Journal of affective disorders · 2026
Precisely targeted brain stimulation for social anxiety: Proactive cognitive control and attentional biases as pathways to symptom reduction.
СтатьяРандомизированное исследованиеНазвание и аннотация: Перевод в очереди
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Lang Xuemei, Kang Tiejun, Deng Guangyue, Du Chenguang, Wu Heng, Ding Xiaobin
Аннотация
BACKGROUND: In individuals with high social anxiety (HSAs), threat-related attentional bias is robust. However, traditional attentional bias modification shows small and unstable effects, suggesting that this bias may be more of a symptom than a cause. Additionally, existing transcranial direct current stimulation (tDCS) trials have primarily focused on symptoms or single behavioral outcomes without clarifying the cognitive processes being modulated.
OBJECTIVE: To examine whether high-definition tDCS (HD-tDCS) targeting the left dorsolateral prefrontal cortex (DLPFC) enhances proactive cognitive control, thereby improving attentional bias toward threat cues and alleviating social anxiety symptoms.
METHODS: In this randomized, sham-controlled, single-blind trial, 59 HSAs received either active or sham HD-tDCS (2 mA, 20 min/day, for 5 consecutive days). Questionnaires, behavioral tasks (AX-continuous performance task, dot-probe) with concurrent EEG recording, and resting-state EEG were collected before and after the intervention. Follow-up questionnaires were completed 1 month post-intervention.
RESULTS: The active group showed a significant reduction in social anxiety symptoms, which was maintained at the one-month follow-up. Active stimulation significantly enhanced proactive control (increased d' Context and cue-locked P3b amplitude), while decreasing the theta/beta ratio at the F3 electrode. Furthermore, active stimulation significantly facilitated disengagement from threat (smaller disengagement index and increased target-locked P3 amplitude), along with enhanced threat avoidance. Mediation analysis further showed that improvements in proactive control partially explained the facilitation of disengagement from threat.
CONCLUSION: Our findings provide initial multimodal support for a mechanistic pathway linking HD-tDCS over the left DLPFC to symptom reduction through enhanced proactive control and improved disengagement from threat.
OBJECTIVE: To examine whether high-definition tDCS (HD-tDCS) targeting the left dorsolateral prefrontal cortex (DLPFC) enhances proactive cognitive control, thereby improving attentional bias toward threat cues and alleviating social anxiety symptoms.
METHODS: In this randomized, sham-controlled, single-blind trial, 59 HSAs received either active or sham HD-tDCS (2 mA, 20 min/day, for 5 consecutive days). Questionnaires, behavioral tasks (AX-continuous performance task, dot-probe) with concurrent EEG recording, and resting-state EEG were collected before and after the intervention. Follow-up questionnaires were completed 1 month post-intervention.
RESULTS: The active group showed a significant reduction in social anxiety symptoms, which was maintained at the one-month follow-up. Active stimulation significantly enhanced proactive control (increased d' Context and cue-locked P3b amplitude), while decreasing the theta/beta ratio at the F3 electrode. Furthermore, active stimulation significantly facilitated disengagement from threat (smaller disengagement index and increased target-locked P3 amplitude), along with enhanced threat avoidance. Mediation analysis further showed that improvements in proactive control partially explained the facilitation of disengagement from threat.
CONCLUSION: Our findings provide initial multimodal support for a mechanistic pathway linking HD-tDCS over the left DLPFC to symptom reduction through enhanced proactive control and improved disengagement from threat.