1. Intermittent theta burst stimulation of the left dorsolateral prefrontal cortex has no additional effect on the efficacy of virtual reality exposure therapy for acrophobia. A randomized double-blind placebo-controlled study.
- Author
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Bohmeier B, Cybinski LM, Gromer D, Bellinger D, Deckert J, Erhardt-Lehmann A, Deserno L, Mühlberger A, Pauli P, Polak T, and Herrmann MJ
- Subjects
- Humans, Double-Blind Method, Male, Female, Adult, Treatment Outcome, Young Adult, Middle Aged, Theta Rhythm physiology, Prefrontal Cortex physiology, Combined Modality Therapy, Transcranial Magnetic Stimulation methods, Dorsolateral Prefrontal Cortex physiology, Virtual Reality Exposure Therapy methods, Phobic Disorders therapy
- Abstract
Anxiety disorders are among the most common mental disorders. Treatment guidelines recommend pharmacotherapy and cognitive behavioral therapy as standard treatment. Although cognitive behavioral therapy is an effective therapeutic approach, not all patients benefit sufficiently from it. In recent years, non-invasive brain stimulation techniques, such as transcranial magnetic stimulation, have been investigated as promising adjuncts in the treatment of affective disorders. The aim of this study is to investigate whether a combination of intermittent theta burst stimulation (iTBS) and virtual reality exposure therapy leads to a significantly greater reduction in acrophobia than virtual reality exposure with sham stimulation. In this randomized double-blind placebo-controlled study, 43 participants with acrophobia received verum or sham iTBS over the left dorsolateral prefrontal cortex prior to two sessions of virtual reality exposure therapy. Stimulation of the left dorsolateral prefrontal cortex with iTBS was motivated by an experimental study showing a positive effect on extinction memory retention. Acrophobic symptoms were assessed using questionnaires and two behavioral approach tasks one week before, after treatment and six months after the second diagnostic session. The results showed that two sessions of virtual reality exposure therapy led to a significant reduction in acrophobic symptoms, with an overall remission rate of 79 %. However, there was no additional effect of iTBS of the left dorsolateral prefrontal cortex on the therapeutic effects. Further research is needed to determine how exactly a combination of transcranial magnetic stimulation and exposure therapy should be designed to enhance efficacy., Competing Interests: Declaration of Competing Interest PP and AM are shareholders in VTplus GmbH, a commercial company specializing in the development research systems for virtual environments. There are no other financial interests that could potentially compete with this agreement., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)
- Published
- 2025
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