Pilot Study of Brain Stimulation Combined with Writing Therapy for PTSD
Casey Straud, PsyD
Evaluate the safety, feasibility, and psychological and physiological treatment benefits of transcranial direct current stimulation (tDCS), a noninvasive brain stimulation technique, when delivered in combination with Written Exposure Therapy for posttraumatic stress disorder.
Symptoms of posttraumatic stress disorder (PTSD) include intrusive memories about the event, physiological hyperarousal such as always being on edge, sleep problems, and negative effect on a person’s mood and thoughts. All of this can have significant, long-term effects on health and functioning.
Evidence-based psychotherapies can help many patients, but there remains room for improvement, as too many patients do not significantly improve following treatment.
New approaches to treatment could help more people to recover from trauma.
The field of non-invasive brain stimulation is rapidly gaining attention as a potential treatment for PTSD based on its ability to restore healthy activity in regions of the brain associated with PTSD and its treatment.
Research is needed to determine the safety, feasibility, and benefits of non-invasive brain stimulation for those with PTSD. Toward that end, a STRONG STAR-affiliated research team led by Casey Straud, PsyD, a faculty member at The University of Texas Health Science Center at San Antonio, will conduct a randomized controlled pilot study of transcranial direct current stimulation (tDCS) vs. a placebo.
How the study and treatment will work
The study will involve 40 adults with PTSD receiving five weekly sessions of Written Exposure Therapy (WET), an evidence-based, behavioral psychotherapy for PTSD. By random assignment, half also will receive tDCS, while half will receive a placebo treatment that only appears to be administering tDCS. Study participants will include military veterans and non-veteran civilians in the San Antonio area who are seeking treatment for PTSD.
WET involves patients writing about their trauma and then discussing the written narrative with a therapist. In this study, patients will receive tDCS or placebo during the writing part of the therapy session, via electrodes secured to the head with elastic bands. During stimulation, a mild current flows between the electrodes passing through the brain to complete the circuit. The current is believed to enhance the resting potential of neurons that typically are overly active in brains of PTSD patients.
The study team also will monitor physical responses to stress via devices placed on the non-writing hand to measure heart rate and sweat production.
Pilot study expectations
The investigators believe that the study will show that tDCS is safe and compatible with WET, and that WET plus tDCS will result in greater reductions in PTSD symptoms than WET plus placebo. If successful, the pilot study could provide rationale for a larger study in the effort to add more treatment options for individuals with PTSD.