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Nervenheilkunde 2019; 38(08): 537-541
DOI: 10.1055/a-0916-1334
Schwerpunkt
© Georg Thieme Verlag KG Stuttgart · New York

Nicht invasive Hirnstimulation und Furchtextinktion

Ein systematisches ReviewA systematic review of non-invasive brain stimulation and fear extinction
Martin J. Herrmann
1   Center of Mental Health, Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Würzburg
,
Andreas Mühlberger∗
2   Department of Psychology, Clinical Psychology and Psychotherapy, University of Regensburg
,
Ann-Christine Ehlis∗
3   Department of Psychiatry and Psychotherapy, University Hospital of Tübingen
,
Jürgen Deckert∗
1   Center of Mental Health, Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Würzburg
,
Thomas Polak∗
1   Center of Mental Health, Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Würzburg
› Author Affiliations
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Publication History

Publication Date:
01 August 2019 (online)

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ZUSAMMENFASSUNG

Gegenstand und Ziel: Obwohl stress- und angstbedingte Störungen weit verbreitet sind, ist die Wirksamkeit entsprechender therapeutischer Maßnahmen nicht optimal. In jüngster Zeit wurde in einer Reihe von Studien der zusätzliche Nutzen einer nicht invasiven Hirnstimulation (NIBS) bei der Psychotherapie von Angsterkrankungen untersucht. Um die Effektivität der Hirnstimulation in Kombination mit einer Psychotherapieweiter zu verbessern, ist es notwendig, die Modulation von therapierelevanten Lernprozessen besser zu verstehen.

Material und Methode: In diesem systematischen Review werden die Studien dargestellt, die eine Modulation der Furchtextinktion beim Menschen mittels NIBS untersuchen.

Ergebnisse: Insgesamt konnten 7 Studien identifiziert und analysiert werden, die entweder die repetitive transkranielle Magnetstimulation (rTMS) oder die transkranielle Gleichstromstimulation (tDCS) bei der Furchtextinktion verwenden.

Schlussfolgerungen: Das Review zeigt, dass mittels NIBS das Extinktionslernen verbessert werden kann. Die Übertragung dieser Ergebnisse in klinische Studien wurde bereits begonnen, sodass damit zu rechnen ist, dass in den nächsten Jahren genauere Informationen zu den optimalen Stimulationsparametern vorliegen.

ABSTRACT

Objective: Despite the high prevalence of stress- and anxiety-related disorders, corresponding therapeutic measures have not yet reached their full potential. Recently, a number of studies have investigated the additional benefit of non-invasive brain stimulation (NIBS) in the psychotherapy of anxiety disorders. In order to further improve the effectiveness of brain stimulation in combination with psychotherapy, it is necessary to focus more on the modulation of therapy-relevant learning processes.

Material and methods: This systematic review presents the studies to date that have investigated modulation of fear extinction in humans using NIBS.

Results: A total of 7 studies were identified and analyzed using either repetitive transcranial magnetic stimulation (rTMS) or transcranial direct current stimulation (tDCS) for fear extinction.

Conclusions: The review shows that NIBS can improve extinction learning. The transfer of these results into clinical trials has already begun and will provide clarity on the optimal stimulation parameters in the coming years.

Schlüsselwörter

Nicht invasive Hirnstimulation - tDCS - rTMS - Angsterkrankungen

Key Words

Noninvasive brain stimulation - tDCS - rTMS - anxiety disorders
 

  • Literatur

  • 1 Jacobi F, Hofler M. et al [Mental disorders in the general population : Study on the health of adults in Germany and the additional module mental health (DEGS1-MH)]. Der Nervenarzt 2014; 85 (01) 77-87
    CrossrefPubMedGoogle Scholar
  • 2 Whiteford HA, Degenhardt L. et al Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010. Lancet 2013; 382 (99/04) 1575-86
    CrossrefPubMedGoogle Scholar
  • 3 Carpenter JK, Andrews LA, Witcraft SM. et al Cognitive behavioral therapy for anxiety and related disorders: A meta-analysis of randomized placebo-controlled trials. Depression and anxiety 2018; 35 (06) 502-14
    CrossrefPubMedGoogle Scholar
  • 4 Gloster AT, Wittchen HU, Einsle F. et al Psychological treatment for panic disorder with agoraphobia: a randomized controlled trial to examine the role of therapist-guided exposure in situ in CBT. Journal of consulting and clinical psychology 2011; 79 (03) 406-20
    CrossrefPubMedGoogle Scholar
  • 5 Li H, Wang JJ, Li CB, Xiao ZP. Repetitive transcranial magnetic stimulation (rTMS) for panic disorder in adults. Cochrane Database of Systematic Reviews. 2014: 09
    Google Scholar
  • 6 Berlim MT, Van Den Eynde F. Repetitive transcranial magnetic stimulation over the dorsolateral prefrontal cortex for treating posttraumatic stress disorder: an exploratory meta-analysis of randomized, double-blind and sham-controlled trials. Canadian journal of psychiatry Revue canadienne de psychiatrie 2014; 59 (09) 487-96
    PubMedGoogle Scholar
  • 7 Marin MF, Camprodon JA, Dougherty DD. et al Device-based brain stimulation to augment fear extinction: implications for PTSD treatment and beyond. Depression and anxiety 2014; 31 (04) 269-78
    CrossrefPubMedGoogle Scholar
  • 8 Herrmann MJ, Cybinski LM, Unterecker S. et al Nichtinvasive Hirnstimulation in Kombinaation mit Psychotherapie bei Angsterkrankungen. Psychotherapeut 2019; 64: 220-4
    CrossrefGoogle Scholar
  • 9 Vervliet B, Craske MG, Hermans D. Fear extinction and relapse: state of the art. Annual review of clinical psychology 2013; 9: 215-48
    CrossrefPubMedGoogle Scholar
  • 10 Nunez M, Zinbarg RE, Mittal VA. Efficacy and mechanisms of non-invasive brain stimulation to enhance exposure therapy: A review. Clinical psychology review 2019; 70: 64-78
    CrossrefPubMedGoogle Scholar
  • 11 Lang N, Siebner HR. Repetitive transkranielle Magnet stimulation. In: Siebner H, Ziemann U. (eds.) Das TMS-Buch Handbuch der transkraniellen Magnetstimulation Heidelberg: Springer; 2007: 500-11
    Google Scholar
  • 12 Nitsche MA, Paulus W. Excitability changes induced in the human motor cortex by weak transcranial direct current stimulation. The Journal of physiology 2000; 527 Pt 3 633-9
    CrossrefPubMedGoogle Scholar
  • 13 Guhn A, Dresler T, Andreatta M. et al Medial prefrontal cortex stimulation modulates the processing of conditioned fear. Frontiers in behavioral neuroscience 2014; 8: 44
    PubMedGoogle Scholar
  • 14 Raij T, Nummenmaa A, Marin MF. et al Prefrontal Cortex Stimulation Enhances Fear Extinction Memory in Humans. Biological psychiatry 2018; 84 (02) 129-37
    CrossrefPubMedGoogle Scholar
  • 15 van’t Wout M, Mariano TY, Garnaat SL. et al Can Transcranial Direct Current Stimulation Augment Extinction of Conditioned Fear? Brain stimulation. 2016; 9 (04) 531-8
    PubMedGoogle Scholar
  • 16 Abend R, Jalon I, Gurevitch G. et al Modulation of fear extinction processes using transcranial electrical stimulation. Translational psychiatry 2016; 6 (10) e913
    CrossrefPubMedGoogle Scholar
  • 17 Dittert N, Huettner S, Polak T. et al Augmentation of Fear Extinction by Transcranial Direct Current Stimulation (tDCS). Frontiers in behavioral neuroscience 2018; 12
    PubMedGoogle Scholar
  • 18 van t’Wout M, Longo SM, Reddy MK. et al Transcranial direct current stimulation may modulate extinction memory in posttraumatic stress disorder. Brain and behavior. 2017 7 05
    PubMedGoogle Scholar
  • 19 Ganho-Ávila A, Gonçalves OF. et al The effect of cathodal tDCS on fear extinction: a cross-measures study [Internet]. bioRxiv 2019
    PubMedGoogle Scholar
  • 20 Herrmann MJ, Katzorke A, Busch Y. et al Medial prefrontal cortex stimulation accelerates therapy response of exposure therapy in acrophobia. Brain stimulation 2017; 10 (02) 291-7
    CrossrefPubMedGoogle Scholar
  • 21 van’t Wout M, Mariano TY, Garnaat SL. et al Can Transcranial Direct Current Stimulation Augment Extinction of Conditioned Fear?. Brain stimulation 2016; 9 (04) 529-36
    CrossrefPubMedGoogle Scholar
  • 22 Asthana M, Nueckel K, Muhlberger A. et al Effects of transcranial direct current stimulation on consolidation of fear memory. Frontiers in psychiatry 2013; 4: 107
    PubMedGoogle Scholar
  • 23 Raij T, Nummenmaa A, Marin MF. et al Prefrontal Cortex Stimulation Enhances Fear Extinction Memory in Humans. Biol Psychiatry 2018; 84: 129-37
    CrossrefPubMedGoogle Scholar
  • 24 van’t Wout-Frank M. et al Combined transcranial direct current stimulation with virtual reality exposure for posttraumatic stress disorder: Feasibility and pilot results. Brain stimulation 2019; 12 (01) 41-3
    CrossrefPubMedGoogle Scholar
  • 25 Herrmann MJ, Beier JS, Simons B, Polak T. Transcranial Direct Current Stimulation (tDCS) of the Right Inferior Frontal Gyrus Attenuates Skin Conductance Responses to Unpredictable Threat Conditions. Frontiers in human neuroscience 2016; 10: 352
    PubMedGoogle Scholar
  • 26 Herrmann MJ, Simons BSE, Horst AK. et al Modulation of sustained fear by transcranial direct current stimulation (tDCS) of the right inferior frontal cortex (rIFC). Biological psychology 2018; 139: 173-7
    CrossrefPubMedGoogle Scholar
  • 27 Lonsdorf TB, Menz MM, Andreatta M. et al Don’t fear ‘fear conditioning’: Methodological considerations for the design and analysis of studies on human fear acquisition, extinction, and return of fear. Neuroscience and biobehavioral reviews 2017; 77: 247-85
    CrossrefPubMedGoogle Scholar
  • 28 Vicario CM, Nitsche MA, Felmingham K. Forgetting fear associations through tES: which memory process might be critical?. Translational psychiatry 2017; 7
    Google Scholar
  • 29 Moher D, Liberati A, Tetzlaff J. et al Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med 2009; 6 (07) e1000097 doi:10.1371/journal.pmed1000097
    CrossrefPubMedGoogle Scholar