Virtual reality and transcranial direct current stimulation for posttraumatic stress disorder: A randomized clinical trial
APA Citation:
van ’t Wout-Frank, M., Arulpragasam, A. R., Faucher, C., Aiken, E., Shea, M. T., Jones, R. N., Greenberg, B. D., & Philip, N. S. (2024). Virtual reality and transcranial direct current stimulation for posttraumatic stress disorder: A randomized clinical trial. JAMA Psychiatry, 81(5), 437-446. https://doi.org/10.1001/jamapsychiatry.2023.5661
Focus:
Veterans
Programming
Mental health
Branch of Service:
Multiple branches
Military Affiliation:
Veteran
Subject Affiliation:
Veteran
Population:
Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
Authors:
van ’t Wout-Frank, Mascha, Arulpragasam, Amanda R., Faucher, Christiana, Aiken, Emily, Shea, M. Tracie, Jones, Richard N., Greenberg, Benjamin D., Philip, Noah S.
Abstract:
Posttraumatic stress disorder (PTSD) is a common psychiatric disorder that is particularly difficult to treat in military veterans. Noninvasive brain stimulation has significant potential as a novel treatment to reduce PTSD symptoms.To test whether active transcranial direct current stimulation (tDCS) plus virtual reality (VR) is superior to sham tDCS plus VR for warzone-related PTSD.This double-blind randomized clinical trial was conducted among US military veterans enrolled from April 2018 to May 2023 at a secondary care Department of Veterans Affairs hospital and included 1- and 3-month follow-up visits. Participants included US military veterans with chronic PTSD and warzone-related exposure, recruited via referral and advertisement. Patients in psychiatric treatment had to be on a stable regimen for at least 6 weeks to be eligible for enrollment. Data were analyzed from May to September 2023.Participants were randomly assigned to receive 2-mA anodal tDCS or sham tDCS targeted to the ventromedial prefrontal cortex, during six 25-minute sessions of standardized warzone VR exposure, delivered over 2 to 3 weeks.The co–primary outcomes were self-reported PTSD symptoms, measured via the PTSD checklist for DSM-5 (PCL-5), alongside quality of life. Other outcomes included psychophysiological arousal, clinician-assessed PTSD, depression, and social/occupational function.A total of 54 participants (mean [SD] age, 45.7 [10.5] years; 51 [94%] males) were assessed, including 26 in the active tDCS group and 28 in the sham tDCS group. Participants in the active tDCS group reported a superior reduction in self-reported PTSD symptom severity at 1 month (t =
Publication Type:
Article
Keywords:
exposure therapy, virtual reality therapy, transcranial direct current stimulation, tDCS, posttraumatic Stress Disorder, PTSD