FV 17 Improved treatment of anxiety disorders by non-invasive brain stimulation?. Issue 10 (October 2017)

• Record Type: Journal Article
• Authors: Fallgatter, A.J.; Deppermann, S.; Vennewald, N.; Dresler, T.; Notzon, S.; Ehlis, A.C.; Zwanzger, P.
• Is Part Of: Clinical neurophysiology. Volume 128:Issue 10(2017:Oct.)
• Page Start: e314
• Page End: e315
• Publication Date: 2017-10
• Subjects: Neurophysiology -- Periodicals; Electroencephalography -- Periodicals; Electromyography -- Periodicals; Neurology -- Periodicals; 612.8
• DOI: 10.1016/j.clinph.2017.06.059
• Languages: English
• ISSNs: 1388-2457

Abstract

Abstract : Introduction: Anxiety disorders are the most frequent psychiatric disorders worldwide. The most severe form is panic disorder with a very unfavourable spontaneous course. Although state-of-the art treatment with cognitive behavioural therapy, pharmacotherapy or a combination of both is effective, roughly one third of patients can not be treated sufficiently. Methods: In the past years, several attempts have been made to improve standard treatment of panic disorders by means of non-invasive brain stimulation, in particular Transcranial Magnetic Stimulation (rTMS) to the prefrontal cortex. Results: In a pilot study, we investigated whether 15 sessions of intermittent Theta Burst Stimulation (iTBS) to the left dorsolateral prefrontal cortex applied as add-on treatment to cognitive behavioural therapy might have a beneficial therapeutic effect. Patients with panic disorder ( n = 44) were randomly assigned to verum or sham stimulation groups. Although we did not find significantly different reduction in anxiety symptoms, exploratory analyses pointed to a possible beneficial effect (reduction of medication during the treatment phase only in the verum stimulation group). Neurophysiological effects as assessed with Near-Infrared Spectroscopy (NIRS) in terms of a normalized function of the lateral prefrontal cortex during emotional paradigms were found only in the verum stimulated patients. Conclusions: We provide hints for a beneficial effect of additional iTBS in the treatment of patients with panic disorders mainly on the neurophysiological and, to a lesser extent, on the clinical level.