Generalized anxiety disorder (GAD) is a typical multisystem disease characterized by decreased activity in the left dorsolateral prefrontal cortex (DLPFC). Transcranial near-infrared stimulation (tNIRS) was used to stimulate the left DLPFC to relieve anxiety, and transcranial magnetic stimulation with electroencephalography (TMS-EEG) was used to assess changes in brain connectivity associated with the anti-anxiolytic effect.
A double-blind, randomized controlled trial was conducted to assess the efficacy of tNIRS on the left DLPFC in patients with GAD. 36 patients with GAD were randomized to receive active tNIRS or sham stimulation for two weeks. Clinical effectiveness was assessed before, after, and at the 2-, 4-, and 8-week follow-ups. TMS-EEG was performed for twenty minutes before and immediately after the tNIRS treatment, and healthy controls were collected only once.
The active stimulation group’s posttreatment Hamilton Anxiety Scale (HAMA) scores decreased more than the sham stimulation group’s, a statistically significant difference (p=0.021). The HAMA scores of both the active and the sham stimulation groups at posttreatment and at the 2-, 4-, and 8-week follow-up visits were lower than the scores before the treatment. However, the active stimulation group improved significantly greater than the sham group. TMS-EEG targeting the left DLPFC of patients after active treatment induced information outflow from the left DLPFC and left posterior temporal region.
Stimulation of the left DLPFC by (tNIRS) in patients with GAD relieved anxiety, which promoted the recovery of brain network connectivity.
Transcranial near-infrared stimulation, generalized anxiety disorder, dorsolateral prefrontal cortex, Hamilton Anxiety Scale, TMS-EEG