Pathway to response: Associations between individual electrical fields and psychophysiological habituation to predict clinical outcomes to transcranial direct current stimulation combined with virtual reality for PTSD

van ’t Wout-Frank et al, 2025. Brain Stimulation.

• tDCS is a subthreshold neuromodulation technique that is well-suited for combination with other therapeutic modalities to leverage synergistic effects.
• In a double-blind randomized clinical trial, we demonstrated that six sessions of 24-min of 2mA tDCS plus virtual reality exposure (tDCS + VR) augmented psychophysiological habituation (measured via skin conductance) and significantly improved PTSD symptoms compared to sham + VR, with outcomes favoring active stimulation at one year.
• Our tDCS target was the ventromedial prefrontal cortex (VMPFC), which is involved in threat processing and extinction, and PTSD is associated with both VMPFC hypoactivation and extinction deficits.
• We and others previously demonstrated that VMPFC-targeted tDCS can modulate extinction.

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