Abstract
High frequency repetitive Transcranial Magnetic Stimulation (rTMS) over the left dorsolateral prefrontal cortex (DLPFC) has been shown to reduce depressive symptoms and improve cognitive biases such as attentional bias. One promising technique that may complement rTMS treatment is attentional bias modification (ABM) training, given the similarity in modulating attentional bias and affecting neuronal activity. We tested whether the combination of rTMS treatment and ABM training in a single session would attenuate maladaptive attentional processing and improve mood in participants with subclinical depressive symptoms. To this end, 122 healthy participants were randomly assigned to one of four groups, receiving either a single rTMS treatment, a single ABM treatment, a combination of rTMS and ABM or a sham treatment. Of these 122 participants, 72 showed a heightened BDI-II score (between 9 and 25) and were included in our main analyses. In our subclinical (≥9 and ≤25 BDI-II) sample, a single combination treatment of rTMS and ABM training induced no significant changes in attentional bias, attentional control or mood, nor did rTMS alone affect attentional bias systematically. We discuss these null findings in light of the task specifics and relate them to the ongoing discussion on ABM training in depression.
Highlights
The lifetime prevalence of major depressive disorder (MDD) is the highest among all mental disorders[1]
The left dorsolateral prefontal cortex (DLPFC) is a common stimulation site for repetitive transcranial magnetic stimulation (rTMS) treatment, as functional neuroimaging studies have shown a decrease in regional cerebral blood flow in this region in depressed patients[15,16]
We aimed to replicate the beneficial effect of rTMS and attentional bias modification (ABM) treatment separately on these measurements, and, more important, investigate whether combining both treatments results in stronger effects
Summary
The lifetime prevalence of major depressive disorder (MDD) is the highest among all mental disorders[1]. The left dorsolateral prefontal cortex (DLPFC) is a common stimulation site for rTMS treatment, as functional neuroimaging studies have shown a decrease in regional cerebral blood flow in this region in depressed patients[15,16]. By increasing the frequency of the dot appearing behind the neutral/positive stimuli, participants’ attention can be selectively trained towards neutral/positive stimuli and away from negative valenced stimuli[33,34] This form of ABM training has shown some success in modifying attentional bias and in turn in reducing emotional vulnerability in response to stressful situations even after a single session (for review see ref.[35,36])
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