TITLE
Medial Prefrontal Cortex Stimulation Accelerates Therapy Response of Exposure Therapy in Acrophobia
AUTHORS
Herrmann MJ; Katzorke A; Busch Y; Gromer D; Polak T; Pauli P; Deckert J. Institution Herrmann, Martin J. Department of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University of Wurzburg, Wurzburg, Germany. Katzorke, Andrea. Department of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University of Wurzburg, Wurzburg, Germany. Busch, Yasmin. Department of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University of Wurzburg, Wurzburg, Germany. Gromer, Daniel. Department of Psychology, Center of Mental Health, University of Wurzburg, Wurzburg, Germany. Polak, Thomas. Department of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University of Wurzburg, Wurzburg, Germany. Pauli, Paul. Department of Psychology, Center of Mental Health, University of Wurzburg, Wurzburg, Germany. Deckert, Jurgen. Department of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University of Wurzburg, Wurzburg, Germany.
ELECTRONIC ADDRESS
Herrmann_m@ukw.de
SOURCE
Brain Stimulation. 10(2):291-297, 2017 Mar – Apr.
BACKGROUND
Animal as well as human research indicated that the ventral medial prefrontal cortex (vmPFC) is highly relevant for fear extinction learning. Recently, we showed that targeting the vmPFC with high-frequency repetitive transcranial magnetic stimulation (rTMS) in a placebo-controlled study with 45 healthy controls induced higher prefrontal activity during extinction of conditioned stimuli (CS+) in the active compared to the sham stimulated group and better extinction learning as indicated by ratings, fear potentiated startles and skin conductance responses.
OBJECTIVE
In this study, we aimed to proof our concept of accelerating extinction learning using rTMS of the mPFC in a group of anxiety disorder patients.
METHODS
To specifically evaluate the impact of rTMS on exposure-based therapy, we applied a sham-controlled protocol over the vmPFC (FPz) succeeded by a virtual reality exposure therapy (VRET) in n = 20 participants with acrophobia and n = 19 controls.
RESULTS
We found a significantly higher reduction in active compared to sham stimulated group for anxiety (t[37] = 2.33, p < 0.05) as well as avoidance ratings t[37] = 2.34, p < 0.05) from pre to post therapy.
CONCLUSION
This study provides first clinical evidence that high-frequency rTMS over the vmPFC improves exposure therapy response of acrophobia symptoms.
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