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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.
Bohmeier, Barbara; Cybinski, Lisa M; Gromer, Daniel; Bellinger, Daniel; Deckert, Jürgen; Erhardt-Lehmann, Angelika; Deserno, Lorenz; Mühlberger, Andreas; Pauli, Paul; Polak, Thomas; Herrmann, Martin J.
Affiliation
  • Bohmeier B; Center of Mental Health, Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Wuerzburg, Wuerzburg, Germany.
  • Cybinski LM; Center of Mental Health, Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Wuerzburg, Wuerzburg, Germany.
  • Gromer D; Department of Psychology (Clinical Psychology and Psychotherapy), University of Wuerzburg, Wuerzburg, Germany.
  • Bellinger D; Center of Mental Health, Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Wuerzburg, Wuerzburg, Germany.
  • Deckert J; Center of Mental Health, Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Wuerzburg, Wuerzburg, Germany.
  • Erhardt-Lehmann A; Center of Mental Health, Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Wuerzburg, Wuerzburg, Germany; Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany.
  • Deserno L; Center of Mental Health, Department for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Wuerzburg, Wuerzburg, Germany.
  • Mühlberger A; Department of Psychology (Clinical Psychology and Psychotherapy), University of Regensburg, Regensburg, Germany.
  • Pauli P; Department of Psychology (Clinical Psychology and Psychotherapy), University of Wuerzburg, Wuerzburg, Germany.
  • Polak T; Center of Mental Health, Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Wuerzburg, Wuerzburg, Germany.
  • Herrmann MJ; Center of Mental Health, Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Wuerzburg, Wuerzburg, Germany. Electronic address: Herrmann_M@ukw.de.
Behav Brain Res ; 476: 115232, 2025 Jan 05.
Article in En | MEDLINE | ID: mdl-39236930
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.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Phobic Disorders / Transcranial Magnetic Stimulation / Virtual Reality Exposure Therapy / Dorsolateral Prefrontal Cortex Limits: Adult / Female / Humans / Male / Middle aged Language: En Journal: Behav Brain Res Year: 2025 Document type: Article

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Phobic Disorders / Transcranial Magnetic Stimulation / Virtual Reality Exposure Therapy / Dorsolateral Prefrontal Cortex Limits: Adult / Female / Humans / Male / Middle aged Language: En Journal: Behav Brain Res Year: 2025 Document type: Article