Targeting the left DLPFC and right VLPFC in unmarried romantic relationship breakup (love trauma syndrome) with intensified electrical stimulation: A randomized, single-blind, parallel-group, sham-controlled study

Jaber Alizadehgoradel; Seyed Danial Razavi; Zahra Shirani; Mobina Barati; Mina Taherifard; Vahid Nejati; Michael A Nitsche

doi:10.1016/j.jpsychires.2024.05.020

Targeting the left DLPFC and right VLPFC in unmarried romantic relationship breakup (love trauma syndrome) with intensified electrical stimulation: A randomized, single-blind, parallel-group, sham-controlled study

J Psychiatr Res. 2024 May 9:175:170-182. doi: 10.1016/j.jpsychires.2024.05.020. Online ahead of print.

Authors

Jaber Alizadehgoradel¹, Seyed Danial Razavi², Zahra Shirani³, Mobina Barati³, Mina Taherifard⁴, Vahid Nejati⁵, Michael A Nitsche⁶

Affiliations

¹ Department of Psychology, Faculty of Humanities, University of Zanjan, Zanjan, Iran. Electronic address: j.alizadeh@znu.ac.ir.
² Family Research Institute, Shahid Beheshti University, Tehran, Iran.
³ Department of Psychology, Faculty of Humanities, University of Zanjan, Zanjan, Iran.
⁴ Department of Psychology, Mohaghegh-Ardabili University, Ardabil, Iran.
⁵ Department of Psychology, Shahid Beheshti University, Tehran, Iran.
⁶ Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany; Bielefeld University, University Hospital OWL, Protestant Hospital of Bethel Foundation, University Clinic of Psychiatry and Psychotherapy and University Clinic of Child and Adolescent Psychiatry and Psychotherapy, Germany; German Centre for Mental Health (DZPG), Germany.

PMID: 38735262
DOI: 10.1016/j.jpsychires.2024.05.020

Abstract

Background: Ending a romantic relationship is one of the most painful losses an adult experience. Neuroimaging studies suggest that there is a neuropsychological link between breakup experiences and bereaved individuals, and that specific prefrontal regions are involved. The aim of this study was to determine whether enhancement of left DLPFC and right VLPFC activity with a novel intensified anodal transcranial direct current stimulation protocol reduces core symptoms of love trauma syndrome (LTS) and improves treatment-related variables.

Methods: In this randomized, sham-controlled, single-blind parallel trial, we assessed the efficacy of an intensified anodal stimulation protocol (20 min, twice-daily sessions with 20 min intervals, 5 consecutive days) with two montages (left DLPFC vs right VLPFC) to reduce love trauma symptoms. 36 participants with love trauma syndrome were randomized in three tDCS condition (left DLPFC, right VLPFC, sham stimulation). LTS symptoms, treatment-related outcome variables (depressive state, anxiety, emotion regulation, positive and negative affect), and cognitive functions were assessed before, right after, and one month after intervention.

Results: Both DLPFC and VLPFC protocols significantly reduced LTS symptoms, and improved depressive state and anxiety after the intervention, as compared to the sham group. The improving effect of the DLPFC protocol on love trauma syndrome was significantly larger than that of the VLPFC protocol. For emotion regulation and positive and negative affect, improved regulation of emotions and positive affect and reduced negative affect were revealed after intervention in the two real stimulation conditions compared to the sham. For cognitive functions, no significant difference was observed between the groups, but again a positive effect of intervention within groups in the real stimulation conditions (DLPFC and VLPFC) was found for most components of the cognitive tasks.

Conclusions: Enhancement of left DLPFC and right VLPFC activity with intensified stimulation improves LTS symptoms and treatment-related variables. For LTS symptoms, DLPFC stimulation was more efficient than VLPFC stimulation., For the other variables, no significant difference was observed between these two stimulation groups. These promising results require replication in larger trials.

Keywords: Dorsolateral prefrontal cortex (DLPFC); Love trauma syndrome (LTS); Romantic relationship breakup; Transcranial direct current stimulation (tDCS); Ventrolateral prefrontal cortex (VLPFC).