3964
EP - 3974
JO - Psychological medicine
JF - Psychological medicine
IS - 16
ER -