Transcranial Alternating Current Stimulation to Reduce Emotional Dysregulation in Veterans with Posttraumatic Stress Disorder

Need/Problem: Approximately one in five military veterans suffer from posttraumatic stress disorder (PTSD). Research documents PTSD is associated with poor post-deployment adjustment in military veterans, including increased risk of suicide, homelessness, violence, criminal arrest, and unemployment. As thousands of troops return home, there is an urgent need to develop effective treatment approaches that overcome barriers, are more feasible and less time-consuming to implement, and that veterans will prefer and actually use.

Grant Summary: Transcranial Alternating Current Stimulation (tACS) provides a safe, non-invasive, easy-to-administer, and cutting-edge technology and procedure that applies weak electric currents to the scalp to modulate rhythmic brain activity patterns. The objective of this project is to establish the feasibility of the tACS treatment and collect pilot efficacy and electroencephalogram (EEG) biomarkers data for optimizing the design of subsequent large-scale studies. To achieve this, we will conduct a randomized clinical trial of tACS with veterans with PTSD. N=30 veterans with PTSD will be randomized to either tACS involving bifrontal 10Hz alpha (α) stimulation (2mA) or a sham stimulation condition, both for a total of five 40-minute sessions.

Goals and Projected Outcomes: This will be the first study of tACS for the treatment of PTSD. The specific targeting of pathological brain activity patterns is unique. This FOH-funded project will build a solid infrastructure to study tACS with veterans. If tACS is feasible and effective for veterans with PTSD, findings will provide persuasive preliminary results for DoD and NIH proposals to fund a large-scale clinical trial.

Flavio Frolich

Eric Elbogen

Grant Details: The objective of this project is to establish the feasibility of the tACS treatment and collect pilot efficacy and electroencephalogram (EEG) biomarkers data for optimizing the design of subsequent large-scale studies. To achieve this, we will conduct a randomized clinical trial of tACS with veterans with PTSD. N=30 veterans with PTSD will be randomized to either tACS involving bifrontal 10Hz alpha (α) stimulation (2mA) or a sham stimulation condition, both for a total of five 40-minute sessions. Please note that tACS involves a very weak stimulation amplitude and carries an Institutional Review Board (IRB) designation of “nonsignificant risk.”

Prior to randomization and one month afterward, veterans will be interviewed and administered cognitive and behavioral assessments as well as EEGs. We hypothesize that veterans with PTSD in the tACS condition will show reduced emotional dysregulation, anger, suicidality, and aggressive behavior than participants in the control group.

Further, empirical research indicates that alpha power is increased and alpha (a) frequency slowed in meditation and mindfulness. Conversely, resting state EEG, particularly in the alpha (a) frequency band (8-12Hz), has been related to both emotional calmness in which alpha (a) power is suppressed and peak alpha (α) frequency is reduced. For these reasons, we hypothesize that veterans in the intervention groups will show lower (8–12 Hz) alpha (α) amplitude and higher peak (α) frequency compared to veterans in the control group.

This is the first study of tACS for the treatment of PTSD and the specific targeting of pathological brain activity patterns is unique. As a result, whether veterans with PTSD are amenable to tACS is not yet known. However, Dr. Elbogen has obtained DoD and NIH funding implementing technological interventions to reduce emotional dysregulation in veterans with PTSD and consistently has met or exceeded target enrollment. Dr. Frolich has conducted many studies of tACS to reduce psychiatric symptoms and has likewise not encountered difficulties with recruitment.

2019-04-30T18:09:07-04:00