背景:研究表明,腹内侧前额叶皮质的损伤在同时滥用可卡因和酒精的法医患者的暴力行为中起着至关重要的作用。此外,旨在降低这些患者暴力风险的干预措施被发现不是最佳的.一种有希望的干预措施可能是通过高清(HD)经颅直流电刺激(tDCS)调节腹内侧前额叶皮质。当前的研究旨在检查HD-tDCS作为一种干预措施,以提高法医物质依赖罪犯的移情能力并减少暴力行为。此外,使用脑电图,我们研究了在描述侵略受害者的情况下对P3和事件相关电位的后期正电位的影响.
方法:对50名具有物质依赖性的男性法医患者进行了双盲测试,安慰剂对照随机研究。患者接受HD-tDCS,每天2次,持续20分钟,连续5天。干预前后,患者完成了自我报告并执行了点减影攻击范式,在患者执行移情任务时记录脑电图。
结果:结果显示,在主动tDCS组中,点减影攻击范式上的攻击性反应和自我报告的反应性攻击性降低。此外,我们发现在主动tDCS后,晚期正电位幅度普遍增加。没有发现对特质移情和P3的影响。
结论:目前的发现是第一个发现HD-tDCS在减少法医患者的攻击性和调节电生理反应方面的积极作用,显示了使用tDCS作为干预措施以减少法医精神保健中的攻击性的潜力。
BACKGROUND: Studies have shown that impairments in the ventromedial prefrontal cortex play a crucial role in violent behavior in forensic patients who also abuse cocaine and alcohol. Moreover, interventions that aimed to reduce violence risk in those patients are found not to be optimal. A promising intervention might be to modulate the ventromedial prefrontal cortex by high-definition (HD) transcranial direct current stimulation (tDCS). The current study aimed to examine HD-tDCS as an intervention to increase empathic abilities and reduce violent behavior in forensic substance dependent offenders. In addition, using electroencephalography, we examined the effects on the P3 and the late positive potential of the event-related potentials in reaction to situations that depict victims of aggression.
METHODS: Fifty male forensic patients with a substance dependence were tested in a double-blind, placebo-controlled randomized study. The patients received HD-tDCS 2 times a day for 20 minutes for 5 consecutive days. Before and after the intervention, the patients completed self-reports and performed the Point Subtraction Aggression Paradigm, and electroencephalography was recorded while patients performed an empathy task.
RESULTS: Results showed a decrease in aggressive responses on the Point Subtraction Aggression Paradigm and in self-reported reactive aggression in the active tDCS group. Additionally, we found a general increase in late positive potential amplitude after active tDCS. No effects on trait empathy and the P3 were found.
CONCLUSIONS: Current findings are the first to find positive effects of HD-tDCS in reducing aggression and modulating electrophysiological responses in forensic patients, showing the potential of using tDCS as an intervention to reduce aggression in forensic mental health care.