Stimulation Therapy in Miltary Veterans

A substantial part of patients with trauma-related anxiety or aggression disorders does not sufficiently recover after psychotherapy. Recovery is likely impaired by difficulties with inhibitory control over (emotional) impulses. Amounting evidence shows positive effects of tDCS to the prefrontal cortex on psychiatric disorders like depression and drug- or alcohol dependence. Moreover, it has been shown that inhibitory control can be enhanced by applying transcranial direct current stimulation (tDCS) to the right inferior frontal gyrus.
The goal of the study is to test within an anxiety and aggression patient sample the effect of a tDCS intervention in combination with an inhibitory control training on inhibitory control performance, attention bias in response to threat and anxiety and aggression symptoms. Subjects undergo a 5-session tDCS intervention that takes place in a period of usual treatment. The tDCS (1.25 mA, 20 min.) electrodes are placed over the right inferior frontal gyrus (anodal) and over the left eyebrow (cathodal). Before and after the intervention inhibitory control performance an symptomatology are measured. Long-term measures of symptomatology are taken at 3 months and 12 months follow-ups.

A tDCS intervention in veterans with anxiety and/or aggression problems increases the effects of an inhibitory control training

T1. Pre-assessment: DSM Axis-I comorbodity, self-report symptomatology, inhibitory control performance.
Intervention. 5 training sessions with stop-signal task (SST).

T2. Post-assessment: self-report symptomatology, inhibitory control performance.

T3. follow-up after 3 months: self-report symptomatology.

T4. follow-up 12 months: self-report symptomatology

TDCS (1.25 mA, 20 min.) increases neural excitability under the anodal electrode (here: attached to the scalp over the right inferior frontal gyrus, rIFG) and decreases neural excitability under the cathodal electrode (here: attached over the left eyebrow). This increases activation of the rIFG, a brain region strongly involved in inhibitory control. Subjects simultaneously receive tDCS and perform an inhibitory control (stop signal) task, to facilitate the effects of tDCS. Subjects receive 5 sessions of either real or sham tDCS + inhibitory control training.