Enhancing Affective Cognitive Control in Bipolar Disorder Using Transcranial Alternating Current Stimulation: A Double-Blind, Randomized, Sham-Controlled Clinical Trial and Proof of Concept Study

IF 3.9 2区医学 Q1 CLINICAL NEUROLOGY

Bipolar Disorders Pub Date : 2026-06-30 DOI:10.1111/bdi.70142

Jacob D. Kraft, Laura Locarno, Takakuni Suzuki, Justin Riddle, Soo-Eun Chang, Melvin G. McInnis, Flavio Fröhlich, Stephan F. Taylor, Ivy F. Tso

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引用次数: 0

Abstract

Introduction

Persistent emotion lability and impulsive behavior in bipolar disorder (BD) are thought to be due to impaired affective cognitive control. Neural synchrony via theta-gamma phase-amplitude coupling (PAC) in the prefrontal cortex facilitates cognitive control and is impaired in BD. This pilot study aimed to investigate the feasibility and efficacy of transcranial alternating current stimulation (tACS) in targeting the neural coordination (i.e., theta-gamma PAC) of cognitive control in a double-blind, randomized, controlled crossover trial.

Methods

Participants (N = 18) with BD completed an emotional Go/No-Go task during six 5-min stimulation blocks interleaved with 2-min resting blocks. Participants received active- and sham-stimulation 1 week apart; sham comprised a ramp up/down at the beginning and end of the block to mimic stimulation sensations. Tolerability was measured using a side effect questionnaire after active and sham stimulation. Behavioral measures of discriminability (d′) and reaction time during the task, and EEG measures of theta-power and theta-gamma PAC during the interleaved resting states were compared for active versus sham.

Results

Active did not differ from sham stimulation on any side effects (all p's > 0.11). Effect sizes when comparing discriminability, theta-power, and PAC across active versus sham were small but showed a consistent pattern of improvement in the active relative to the sham condition.

Conclusion

This pilot study showed that 30-min tACS is tolerable to BD patients and demonstrated preliminary promise in enhancing affective cognitive control. Future studies should determine the optimal dosage to produce more substantial and enduring effects.

Trial Registration

ClinicalTrials: NCT05480124

查看原文本刊更多论文

经颅交流电刺激增强双相情感认知控制：一项双盲、随机、假对照临床试验和概念验证研究。

导读：双相情感障碍（BD）的持续情绪不稳定和冲动行为被认为是由于情感认知控制受损。前额叶皮层通过theta-gamma相幅耦合（PAC）实现的神经同步促进认知控制，在双盲、随机、对照交叉试验中，本研究旨在探讨经颅交流电刺激（tACS）靶向认知控制的神经协调（即theta-gamma相幅耦合）的可行性和有效性。方法：18名双相障碍患者在6个5分钟的刺激时段和2分钟的休息时段交替进行情绪Go/No-Go任务。参与者分别接受主动刺激和模拟刺激，间隔1周；Sham组在积木的开始和结束处有一个上升/下降的斜坡来模拟刺激的感觉。在主动刺激和假刺激后，使用副作用问卷来测量耐受性。比较了活动组和假组在任务期间的辨别能力（d'）和反应时间的行为测量，以及交错静息状态下的theta-power和theta-gamma PAC的脑电图测量。结果：活性刺激与假刺激在任何副作用上均无差异（p < 0.01）。当比较活动与假手术的可辨别性、theta-power和PAC时，效应量很小，但在活动条件下相对于假手术条件显示出一致的改善模式。结论：本初步研究表明，30分钟的tACS对BD患者是可耐受的，并在增强情感认知控制方面显示出初步的希望。未来的研究应确定最佳剂量，以产生更实质性和持久的效果。试验注册：ClinicalTrials: NCT05480124。

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来源期刊

Bipolar Disorders 医学-精神病学

CiteScore

8.20

自引率

7.40%

发文量

审稿时长

6-12 weeks

期刊介绍： Bipolar Disorders is an international journal that publishes all research of relevance for the basic mechanisms, clinical aspects, or treatment of bipolar disorders and related illnesses. It intends to provide a single international outlet for new research in this area and covers research in the following areas: biochemistry physiology neuropsychopharmacology neuroanatomy neuropathology genetics brain imaging epidemiology phenomenology clinical aspects and therapeutics of bipolar disorders Bipolar Disorders also contains papers that form the development of new therapeutic strategies for these disorders as well as papers on the topics of schizoaffective disorders, and depressive disorders as these can be cyclic disorders with areas of overlap with bipolar disorders. The journal will consider for publication submissions within the domain of: Perspectives, Research Articles, Correspondence, Clinical Corner, and Reflections. Within these there are a number of types of articles: invited editorials, debates, review articles, original articles, commentaries, letters to the editors, clinical conundrums, clinical curiosities, clinical care, and musings.