TY - JOUR
T1 - The Effects of Non-invasive Brain Stimulation on Impulsivity in People with Mental Disorders
T2 - a Systematic Review and Explanatory Meta-Analysis
AU - Yang, Cheng Chang
AU - Mauer, Laura
AU - Völlm, Birgit
AU - Khalifa, Najat
N1 - Publisher Copyright:
© 2020, Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2020/12
Y1 - 2020/12
N2 - Impulsivity is a multi-faceted construct that underpins various mental health disorders. Impulsive behavior exacts a substantial health and economic burden, hence the importance of developing specific interventions to target impulsivity. Two forms of non-invasive brain stimulation, namely transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS), have been used to modulate impulsivity. To date, no reviews have systematically examined their effects on modulating impulsivity in people with mental health disorders. We conducted a systematic review and meta-analysis of the literature from AMED, Embase, Medline and PsycINFO databases on the use of rTMS and tDCS to modulate impulsivity in people with mental health disorders. Results from 11 tDCS and 18 rTMS studies indicate that tDCS has a significant, albeit small, effect on modulating impulsivity (g = 0.29; 95% CI, 0.09 to 0.48; p =.004) whereas rTMS has no significant effect on impulsivity (g = −0.08; 95% Cl, −0.35 to 0.19; p =.550). Subgroup analyses identified the key parameters required to enhance the effects of tDCS and rTMS on impulsivity. Gender and stimulation intensity acted as significant moderators for effects of rTMS on impulsivity. There is insufficient evidence to support the use of tDCS or rTMS in clinical practice to reduce impulsivity in people with mental health disorders. The use of standardized non-invasive brain stimulation protocols and outcome measures in patients with the same diagnosis is advised to minimize methodological heterogeneity.
AB - Impulsivity is a multi-faceted construct that underpins various mental health disorders. Impulsive behavior exacts a substantial health and economic burden, hence the importance of developing specific interventions to target impulsivity. Two forms of non-invasive brain stimulation, namely transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS), have been used to modulate impulsivity. To date, no reviews have systematically examined their effects on modulating impulsivity in people with mental health disorders. We conducted a systematic review and meta-analysis of the literature from AMED, Embase, Medline and PsycINFO databases on the use of rTMS and tDCS to modulate impulsivity in people with mental health disorders. Results from 11 tDCS and 18 rTMS studies indicate that tDCS has a significant, albeit small, effect on modulating impulsivity (g = 0.29; 95% CI, 0.09 to 0.48; p =.004) whereas rTMS has no significant effect on impulsivity (g = −0.08; 95% Cl, −0.35 to 0.19; p =.550). Subgroup analyses identified the key parameters required to enhance the effects of tDCS and rTMS on impulsivity. Gender and stimulation intensity acted as significant moderators for effects of rTMS on impulsivity. There is insufficient evidence to support the use of tDCS or rTMS in clinical practice to reduce impulsivity in people with mental health disorders. The use of standardized non-invasive brain stimulation protocols and outcome measures in patients with the same diagnosis is advised to minimize methodological heterogeneity.
KW - Brain stimulation
KW - Delay discounting
KW - Impulsivity
KW - Response inhibition
KW - Theta burst stimulation
UR - http://www.scopus.com/inward/record.url?scp=85091895426&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85091895426&partnerID=8YFLogxK
U2 - 10.1007/s11065-020-09456-2
DO - 10.1007/s11065-020-09456-2
M3 - Review article
C2 - 33009976
AN - SCOPUS:85091895426
SN - 1040-7308
VL - 30
SP - 499
EP - 520
JO - Neuropsychology Review
JF - Neuropsychology Review
IS - 4
ER -