학술논문

Enhancing Cognitive Restructuring with Concurrent Repetitive Transcranial Magnetic Stimulation: A Transdiagnostic Randomized Controlled Trial
Document Type
Report
Source
Psychotherapy and Psychosomatics. March 1, 2022, Vol. 91 Issue 2, p94, 13 p.
Subject
New York
United States
Language
English
ISSN
0033-3190
Abstract
Introduction: Emotional dysregulation constitutes a serious public health problem in need of novel transdiagnostic treatments. Objective: To this aim, we developed and tested a one-time intervention that integrates behavioral skills training with concurrent repetitive transcranial magnetic stimulation (rTMS). Methods: Forty-six adults who met criteria for at least one DSM-5 disorder and self-reported low use of cognitive restructuring (CR) were enrolled in a randomized, double-blind, sham-controlled trial that used a between-subjects design. Participants were taught CR and underwent active rTMS applied at 10 Hz over the right (n = 17) or left (n = 14) dorsolateral prefrontal cortex (dlPFC) or sham rTMS (n = 15) while practicing reframing and emotional distancing in response to autobiographical stressors. Results: Those who received active left or active right as opposed to sham rTMS exhibited enhanced regulation (ds = 0.21-0.62) as measured by psychophysiological indices during the intervention (higher high-frequency heart rate variability, lower regulation duration). Those who received active rTMS over the left dlPFC also self-reported reduced distress throughout the intervention (d = 0.30), higher likelihood to use CR, and lower daily distress during the week following the intervention. The procedures were acceptable and feasible with few side effects. Conclusions: These findings show that engaging frontal circuits simultaneously with cognitive skills training and rTMS may be clinically feasible, well-tolerated and may show promise for the treatment of transdiagnostic emotional dysregulation. Larger follow-up studies are needed to confirm the efficacy of this novel therapeutic approach. Keywords: Cognitive control, Transdiagnostic intervention, Emotional dysregulation, Repetitive transcranial magnetic stimulation
Author(s): Andrada D. Neacsiu [a]; Lysianne Beynel [a]; John P. Powers [b]; Steven T. Szabo [a,c]; Lawrence G. Appelbaum [a]; Sarah H. Lisanby [a,d]; Kevin S. LaBar [b] Introduction Emotional [...]