Mascha van 't Wout-Frank1, M Tracie Shea2, Victoria C Larson3, Benjamin D Greenberg2, Noah S Philip2. 1. Center for Neurorestoration and Neurotechnology, Providence VA Medical Center, Providence, RI, 02908, USA; Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, 02906, USA. Electronic address: Mascha_vant_Wout@brown.edu. 2. Center for Neurorestoration and Neurotechnology, Providence VA Medical Center, Providence, RI, 02908, USA; Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, 02906, USA. 3. Center for Neurorestoration and Neurotechnology, Providence VA Medical Center, Providence, RI, 02908, USA.
Abstract
BACKGROUND: Facilitating neural activity using non-invasive brain stimulation may improve extinction-based treatments for posttraumatic stress disorder (PTSD). OBJECTIVE/HYPOTHESIS: Here, we examined the feasibility of simultaneous transcranial direct current stimulation (tDCS) application during virtual reality (VR) to reduce psychophysiological arousal and symptoms in Veterans with PTSD. METHODS: Twelve Veterans with PTSD received six combat-related VR exposure sessions during sham-controlled tDCS targeting ventromedial prefrontal cortex. Primary outcome measures were changes in skin conductance-based arousal and self-reported PTSD symptom severity. RESULTS: tDCS + VR components were combined without technical difficulty. We observed a significant interaction between reduction in arousal across sessions and tDCS group (p = .03), indicating that the decrease in physiological arousal was greater in the tDCS + VR versus sham group. We additionally observed a clinically meaningful reduction in PTSD symptom severity. CONCLUSIONS: This study demonstrates feasibility of applying tDCS during VR. Preliminary data suggest a reduction in psychophysiological arousal and PTSD symptomatology, supporting future studies.
BACKGROUND: Facilitating neural activity using non-invasive brain stimulation may improve extinction-based treatments for posttraumatic stress disorder (PTSD). OBJECTIVE/HYPOTHESIS: Here, we examined the feasibility of simultaneous transcranial direct current stimulation (tDCS) application during virtual reality (VR) to reduce psychophysiological arousal and symptoms in Veterans with PTSD. METHODS: Twelve Veterans with PTSD received six combat-related VR exposure sessions during sham-controlled tDCS targeting ventromedial prefrontal cortex. Primary outcome measures were changes in skin conductance-based arousal and self-reported PTSD symptom severity. RESULTS: tDCS + VR components were combined without technical difficulty. We observed a significant interaction between reduction in arousal across sessions and tDCS group (p = .03), indicating that the decrease in physiological arousal was greater in the tDCS + VR versus sham group. We additionally observed a clinically meaningful reduction in PTSD symptom severity. CONCLUSIONS: This study demonstrates feasibility of applying tDCS during VR. Preliminary data suggest a reduction in psychophysiological arousal and PTSD symptomatology, supporting future studies.
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