Journal of Research in Rehabilitation Sciences

The Effectiveness of Transcranial Direct Current Stimulation (tDCS) on the Anxiety and Severity of Stuttering in Adolescents Aged 15 to 18

Document Type : Original Articles

Authors

1 Department of Psychology, Science and Arts University, Yazd, Iran

2 Assistant Professor, Department of Psychology, Science and Arts University, Yazd, Iran

3 PhD Student, Department of Psychology, Science and Arts University, Yazd, Iran

10.22122/jrrs.v16i0.3605

Abstract

Introduction: Since the anxiety is one of the effective factors in stuttering, the present study was examined the effect of Transcranial direct current stimulation (tDCS) on anxiety and the severity of stuttering in stammering adolescents.Materials and Methods: The present study adopts pre-test and post-test quasi-experimental design with two experimental and one control groups. For this purpose, after applying input and output criteria, 30 stuttering adolescents were selected by convenience sampling method, and were divided into experimental and control groups, randomly. During 10 sessions, one of the experimental groups (EG1) includes 15 participants were experimented by 2 mA current of tDCS on two sides of the anterior temporal region for 20 minutes. The other one (EG2) contains 15 participants as a Sham group was experienced by tDCS with a similar process for 10 sessions. The difference is that the device was turned off after they felt an initial burning sensation. Finally, anxiety and severity of stuttering were evaluated before and after treatment. Findings: Based on the results, there was a significant difference between the experimental and sham groups in the anxiety of the subjects (P < 0.05, F = 645/725). In addition, there was a significant difference in the intensity of stuttering between the experimental and sham groups among participants (P < 0.05, F = 16.875).Conclusion: According to the results, compared to the Sham group, anxiety and the severity stuttering in stammering adolescents who were affected by tDCS, were reduced significantly. So, it seems that tDCS on both sides of the anterior temporal region can be effective in treating anxiety and severity of stuttering.  Though, other similar studies in this field are needed to prove the obtained results.

Keywords

  1. Blood GW, Blood IM. Long-term consequences of childhood bullying in adults who stutter: Social Anxiety, fear of negative evaluation, self-esteem, and satisfaction with life. J Fluency Disord 2016; 50: 72-84.
  2. Perez HR, Stoeckle JH. Stuttering: Clinical and research update. Can Fam Physician 2016; 62(6): 479-84.
  3. Yang Y, Jia F, Siok WT, Tan LH. The role of anxiety in stuttering: Evidence from functional connectivity. Neuroscience 2017; 346: 216-25.
  4. Chesters J, Watkins KE, Mottonen R. Investigating the feasibility of using transcranial direct current stimulation to enhance fluency in people who stutter. Brain Lang 2017; 164: 68-76.
  5. Stein DJ, Fernandes ML, Caumo W, Torres IL. Transcranial direct current stimulation in patients with anxiety: Current perspectives. Neuropsychiatr Dis Treat 2020; 16: 161-9.
  6. Nitsche MA, Paulus W. Excitability changes induced in the human motor cortex by weak transcranial direct current stimulation. J Physiol 2000; 527 Pt 3: 633-9.
  7. Ironside M, Harmer C, O'Shea J, Ebmeier K, Brunoni AR. An exploration of the mechanisms of action of transcranial direct current stimulation (tDCS) in mood and anxiety disorder research [PhD Thesis]. Oxford, UK: University of Oxford; 2016.
  8. Yada Y, Tomisato S, Hashimoto RI. Online cathodal transcranial direct current stimulation to the right homologue of Broca's area improves speech fluency in people who stutter. Psychiatry Clin Neurosci 2019; 73(2): 63-9.
  9. Pantazatos SP, Talati A, Schneier FR, Hirsch J. Reduced anterior temporal and hippocampal functional connectivity during face processing discriminates individuals with social anxiety disorder from healthy controls and panic disorder, and increases following treatment. Neuropsychopharmacology 2014; 39(2): 425-34.
  10. Yang C, Zhang Y, Lu M, Ren J, Li Z. White matter structural brain connectivity of young healthy individuals with high trait anxiety. Front Neurol 2019; 10: 1421.
  11. Montag C, Reuter M, Weber B, Markett S, Schoene-Bake JC. Individual differences in trait anxiety are associated with white matter tract integrity in the left temporal lobe in healthy males but not females. Neuroscience 2012; 217: 77-83.
  12. Vicario CM, Salehinejad MA, Felmingham K, Martino G, Nitsche MA. A systematic review on the therapeutic effectiveness of non-invasive brain stimulation for the treatment of anxiety disorders. Neurosci Biobehav Rev 2019; 96: 219-31.
  13. Chesters J, Mottonen R, Watkins KE. Transcranial direct current stimulation over left inferior frontal cortex improves speech fluency in adults who stutter. Brain 2018; 141(4): 1161-71.
  14. Shiozawa P, Leiva AP, Castro CD, da Silva ME, Cordeiro Q, Fregni F, et al. Transcranial direct current stimulation for generalized anxiety disorder: A case study. Biol Psychiatry 2014; 75(11): e17-e18.
  15. Movahed F, Alizadehgoradel J, Pouresmali A, Mowlaie M. Effectiveness of transcranial direct current stimulation on worry, anxiety, and depression in generalized anxiety disorder: A Randomized, single-blind pharmacotherapy and sham-controlled clinical trial. Iran J Psychiatry Behav Sci 2018; 12(2): e11071.
  16. Shiozawa P, da Silva ME, Cordeiro Q. Transcranial direct current stimulation (tDCS) for panic disorder: A case study. Depress Anxiety 20 2014; 3(3): 1000158.
  17. Heeren A, Billieux J, Philippot P, De Raedt R, Baeken C, de Timary P, et al. Impact of transcranial direct current stimulation on attentional bias for threat: A proof-of-concept study among individuals with social anxiety disorder. Soc Cogn Affect Neurosci 2017; 12(2): 251-60.
  18. Palm U, Kirsch V, Kubler H, Sarubin N, Keeser D, Padberg F, et al. Transcranial direct current stimulation (tDCS) for treatment of phobic postural vertigo: an open label pilot study. Eur Arch Psychiatry Clin Neurosci 2019; 269(2): 269-72.
  19. Delavar A. Theoretical and practical research in the humanities and social sciences. 9th ed. Tehran, Iran: Roshd Publications; 2011. [In Persian].
  20. Kekic M, Boysen E, Campbell IC, Schmidt U. A systematic review of the clinical efficacy of transcranial direct current stimulation (tDCS) in psychiatric disorders. J Psychiatr Res 2016; 74: 70-86.
  21. Sazgar M, Young MG. Overview of EEG, electrode placement, and montages. In: Sazgar M, Young MG, editors. Absolute epilepsy and EEG rotation review: Essentials for trainees. Cham, Switzerland: Springer International Publishing; 2019. p. 117-25.
  22. Beck AT, Steer RA. Beck Anxiety Inventory Manual. San Antonio, TX: Psychological Corporation. 1993.
  23. Kaviani H, Mousavi A S. Psychometric properties of the Persian version of Beck Anxiety Inventory (BAI). Tehran Univ Med J 2008; 66 (2): 136-40. [In Persian].
  24. Riley GD. A stuttering severity instrument for children and adults. J Speech Hear Disord 1972; 37(3): 314-22.
  25. Zolfaghari M, Shafiei B, Tahmasebi Garmatani N, Ashoorioon V. Reliability of the Persian version of the Stuttering Severity Instrument-Fourth Edition (SSI-4) for Preschool-Age Children. Middle Eastern Journal of Disability Studies 2014; 4(2): 20-5. [In Persian].
  26. Heij GJ, Penninx BWHJ, van Velzen LS, van Tol MJ, van der Wee NJA, Veltman DJ, et al. White matter architecture in major depression with anxious distress symptoms. Prog Neuropsychopharmacol Biol Psychiatry 2019; 94: 109664.
  27. Neef NE, Anwander A, Butfering C, Schmidt-Samoa C, Friederici AD, Paulus W, et al. Structural connectivity of right frontal hyperactive areas scales with stuttering severity. Brain 2018; 141(1): 191-204.
  28. Phan KL, Orlichenko A, Boyd E, Angstadt M, Coccaro EF, Liberzon I, et al. Preliminary evidence of white matter abnormality in the uncinate fasciculus in generalized social anxiety disorder. Biol Psychiatry 2009; 66(7): 691-4.
  29. Lavid N. Understanding stuttering. Jackson, MS: University Press of Mississippi; 2003.
  30. Ahmadizadeh MJ, Rezaei M, Fitzgerald PB. Transcranial direct current stimulation (tDCS) for post-traumatic stress disorder (PTSD): A randomized, double-blinded, controlled trial. Brain Res Bull 2019; 153: 273-8.
Journal of Research in Rehabilitation Sciences
Volume 16, Issue 1 - Serial Number 1
April 2020
Pages 224-231