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. 2021 May 19:2:652162.
doi: 10.3389/fnrgo.2021.652162. eCollection 2021.

Transcranial Direct Current Stimulation (tDCS) Augments the Effects of Gamified, Mobile Attention Bias Modification

Sarah Myruski  1 , Hyein Cho  2   3 , Marom Bikson  4 , Tracy A Dennis-Tiwary  2   3
Affiliations

Transcranial Direct Current Stimulation (tDCS) Augments the Effects of Gamified, Mobile Attention Bias Modification

Sarah Myruski et al. Front Neuroergon. .

Abstract

Anxiety-related attention bias (AB) is the preferential processing of threat observed in clinical and sub-clinical anxiety. Attention bias modification training (ABMT) is a computerized cognitive training technique designed to systematically direct attention away from threat and ameliorate AB, but mixed and null findings have highlighted gaps in our understanding of mechanisms underlying ABMT and how to design the most effective delivery systems. One neuromodulation technique, transcranial direct current stimulation (tDCS) across the pre-frontal cortex (PFC) may augment the effects of ABMT by strengthening top-down cognitive control processes, but the evidence base is limited and has not been generalized to current approaches in digital therapeutics, such as mobile applications. The present study was a single-blind randomized sham-controlled design. We tested whether tDCS across the PFC, vs. sham stimulation, effectively augments the beneficial effects of a gamified ABMT mobile app. Thirty-eight adults (Mage = 23.92, SD = 4.75; 18 females) evidencing low-to-moderate anxiety symptoms were randomly assigned to active or sham tDCS for 30-min while receiving ABMT via a mobile app. Participants reported on potential moderators of ABMT, including life stress and trait anxiety. ECG was recorded during a subsequent stressor to generate respiratory sinus arrhythmia (RSA) suppression as a metric of stress resilience. ABMT delivered via the app combined with tDCS (compared to sham) reduced AB and boosted stress resilience measured via RSA suppression, particularly for those reporting low life stress. Our results integrating tDCS with ABMT provide insight into the mechanisms of AB modulation and support ongoing evaluations of enhanced ABMT reliability and effectiveness via tDCS.

Keywords: attention bias modification training; mobile application; respiratory sinus arrhythmia; stress; transcranial direct current stimulation.

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Conflict of interest statement

TD-T has equity in Wise Therapeutics Inc, which owns Personal Zen, and is on the advisory board of Lil Space Inc. TD-T is an inventor, with IP under patent review, on a digital therapeutics system and cognitive training method related to Personal Zen. The City University of New York (CUNY) has IP on neurostimulation system and methods with author MB as inventors. MB has equity in Soterix Medical Inc and is a consultant for GSK, Halo, and X. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flowchart demonstrating participant selection process for the study. tDCS is for transcranial Direct Current Stimulation.
Figure 2
Figure 2
AB following ABMT, as measured via difficulty disengaging from threat, was significantly lower in the active vs. sham Group. Error bars represent ±1 SE.
Figure 3
Figure 3
Active tDCS was associated with greater RSA suppression, but only for those with low levels of recent life changes.
See this image and copyright information in PMC

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