Transcranial Direct Current Stimulation Targeting the Ventromedial Prefrontal Cortex Reduces Reactive Aggression and Modulates Electrophysiological Responses in a Forensic Population

Carmen S Sergiou; Emiliano Santarnecchi; Sara M Romanella; Matthias J Wieser; Ingmar H A Franken; Eric G C Rassin; Josanne D M van Dongen

doi:10.1016/j.bpsc.2021.05.007

Transcranial Direct Current Stimulation Targeting the Ventromedial Prefrontal Cortex Reduces Reactive Aggression and Modulates Electrophysiological Responses in a Forensic Population

Biol Psychiatry Cogn Neurosci Neuroimaging. 2022 Jan;7(1):95-107. doi: 10.1016/j.bpsc.2021.05.007. Epub 2021 Jun 1.

Authors

Carmen S Sergiou¹, Emiliano Santarnecchi², Sara M Romanella², Matthias J Wieser³, Ingmar H A Franken³, Eric G C Rassin³, Josanne D M van Dongen⁴

Affiliations

¹ Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, the Netherlands. Electronic address: sergiou@essb.eur.nl.
² Berenson-Allen Center for Non-Invasive Brain Stimulation, Beth Israel Medical Center, Harvard Medical School, Boston, Massachusetts.
³ Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, the Netherlands.
⁴ Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, the Netherlands. Electronic address: j.d.m.vandongen@essb.eur.nl.

PMID: 34087482
DOI: 10.1016/j.bpsc.2021.05.007

Abstract

Background: Studies have shown that impairments in the ventromedial prefrontal cortex play a crucial role in violent behavior in forensic patients who also abuse cocaine and alcohol. Moreover, interventions that aimed to reduce violence risk in those patients are found not to be optimal. A promising intervention might be to modulate the ventromedial prefrontal cortex by high-definition (HD) transcranial direct current stimulation (tDCS). The current study aimed to examine HD-tDCS as an intervention to increase empathic abilities and reduce violent behavior in forensic substance dependent offenders. In addition, using electroencephalography, we examined the effects on the P3 and the late positive potential of the event-related potentials in reaction to situations that depict victims of aggression.

Methods: Fifty male forensic patients with a substance dependence were tested in a double-blind, placebo-controlled randomized study. The patients received HD-tDCS 2 times a day for 20 minutes for 5 consecutive days. Before and after the intervention, the patients completed self-reports and performed the Point Subtraction Aggression Paradigm, and electroencephalography was recorded while patients performed an empathy task.

Results: Results showed a decrease in aggressive responses on the Point Subtraction Aggression Paradigm and in self-reported reactive aggression in the active tDCS group. Additionally, we found a general increase in late positive potential amplitude after active tDCS. No effects on trait empathy and the P3 were found.

Conclusions: Current findings are the first to find positive effects of HD-tDCS in reducing aggression and modulating electrophysiological responses in forensic patients, showing the potential of using tDCS as an intervention to reduce aggression in forensic mental health care.

Keywords: Aggression; Electroencephalography; Empathy; Forensic patients; Neuromodulation; Transcranial direct current stimulation.

Publication types

Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Aggression / physiology
Electroencephalography
Evoked Potentials / physiology
Humans
Male
Prefrontal Cortex / physiology
Transcranial Direct Current Stimulation* / methods