Challenging control over emotions in borderline personality disorder - a tDCS study

Area of Science:

• Neuroscience
• Psychiatry
• Neuromodulation

Background:

• Borderline personality disorder (BPD) is characterized by deficient cognitive control (CC) over emotional distraction.
• Reduced activation in the left dorsolateral prefrontal cortex (dlPFC) is associated with these CC deficits in BPD.
• This study explores the potential of anodal transcranial direct current stimulation (tDCS) to improve CC in BPD.

Purpose of the Study:

• To investigate if anodal tDCS applied to the left dlPFC can ameliorate cognitive control deficits in patients with BPD.
• To determine if the severity of CC impairment influences the response to tDCS in BPD.

Main Methods:

• A double-blinded, randomized, sham-controlled crossover trial involving 20 BPD patients and 20 healthy controls (HCs).
• Single-session anodal tDCS (1 mA for 20 min) applied to the left dlPFC (F3) while participants performed a delayed response working memory task.
• The task included negative, neutral, and positive emotional pictures during the delay period to assess CC.

Main Results:

• Emotional pictures prolonged response times in both BPD patients and HCs compared to a control condition.
• Anodal tDCS to the left dlPFC did not significantly improve CC in the overall sample.
• However, participants with more impaired CC showed the greatest improvement with anodal tDCS, particularly within the subgroup exhibiting an interference effect.

Conclusions:

• Anodal tDCS applied to the left dlPFC can enhance deficient cognitive control.
• The effectiveness of tDCS is moderated by baseline cognitive control performance.
• tDCS may serve as a valuable adjunct to behavioral therapies for enhancing CC in individuals with significant impairments.