Combining transcranial direct current stimulation with group cognitive behavioral therapy developed to treat rumination: a clinical pilot study
BackgroundAs part of repetitive negative thinking (RNT), rumination is a maladaptive cognitive response style to stress or negative mood which can increase the risk of depression and may prohibit complete recovery. Cognitive behavioral therapy (CBT) and transcranial direct current stimulation (tDCS)...
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Frontiers Media S.A.
2023-04-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2023.1167029/full |
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| author | Paula Horczak Paula Horczak Chanyu Wang Chanyu Wang Sara De Witte Sara De Witte Sara De Witte Sara De Witte Sara De Witte Stefanie De Smet Stefanie De Smet Jonathan Remue Rudi De Raedt Marie-Anne Vanderhasselt Marie-Anne Vanderhasselt Guo-Rong Wu Gilbert M. D. Lemmens Gilbert M. D. Lemmens Chris Baeken Chris Baeken Chris Baeken Chris Baeken Chris Baeken Chris Baeken Chris Baeken |
| author_facet | Paula Horczak Paula Horczak Chanyu Wang Chanyu Wang Sara De Witte Sara De Witte Sara De Witte Sara De Witte Sara De Witte Stefanie De Smet Stefanie De Smet Jonathan Remue Rudi De Raedt Marie-Anne Vanderhasselt Marie-Anne Vanderhasselt Guo-Rong Wu Gilbert M. D. Lemmens Gilbert M. D. Lemmens Chris Baeken Chris Baeken Chris Baeken Chris Baeken Chris Baeken Chris Baeken Chris Baeken |
| author_sort | Paula Horczak |
| collection | DOAJ |
| description | BackgroundAs part of repetitive negative thinking (RNT), rumination is a maladaptive cognitive response style to stress or negative mood which can increase the risk of depression and may prohibit complete recovery. Cognitive behavioral therapy (CBT) and transcranial direct current stimulation (tDCS) both proved to be effective in decreasing rumination. However, the combined effects of tDCS and CBT interventions on rumination have not yet been explored. The first aim of this pilot study is to investigate whether the combination of tDCS and CBT has an accumulating positive effect on modulating state rumination. The second aim is to assess the feasibility and safety profile of the proposed combined approach.MethodSeventeen adults aged 32–60 years, suffering from RNT, were referred by their primary care professional to participate in an 8-week group intervention for RNT (“Drop It”) comprising 8 sessions of CBT. Before each CBT session, patients underwent one double-blinded prefrontal active (2 mA for 20 min) or sham tDCS (anode over F3, cathode over the right supraorbital region) combined with an internal cognitive attention task focused on individual RNT, i.e., online tDCS priming. During each session, the Brief State Rumination Inventory was used to assess state rumination.ResultsA mixed effects model analysis revealed no significant differences between the stimulation conditions, weekly sessions, or their interaction in terms of state rumination scores.ConclusionOverall, the combination of online tDCS priming followed by group CBT was found to be safe and feasible. On the other hand, no significant additional effects of this combined approach on state rumination were established. Although our pilot study may have been too small to find significant clinical effects, future larger RCT studies on combined tDCS-CBT treatment protocols may reevaluate the selection of internal cognitive attention tasks and more objective neurophysiological measurements, consider the optimal timing of the combination (concurrently or sequentially), or may add additional tDCS sessions when following CBT. |
| first_indexed | 2024-04-09T16:06:27Z |
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| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-09T16:06:27Z |
| publishDate | 2023-04-01 |
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| series | Frontiers in Neurology |
| spelling | doaj.art-7fdef1c791b5472dba84e4e02a53a0f02023-04-25T05:42:58ZengFrontiers Media S.A.Frontiers in Neurology1664-22952023-04-011410.3389/fneur.2023.11670291167029Combining transcranial direct current stimulation with group cognitive behavioral therapy developed to treat rumination: a clinical pilot studyPaula Horczak0Paula Horczak1Chanyu Wang2Chanyu Wang3Sara De Witte4Sara De Witte5Sara De Witte6Sara De Witte7Sara De Witte8Stefanie De Smet9Stefanie De Smet10Jonathan Remue11Rudi De Raedt12Marie-Anne Vanderhasselt13Marie-Anne Vanderhasselt14Guo-Rong Wu15Gilbert M. D. Lemmens16Gilbert M. D. Lemmens17Chris Baeken18Chris Baeken19Chris Baeken20Chris Baeken21Chris Baeken22Chris Baeken23Chris Baeken24Ghent Experimental Psychiatry (GHEP) Lab, Ghent University, Ghent, BelgiumDepartment of Head and Skin – Psychiatry and Medical Psychology, Ghent University, Ghent, BelgiumGhent Experimental Psychiatry (GHEP) Lab, Ghent University, Ghent, BelgiumDepartment of Head and Skin – Psychiatry and Medical Psychology, Ghent University, Ghent, BelgiumGhent Experimental Psychiatry (GHEP) Lab, Ghent University, Ghent, BelgiumDepartment of Head and Skin – Psychiatry and Medical Psychology, Ghent University, Ghent, BelgiumDepartment of Neurology and Bru-BRAIN, University Hospital Brussels, Brussels, BelgiumNeuroprotection and Neuromodulation Research Group (NEUR), Center for Neurosciences (C4N), Vrije Universiteit Brussel (VUB), Brussels, BelgiumDepartment of Psychiatry, Universitair Ziekenhuis Brussel (UZ Brussel), Vrije Universiteit Brussel (VUB), Brussels, BelgiumGhent Experimental Psychiatry (GHEP) Lab, Ghent University, Ghent, BelgiumDepartment of Head and Skin – Psychiatry and Medical Psychology, Ghent University, Ghent, BelgiumDepartment of Psychiatry, Ghent University Hospital, Ghent, East Flanders, BelgiumDepartment of Experimental Clinical and Health Psychology, Ghent University, Ghent, BelgiumGhent Experimental Psychiatry (GHEP) Lab, Ghent University, Ghent, BelgiumDepartment of Head and Skin – Psychiatry and Medical Psychology, Ghent University, Ghent, BelgiumKey Laboratory of Cognition and Personality, Faculty of Psychology, Southwest University, Chongqing, ChinaDepartment of Head and Skin – Psychiatry and Medical Psychology, Ghent University, Ghent, BelgiumDepartment of Psychiatry, Ghent University Hospital, Ghent, East Flanders, BelgiumGhent Experimental Psychiatry (GHEP) Lab, Ghent University, Ghent, BelgiumDepartment of Head and Skin – Psychiatry and Medical Psychology, Ghent University, Ghent, BelgiumDepartment of Neurology and Bru-BRAIN, University Hospital Brussels, Brussels, BelgiumNeuroprotection and Neuromodulation Research Group (NEUR), Center for Neurosciences (C4N), Vrije Universiteit Brussel (VUB), Brussels, BelgiumDepartment of Psychiatry, Universitair Ziekenhuis Brussel (UZ Brussel), Vrije Universiteit Brussel (VUB), Brussels, BelgiumDepartment of Psychiatry, Ghent University Hospital, Ghent, East Flanders, BelgiumDepartment of Electrical Engineering, Eindhoven University of Technology, Eindhoven, NetherlandsBackgroundAs part of repetitive negative thinking (RNT), rumination is a maladaptive cognitive response style to stress or negative mood which can increase the risk of depression and may prohibit complete recovery. Cognitive behavioral therapy (CBT) and transcranial direct current stimulation (tDCS) both proved to be effective in decreasing rumination. However, the combined effects of tDCS and CBT interventions on rumination have not yet been explored. The first aim of this pilot study is to investigate whether the combination of tDCS and CBT has an accumulating positive effect on modulating state rumination. The second aim is to assess the feasibility and safety profile of the proposed combined approach.MethodSeventeen adults aged 32–60 years, suffering from RNT, were referred by their primary care professional to participate in an 8-week group intervention for RNT (“Drop It”) comprising 8 sessions of CBT. Before each CBT session, patients underwent one double-blinded prefrontal active (2 mA for 20 min) or sham tDCS (anode over F3, cathode over the right supraorbital region) combined with an internal cognitive attention task focused on individual RNT, i.e., online tDCS priming. During each session, the Brief State Rumination Inventory was used to assess state rumination.ResultsA mixed effects model analysis revealed no significant differences between the stimulation conditions, weekly sessions, or their interaction in terms of state rumination scores.ConclusionOverall, the combination of online tDCS priming followed by group CBT was found to be safe and feasible. On the other hand, no significant additional effects of this combined approach on state rumination were established. Although our pilot study may have been too small to find significant clinical effects, future larger RCT studies on combined tDCS-CBT treatment protocols may reevaluate the selection of internal cognitive attention tasks and more objective neurophysiological measurements, consider the optimal timing of the combination (concurrently or sequentially), or may add additional tDCS sessions when following CBT.https://www.frontiersin.org/articles/10.3389/fneur.2023.1167029/fulltranscranial direct current stimulationgroup cognitive behavioral therapyruminationrepetitive negative thinkingmajor depressive disordergeneralized anxiety disorder |
| spellingShingle | Paula Horczak Paula Horczak Chanyu Wang Chanyu Wang Sara De Witte Sara De Witte Sara De Witte Sara De Witte Sara De Witte Stefanie De Smet Stefanie De Smet Jonathan Remue Rudi De Raedt Marie-Anne Vanderhasselt Marie-Anne Vanderhasselt Guo-Rong Wu Gilbert M. D. Lemmens Gilbert M. D. Lemmens Chris Baeken Chris Baeken Chris Baeken Chris Baeken Chris Baeken Chris Baeken Chris Baeken Combining transcranial direct current stimulation with group cognitive behavioral therapy developed to treat rumination: a clinical pilot study Frontiers in Neurology transcranial direct current stimulation group cognitive behavioral therapy rumination repetitive negative thinking major depressive disorder generalized anxiety disorder |
| title | Combining transcranial direct current stimulation with group cognitive behavioral therapy developed to treat rumination: a clinical pilot study |
| title_full | Combining transcranial direct current stimulation with group cognitive behavioral therapy developed to treat rumination: a clinical pilot study |
| title_fullStr | Combining transcranial direct current stimulation with group cognitive behavioral therapy developed to treat rumination: a clinical pilot study |
| title_full_unstemmed | Combining transcranial direct current stimulation with group cognitive behavioral therapy developed to treat rumination: a clinical pilot study |
| title_short | Combining transcranial direct current stimulation with group cognitive behavioral therapy developed to treat rumination: a clinical pilot study |
| title_sort | combining transcranial direct current stimulation with group cognitive behavioral therapy developed to treat rumination a clinical pilot study |
| topic | transcranial direct current stimulation group cognitive behavioral therapy rumination repetitive negative thinking major depressive disorder generalized anxiety disorder |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2023.1167029/full |
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