Psychophysiological effects of an iTBS modulated virtual reality challenge including participants with spider phobia

S Notzon; S Deppermann; A Fallgatter; J Diemer; A Kroczek; K Domschke; P Zwanzger; A-C Ehlis

doi:10.1016/j.biopsycho.2015.10.003

Psychophysiological effects of an iTBS modulated virtual reality challenge including participants with spider phobia

Biol Psychol. 2015 Dec:112:66-76. doi: 10.1016/j.biopsycho.2015.10.003. Epub 2015 Oct 22.

Authors

S Notzon¹, S Deppermann², A Fallgatter³, J Diemer⁴, A Kroczek⁵, K Domschke⁶, P Zwanzger⁷, A-C Ehlis²

Affiliations

¹ Mood and Anxiety Disorders Research Unit, Department of Psychiatry, University of Muenster, Albert-Schweitzer-Campus 1, Gebaeude A9, 48149 Muenster, Germany. Electronic address: swantje.notzon@ukmuenster.de.
² Department of Psychiatry and Psychotherapy, Calwerstr. 14, University of Tuebingen, 72076 Tuebingen, Germany.
³ Department of Psychiatry and Psychotherapy, Calwerstr. 14, University of Tuebingen, 72076 Tuebingen, Germany; Graduate School LEAD, Europastr. 6, University of Tuebingen, 72072 Tuebingen, Germany; Cluster of Excellence CIN, Otfried-Mueller-Str. 25, University of Tuebingen, 72076 Tuebingen, Germany.
⁴ Department of Psychology (Clinical Psychology and Psychotherapy), Universitaetsstr. 31, University of Regensburg, 93053 Regensburg, Germany.
⁵ Department of Psychiatry and Psychotherapy, Calwerstr. 14, University of Tuebingen, 72076 Tuebingen, Germany; IMPRS for Cognitive and Neuroscience, Oesterbergstr. 3, 72076 Tuebingen, Germany.
⁶ Department of Psychiatry, Psychosomatics and Psychotherapy, University of Wuerzburg, Fuechsleinstrasse 15, 97080 Wuerzburg, Germany.
⁷ Mood and Anxiety Disorders Research Unit, Department of Psychiatry, University of Muenster, Albert-Schweitzer-Campus 1, Gebaeude A9, 48149 Muenster, Germany; kbo-Inn-Salzach-Hospital, Gabersee 7, 83512 Wasserburg am Inn, Germany; Department of Psychiatry und Psychotherapy, Ludwig Maximilians University, Nußbaumstraße 7, 80336 Munich, Germany.

PMID: 26476332
DOI: 10.1016/j.biopsycho.2015.10.003

Abstract

Preliminary evidence suggests beneficial effects of transcranial magnetic stimulation (TMS) on anxiety. The objective of this study was to investigate the effects of intermittent theta burst stimulation (iTBS) as a form of TMS on acute anxiety provoked by a virtual reality (VR) scenario. Participants with spider phobia (n=41) and healthy controls (n=42) were exposed to a spider scenario in VR after one session of iTBS over the prefrontal cortex or sham treatment. Participants with spider phobia reacted with more anxiety compared to healthy controls. Their heart rate and skin conductance increased compared to baseline. Contrary to expectations, iTBS did not influence these reactions, but modulated heart rate variability (HRV). Sympathetic influence on HRV showed an increase in the active iTBS group only. This study does not support the idea of beneficial effects of a single session of iTBS on anxiety, although other protocols or repeated sessions might be effective.

Keywords: Anxiety disorders; Heart rate (HR); Heart rate variability (HRV); Skin conductance level (SCL); Specific phobia; Spider phobia; Theta burst stimulation; Transcranial magnetic stimulation (TMS); Virtual reality (VR); iTBS.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Animals
Female
Galvanic Skin Response / physiology
Heart Rate / physiology
Humans
Male
Phobic Disorders / physiopathology
Phobic Disorders / therapy*
Prefrontal Cortex / physiopathology*
Single-Blind Method
Spiders
Theta Rhythm / physiology*
Transcranial Magnetic Stimulation / methods*
Treatment Outcome
Young Adult