BACKGROUND: Studies have shown that impairments in the ventromedial prefrontal cortex play a crucial role in
violent behavior in forensic patients who also abuse cocaine and alcohol. Moreover, interventions that aimed to
reduce violence risk in those patients are found not to be optimal. A promising intervention might be to modulate the
ventromedial prefrontal cortex by high-definition (HD) transcranial direct current stimulation (tDCS). The current study
aimed to examine HD-tDCS as an intervention to increase empathic abilities and reduce violent behavior in forensic
substance dependent offenders. In addition, using electroencephalography, we examined the effects on the P3 and
the late positive potential of the event-related potentials in reaction to situations that depict victims of aggression.
METHODS: Fifty male forensic patients with a substance dependence were tested in a double-blind, placebocontrolled randomized study. The patients received HD-tDCS 2 times a day for 20 minutes for 5 consecutive days.Before and after the intervention, the patients completed self-reports and performed the Point Subtraction
Aggression Paradigm, and electroencephalography was recorded while patients performed an empathy task.
RESULTS: Results showed a decrease in aggressive responses on the Point Subtraction Aggression Paradigm and in
self-reported reactive aggression in the active tDCS group. Additionally, we found a general increase in late positive
potential amplitude after active tDCS. No effects on trait empathy and the P3 were found.
CONCLUSIONS: Current findings are the first to find positive effects of HD-tDCS in reducing aggression and
modulating electrophysiological responses in forensic patients, showing the potential of using tDCS as an
intervention to reduce aggression in forensic mental health care.
- Sept. 10, 2022, 9:44 p.m. - Transcranial Direct Current Stimulation Targeting the Ventromedial Prefrontal Cortex Reduces Reactive Aggression and Modulates Electrophysiological Responses in a Forensic Population
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