Skip to main content
Journal cover image

Enhancing cognitive restructuring with concurrent fMRI-guided neurostimulation for emotional dysregulation-A randomized controlled trial.

Publication ,  Journal Article
Neacsiu, AD; Beynel, L; Graner, JL; Szabo, ST; Appelbaum, LG; Smoski, MJ; LaBar, KS
Published in: J Affect Disord
March 15, 2022

BACKGROUND: Transdiagnostic clinical emotional dysregulation is a key component of many mental health disorders and offers an avenue to address multiple disorders with one transdiagnostic treatment. In the current study, we pilot an intervention that combines a one-time teaching and practice of cognitive restructuring (CR) with repetitive transcranial magnetic stimulation (rTMS), targeted based on functional magnetic resonance imaging (fMRI). METHODS: Thirty-seven clinical adults who self-reported high emotional dysregulation were enrolled in this randomized, double-blind, placebo-controlled trial. fMRI was collected as participants were reminded of lifetime stressors and asked to downregulate their distress using CR tactics. fMRI BOLD data were analyzed to identify the cluster of voxels within the left dorsolateral prefrontal cortex (dlPFC) with the highest activation when participants attempted to downregulate, versus passively remember, distressing memories. Participants underwent active or sham rTMS (10 Hz) over the left dlPFC target while practicing CR following emotional induction using recent autobiographical stressors. RESULTS: Receiving active versus sham rTMS led to significantly higher high frequency heart rate variability during regulation, lower regulation duration during the intervention, and higher likelihood to use CR during the week following the intervention. There were no differences between conditions when administering neurostimulation alone without the CR skill and compared to sham. Participants in the sham versus active condition experienced less distress the week after the intervention. There were no differences between conditions at the one-month follow up. CONCLUSION: This study demonstrated that combining active rTMS with emotion regulation training for one session significantly enhances emotion regulation and augments the impact of training for as long as a week. These findings are a promising step towards a combined intervention for transdiagnostic emotion dysregulation.

Duke Scholars

Published In

J Affect Disord

DOI

EISSN

1573-2517

Publication Date

March 15, 2022

Volume

301

Start / End Page

378 / 389

Location

Netherlands

Related Subject Headings

  • Treatment Outcome
  • Transcranial Magnetic Stimulation
  • Psychiatry
  • Prefrontal Cortex
  • Magnetic Resonance Imaging
  • Humans
  • Double-Blind Method
  • Cognitive Restructuring
  • Adult
  • 52 Psychology
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Neacsiu, A. D., Beynel, L., Graner, J. L., Szabo, S. T., Appelbaum, L. G., Smoski, M. J., & LaBar, K. S. (2022). Enhancing cognitive restructuring with concurrent fMRI-guided neurostimulation for emotional dysregulation-A randomized controlled trial. J Affect Disord, 301, 378–389. https://doi.org/10.1016/j.jad.2022.01.053
Neacsiu, Andrada D., Lysianne Beynel, John L. Graner, Steven T. Szabo, Lawrence G. Appelbaum, Moria J. Smoski, and Kevin S. LaBar. “Enhancing cognitive restructuring with concurrent fMRI-guided neurostimulation for emotional dysregulation-A randomized controlled trial.J Affect Disord 301 (March 15, 2022): 378–89. https://doi.org/10.1016/j.jad.2022.01.053.
Neacsiu AD, Beynel L, Graner JL, Szabo ST, Appelbaum LG, Smoski MJ, et al. Enhancing cognitive restructuring with concurrent fMRI-guided neurostimulation for emotional dysregulation-A randomized controlled trial. J Affect Disord. 2022 Mar 15;301:378–89.
Neacsiu, Andrada D., et al. “Enhancing cognitive restructuring with concurrent fMRI-guided neurostimulation for emotional dysregulation-A randomized controlled trial.J Affect Disord, vol. 301, Mar. 2022, pp. 378–89. Pubmed, doi:10.1016/j.jad.2022.01.053.
Neacsiu AD, Beynel L, Graner JL, Szabo ST, Appelbaum LG, Smoski MJ, LaBar KS. Enhancing cognitive restructuring with concurrent fMRI-guided neurostimulation for emotional dysregulation-A randomized controlled trial. J Affect Disord. 2022 Mar 15;301:378–389.
Journal cover image

Published In

J Affect Disord

DOI

EISSN

1573-2517

Publication Date

March 15, 2022

Volume

301

Start / End Page

378 / 389

Location

Netherlands

Related Subject Headings

  • Treatment Outcome
  • Transcranial Magnetic Stimulation
  • Psychiatry
  • Prefrontal Cortex
  • Magnetic Resonance Imaging
  • Humans
  • Double-Blind Method
  • Cognitive Restructuring
  • Adult
  • 52 Psychology