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Anxiety & tDCS

Anxiety is one of the most common psychiatric conditions in the world with prescription medication and psychotherapies as the  prevailing treatments. A majority of patients with persistent symptoms find little relief with traditional therapies. Research also supports immune activity as a leading trigger for anxiety symptoms and requires testing to rule out toxins, and acute or chronic bacterial, viral, fungal infections. Some patients report new onset anxiety as a consequence of menopause and thus each patient needs to be evaluated based on age and all other concomitant symptoms. If sleep is disrupted as a result then a focused protocol for enhancing sleep could include Alpha-Stim therapy that treats anxiety and insomnia simultaneously. In recent years transcranial direct current stimulation (tDCS) has risen as a promising safe tool for treating mood disorders such as anxiety. 

Previous studies have reported in anxiety and major depressive disorder an imbalance between the activity of the right and left dorsolateral prefrontal cortex(DLPFC), with hypoactivity in the left side and hyperactivity in the right side. tDCS provides a very safe alternative to modify this imbalance by placing electrodes on the frontal scalp for 20 minutes daily to elevate activity on the left side and reduce hyperactivity on the right side which is associated with negative emotions and generation of anxiety. tDCS works well in combination with all other brain therapies and can be added as a supportive therapy with medication, psychotherapy, and even Neurofeedback therapy. tDCS sessions last 20 minutes are easily implemented in a flexible at home therapy that is very safe and convenient.

Improve Overall Function

  • Improves mood and reduces anxiety
  • Enhances response to other therapies like NFB
  • Can be helpful in reducing pain
  • Safe with no adverse effects

REFERENCE

  1. Yuwei Wu et al; Effects of tDCS on Depression and Comorbid Generalized Anxiety Disorder: A Brain Function Imaging Case Report. Front Neurol. 2022; 13: 879339.Published online 2022 Jun 13. doi: 10.3389/fneur.2022.87933. PMID: 35769365. PMCID: PMC9234299.
  2. Nishida, K. et al. Mindfulness augmentation for anxiety through concurrent use of transcranial direct current stimulation: a randomized double-blind study. Sci Rep 11, 22734 (2021). https://doi.org/10.1038/s41598-021-02177-3
  3. Larissa Ramalho Dantas Varella Dutra et al; Modulating Anxiety and Functional Capacity with Anodal tDCS Over the Left Dorsolateral Prefrontal Cortex in Primary Dysmenorrhea. Int J Womens Health. 2020; 12: 243–251. Published online 2020 Apr 5. doi: 10.2147/IJWH.S226501. PMID: 32308497. PMCID: PMC7147620
  4. Dirson João Stein et al; Transcranial Direct Current Stimulation in Patients with Anxiety: Current Perspectives. Neuropsychiatr Dis Treat. 2020; 16: 161–169. Published online 2020 Jan 14. doi: 10.2147/NDT.S195840. PMID: 32021208. PMCID: PMC6969693
  5.  Moffa AH, Brunoni AR, Nikolin S, Loo CK. Transcranial Direct Current Stimulation in Psychiatric Disorders: A Comprehensive Review. The Psychiatric Clinics of North America 2018;41(3):447–63 doi: 10.1016/j.psc.2018.05.002. PMID: 30098657
  6. Grimm S, Beck J, Schuepbach D, et al. Imbalance between left and right dorsolateral prefrontal cortex in major depression is linked to negative emotional judgment: an fMRI study in severe major depressive disorder. Biol Psychiatry. 2008;63(4):369–376. doi: 10.1016/j.biopsych.2007.05.033.PMID: 17888408
  7. Nitschke JB, Heller W. Distinguishing neural substrates of heterogeneity among anxiety disorders. Int Rev Neurobiol. 2005;67(05):1–42. PMID: 16291018

Study: Transcranial direct current stimulation for depression: 3-week, randomised, sham-controlled trial

Background: Transcranial direct current stimulation (tDCS) is a type of non-invasive brain stimulation technique that has proven effective for neuropsychiatric disorders. Generalized anxiety disorder (GAD) and depression are common psychiatric disorders that often are comorbid, meaning they occur simultaneously. Current evidence supports the value of tDCS for GAD. The objectives of this report is to explore the effect of tDCS on clinical symptoms and cerebral function in a patient with comorbid GAD and depression.

Methods: Our subject was a semiprofessional athlete diagnosed with comorbid GAD and depression. Symptoms included palpitations, sweating, continuous tension, and anxiety. We designed a B-A-B experimental protocol and used the Beck Anxiety Index (BAI), Beck Depression Index (BDI), and Pittsburgh Sleep Quality Index (PSQI) as assessment tools. Treatment consisted of 2 series of 15 days each, separated by a 3-week washout period. We collected functional near-infrared spectroscopy (fNIRS) data before and after both series, as well as fNIRS data immediately after the first treatment in both series. In addition, we collected functional magnetic resonance imaging data before and after the second series.

Results: After the first series, the scores of the three questionnaires (BAI, BDI and PSQI) decreased significantly, which showed the trend of improvement. The functional connection of bilateral prefrontal partial channels decreased significantly immediately after tDCS treatment. The results of the fNIRS before the second-series treatment showed that prefrontal connectivity returned to the state before the first intervention after the washout period. The results of the fNIRS after the second series treatment showed that the symptoms of depression and anxiety alleviated. The results of the fNIRS showed that the prefrontal connectivity decreased again.

Conclusion: In the treatment of comorbid GAD and depression, tDCS can alleviate symptoms and improve sleep quality and social behavior. Brain imaging is widely used to observe functional changes by tDCS such as fMRI and fNIRS. The study also showed that fNIRS can be a safe, simple, and efficient method to assess brain activity.

REFERENCE

  1. Yuwei Wu et al; Effects of tDCS on Depression and Comorbid Generalized Anxiety Disorder: A Brain Function Imaging Case Report. Front Neurol. 2022; 13: 879339.Published online 2022 Jun 13. doi: 10.3389/fneur.2022.87933. PMID: 35769365. PMCID: PMC9234299.

These statements have not been evaluated or approved by the FDA. All of the statements made on this document are not anecdotal and have been taken directly from clinical data.