Enhancing decision-making and cognitive impulse control with transcranial direct current stimulation (tDCS) applied over the orbitofrontal cortex (OFC): A randomized and sham-controlled exploratory study

A behavioral and cognitive neuroscience perspective on impulsivity, suicide, and non-suicidal self-injury: Meta-analysis and recommendations for future research

“…tDCS neuromodulation of various targets has been increasingly applied in treatment research (e.g., to relieve major depression Meron et al, 2015), but it has also been used for experimental manipulation of neural networks to enhance or diminish specific cognitive functions or symptoms, including impulsivity. Anodal tDCS applied to the rIFG appears to reduce behavioral impulsivity (Cai et al, 2016; Cunillera et al, 2014; Ditye et al, 2012; Stramaccia et al, 2015), whereas anodal tDCS to the left OFC has been found to lead to a reduction in cognitive impulsivity (Ouellet et al, 2015). If behavioral and cognitive impulsivity are implicated in short-term risk for self-injurious thoughts and behaviors, tDCS may therefore have potential to become a new protocol for addressing these clinical outcomes, through targeting the respective underlying neural circuitry of these facets of impulsivity.…”

“…If behavioral impulsivity is a short-term prospective predictor of suicide attempts, for example, the rIFG may be implicated in proximal risk for this behavior (Aron et al, 2003; Winstanley et al, 2006). Similarly, to the degree that cognitive impulsivity prospectively predicts proximal risk for this outcome, the OFC may be of particular relevance (Ouellet et al, 2015; Winstanley et al, 2006, 2004). …”

“…Specifically, the orbitofrontal cortex (OFC) and basolateral amygdala (BLA) appear to be uniquely involved in cognitive impulsivity (Ouellet et al, 2015; Peters and Büchel, 2011; Winstanley et al, 2006, 2004), but not behavioral impulsivity (Bari and Robbins, 2013; Winstanley et al, 2006). Additionally, several studies have consistently found that activation of the ventral striatum and ventral medial prefrontal cortex (vmPFC) is correlated with discounting of future rewards in a commonly used paradigm for indexing cognitive impulsivity, the delay discounting task (Peters and Büchel, 2011).…”

The modulating effects of brain stimulation on emotion regulation and decision-making

“…Cathodal stimulation increased choices of the highest rewards, but anodal stimulation induced choices affected less by anticipated rewards and more by recent negative reward prediction errors, indicating that the right FPC is involved in controlling both exploration and exploitation. Ouellet et al [42] studied decisionmaking and cognitive impulse control using tDCS. Anodal tDCS over orbitofrontal cortex (OFC) regardless of laterality increased advantageous decision-making and cognitive impulse control, compared to sham stimulation, indicating that controlling OFC by tDCS helps regulate impulsive behavior in psychiatric populations.…”

“…In summary, tDCS influences and modulates risk-taking behaviors [5,12,18,19,47,82,83], choice modulation [46], delayed discounting [30], maladaptive decisionmaking [81], probabilistic guessing [29], moral judgment [37], sunk-cost effect [4], exploration-exploitation trade-offs [61], decision-making and cognitive impulse control [42], perception of space and time [79], dual-task performance [22], model-based learning [70], addiction [6,17,26,60,80], food craving [23,35], and perceptual decision-making [34].…”