Current Status of Transcranial Direct Current Stimulation in Posttraumatic Stress and Other Anxiety Disorders

• Authors: Benjamin M. Hampstead, VA Ann Arbor Healthcare System; Emily M. Briceño, University of Michigan; Nathan Andrew Mascaro, Emory University; Andoni Mourdoukoutas, The City College of New York of CUNY; Marom Bikson, The City College of New York of CUNY
• Journal Title: Current Behavioral Neuroscience Reports
• Volume: Volume 3, Number 2
• Publisher: Springer Verlag (Germany) | 2016-06, Pages 95-101
• Type of Work: Article | Post-print: After Peer Review
• Publisher DOI: http://doi.org/10.1007/s40473-016-0070-9
• Subjects: Psychology, Behavioral
• Keywords: Anxiety; Generalized Anxiety Disorder; Obsessive Compulsive Disorder; PTSD; Panic disorder; Post-traumatic stress disorder; Transcranial Direct Current Stimulation; brain stimulation; functional neuroimaging; neuromodulation; tDCS

Abstract

Several empirically supported treatments have been identified for post-traumatic stress disorder (PTSD), yet a sizable number of patients are either unable to tolerate these approaches or remain symptomatic following treatment. Transcranial direct current stimulation (tDCS) is a well-tolerated method of modulating neuronal excitability that may hold promise as a novel intervention in PTSD and related disorders. The current review summarizes literature on the disrupted neural circuitry in PTSD and discusses the rationale for the commonly targeted prefrontal cortex (PFC) as it relates to PTSD. We then review the few prior (case) studies that have evaluated tDCS in patients with PTSD (1 study) and other anxiety disorders (4 studies). There was considerable variability in both the methods/justification for selecting the targeted brain region(s) and the tDCS montage used, which obscured any clear trends in the data. Finally, we describe the rationale for our ongoing study that specifically targets the lateral temporal cortex as a method of treating the symptoms of hyperarousal and re-experiencing in PTSD. Overall, it is clear that additional work is needed to establish dosing (e.g., intensity and duration of sessions, number of sessions) and optimal treatment targets as well as to identify synergistic effects with existing treatments.