Challenging control over emotions in borderline personality disorder - a tDCS study

Wolkenstein, Larissa; Rombold-Bruehl, Felicitas; Bingmann, Tiffany; Sommer, Anja; Kanske, Philipp; Plewnia, Christian

doi:10.1016/j.neuropsychologia.2021.107850

Cited by 8 publications

(4 citation statements)

References 62 publications

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“…This evidence could have potential consequences for therapeutic interventions. In this sense, recent randomized controlled trials reported beneficial effects of non-invasive brain stimulation in BPD, reducing impulsivity and aggression and improving the cognitive control [ 52 , 53 , 54 , 55 ]. As non-invasive stimulation exerts effect both on synaptic plasticity and axonal pathways [ 56 ] and its efficacy is probably greater when plasticity is not compromised, the relative sparing of the triple network system morphology might support the efficacy of this treatment.…”

Section: Discussionmentioning

confidence: 99%

Aberrant Structural Connectivity of the Triple Network System in Borderline Personality Disorder Is Associated with Behavioral Dysregulation

Quattrini

Magni

Lanfredi

et al. 2022

JCM

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Background: Core symptoms of Borderline Personality Disorder (BPD) are associated to aberrant connectivity of the triple network system (salience network [SN], default mode network [DMN], executive control network [ECN]). While functional abnormalities are widely reported, structural connectivity (SC) and anatomical changes have not yet been investigated. Here, we explored the triple network’s SC, structure, and its association with BPD clinical features. Methods: A total of 60 BPD and 26 healthy controls (HC) underwent a multidomain neuropsychological and multimodal MRI (diffusion- and T1-weighted imaging) assessment. Metrics (fractional anisotropy [FA], mean diffusivity [MD], cortical thickness) were extracted from SN, DMN, ECN (triple network), and visual network (control network) using established atlases. Multivariate general linear models were conducted to assess group differences in metrics and associations with clinical features. Results: Patients showed increased MD in the anterior SN, dorsal DMN, and right ECN compared to HC. Diffusivity increases were more pronounced in patients with higher behavioral dysregulation, i.e., suicidal attempting, self-harm, and aggressiveness. No differences were detected in network structure. Conclusions: These results indicate that the triple network system is impaired in BPD at the microstructural level. The preferential involvement of anterior and right-lateralized subsystems and their clinical association suggests that these abnormalities could contribute to behavioral dysregulation.

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Section: Discussionmentioning

confidence: 99%

Aberrant Structural Connectivity of the Triple Network System in Borderline Personality Disorder Is Associated with Behavioral Dysregulation

Quattrini

Magni

Lanfredi

et al. 2022

JCM

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“…In two of these studies electrodes were placed on the PFC with either bilateral anodal right or left DLPFC stimulation, and cathodal stimulation to the contralateral prefrontal area [109,110]. The other two studies delivered unilateral stimulation with anodal right or left DLPFC and an extracephalic reference electrode over the mastoid [111,112]. The variability in outcome measures included across these studies, such as emotion dysregulation, executive functioning, impulsivity, and stress-related dissociative states, make idirect comparisons of these studies difficult.…”

Section: Borderline Personality Disordermentioning

confidence: 99%

Pre-clinical indications of brain stimulation treatments for non-affective psychiatric disorders, a status update

Benster,

Weissman,

Stolz

et al. 2023

Transl Psychiatry

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Over the past two decades noninvasive brain stimulation (NIBS) techniques have emerged as powerful therapeutic options for a range of psychiatric and neurological disorders. NIBS are hypothesized to rebalance pathological brain networks thus reducing symptoms and improving functioning. This development has been fueled by controlled studies with increasing size and rigor aiming to characterize how treatments induce clinically effective change. Clinical trials of NIBS for specific indications have resulted in federal approval for unipolar depression, bipolar depression, smoking cessation, and obsessive-compulsive disorder in the United States, and several other indications worldwide. As a rapidly emerging field, there are numerous pre-clinical indications currently in development using a variety of electrical and magnetic, non-convulsive, and convulsive approaches. This review discusses the state-of-the-science surrounding promising avenues of NIBS currently in pre-approval stages for non-affective psychiatric disorders. We consider emerging therapies for psychosis, anxiety disorders, obsessive-compulsive disorder, and borderline personality disorder, utilizing transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), and magnetic seizure therapy (MST), with an additional brief section for early-stage techniques including transcranial focused ultrasound stimulation (tFUS) and transcranial alternating current stimulation (tACS). As revealed in this review, there is considerable promise across all four psychiatric indications with different NIBS approaches. Positive findings are notable for the treatment of psychosis using tDCS, MST, and rTMS. While rTMS is already FDA approved for the treatment of obsessive-compulsive disorder, methodologies such as tDCS also demonstrate potential in this condition. Emerging techniques show promise for treating non-affective disorders likely leading to future regulatory approvals.

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“…Thus, more focal techniques, such as rTMS, would provide more specific localizations. Relatedly, hemispheric lateralization should carefully be considered as the reviewed tDCS studies have highlighted some variability in the modulatory effects of anodal stimulations of rVLPFC, possibly due to the nature of the tasks that participants completed (e.g.,Lisoni et al, 2020 ; Wolkenstein et al, 2021 ).…”

Section: Introductionmentioning

confidence: 98%

“…Impulsivity and aggression measures were significantly reduced only in patients treated with real DCS. Moreover, Wolkenstein et al ( 2021 ) recently found that anodal tDCS to the left dlPFC ameliorates deficient cognitive control over emotional distraction of BPD, which is a central characteristic of these individuals (Soloff et al, 2015 ).…”

Section: Introductionmentioning

confidence: 99%

Can we rewire criminal mind via non-invasive brain stimulation of prefrontal cortex? Insights from clinical, forensic and social cognition studies

et al. 2022

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Non-compliance with social and legal norms and regulations represents a high burden for society. Social cognition deficits are frequently called into question to explain criminal violence and rule violations in individuals diagnosed with antisocial personality disorder (APD), borderline personality disorder (BPD), and psychopathy. In this article, we proposed to consider the potential benefits of non-invasive brain stimulation (NIBS) to rehabilitate forensic population. We focused on the effects of NIBS of the prefrontal cortex, which is central in social cognition, in modulating aggression and impulsivity in clinical disorders, as well as in forensic population. We also addressed the effect of NIBS on empathy, and theory of mind in non-clinical and/or prison population. The reviewed data provide promising evidence on the beneficial effect of NIBS on aggression/impulsivity dyscontrol and social cognitive functions, suggesting its relevance in promoting reintegration of criminals into society.

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Challenging control over emotions in borderline personality disorder - a tDCS study

Cited by 8 publications

References 62 publications

Aberrant Structural Connectivity of the Triple Network System in Borderline Personality Disorder Is Associated with Behavioral Dysregulation

Aberrant Structural Connectivity of the Triple Network System in Borderline Personality Disorder Is Associated with Behavioral Dysregulation

Pre-clinical indications of brain stimulation treatments for non-affective psychiatric disorders, a status update

Can we rewire criminal mind via non-invasive brain stimulation of prefrontal cortex? Insights from clinical, forensic and social cognition studies

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