<p>Transcranial Direct Current Stimulation in Patients with Anxiety: Current Perspectives</p>

Abstract

Anxiety is one of the most prevalent and debilitating psychiatric conditions worldwide. Pharmaco-and psycho-therapies have been employed in the treatment of human anxiety to date. Yet, either alone or in combination, unsatisfactory patient outcomes are prevalent, resulting in a considerable number of people whose symptoms fail to respond to conventional therapies with symptoms remaining after intervention. The demand for new therapies has given birth to several noninvasive brain stimulation techniques. Transcranial direct current stimulation (tDCS) has arisen as a promising tool and has been proven to be safe and well tolerated for the treatment of many diseases, including chronic pain, depression, and anxiety. Here, reports of the use of tDCS in anxiety disorders in human patients were reviewed and summarized. A literature search was conducted in mid-2019, to identify clinical studies that evaluated the use of tDCS for the treatment of anxiety behavior. The PubMed, Web of Science, and Scielo and PsycInfo databases were explored using the following descriptors: "anxiety", "anxious behavior", "tDCS", and "transcranial direct current stimulation". Among the selected articles, considerable variability in the type of tDCS treatment applied in interventions was observed. Evidence shows that tDCS may be more effective when used in combination with drugs and cognitive behavioral therapies; however future large-scale clinical trials are recommended to better clarify the real effects of this intervention alone, or in combination with others.

The Effect of Transcranial Direct Current Stimulation on Relapse, Anxiety, and Depression in Patients With Opioid Dependence Under Methadone Maintenance Treatment: A Pilot Study

“…Few studies have reported the effect of tDCS on the anxiety disorders and fewer in patients with substance dependence disorders (Hampstead et al, 2016;Kar and Sarkar, 2016). Some researchers have proposed the placement of cathode electrode on the right prefrontal cortex and anode electrode on the left prefrontal cortex (Stein et al, 2020). The hypothesis is that the cathodal stimulation may reduce cortical excitability in anxiety disorders, which accompany cortical excitability.…”

Applications of Non-invasive Neuromodulation for the Management of Disorders Related to COVID-19

“…Bifrontal 2 mA stimulation with cathode over the right and anode over the left DLPFC was performed on a recently published controlled randomized trial, supporting the efficacy of tDCS in the treatment of PTSD ( 211 ). In contrast, evidence for tDCS in the treatment of generalized anxiety disorder is less robust ( 212 ). A randomized controlled trial showed improvement in physical stress symptoms but not in the primary outcome measure (Hamilton Anxiety Rating Scale) in the active group in comparison to sham ( 213 ).…”

The Impact of transcranial Direct Current Stimulation on Rumination: A Systematic Review of the Sham-controlled Studies in Healthy and Clinical Samples

“…Because of its non-invasive nature, highly controlled sham condition, and relatively low cost compared to other neuromodulation techniques, tDCS quickly arises as a promising therapeutic tool. Indeed, many several systematic reviews and meta-analyses of randomized controlled trials indicated the safety and therapeutic efficacy of tDCS for a wide range of mental disorders (for a review, see Tortella et al, 2015), including, among others, depression and mood disorders (Borrione et al, 2018;Dondé et al, 2018;Razza et al, 2020), anxiety disorders (e.g., Stein et al, 2020;Yosephi et al, 2019), psychotic disorders (e.g., Lee et al, 2018), pain-related disorders (e.g., Zortea et al, 2019), and eating disorders (e.g., Dalton et al, 2018). Hence, this literature has prompted an exceptionally positive prospect vis-à-vis tDCS as a therapeutic tool.…”