Intermittent theta burst stimulation to the left prefrontal cortex enhances extinction learning but not extinction recall

Cybinski, Lisa M. and Huesch, Sophia and Ziegler, Georg C. and Muehlberger, Andreas and Herrmann, Martin J. (2025) Intermittent theta burst stimulation to the left prefrontal cortex enhances extinction learning but not extinction recall. BEHAVIOURAL BRAIN RESEARCH, 479: 115357. ISSN 0166-4328, 1872-7549

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Abstract

Background: Non-invasive brain stimulation targeting the left ventromedial prefrontal cortex (vmPFC) has shown potential in enhancing fear extinction. However, optimal stimulation parameters for clinical application remain unclear. Methods: This study investigated the effects of intermittent theta burst stimulation (iTBS) on fear extinction using a three-day paradigm. Fifty healthy participants underwent fear acquisition (day 1), extinction learning (day 2), and both a spontaneous recovery and reinstatement test (day 3). Active or sham iTBS was applied before extinction learning to the left posterior PFC (MNI: -56, 2, 40), previously shown to be functionally connected to the vmPFC. Fear responses were measured using skin conductance responses (SCR) during CS+ and CS- presentations, along with arousal, valence, and contingency awareness ratings. Results: A significant time x group interaction was found for iTBS administered before extinction learning, with the active group showing reduced SCR during extinction learning compared to sham. However, no TMS effects were observed during the spontaneous recovery or reinstatement tests. Conclusion: These findings suggest limited therapeutic potential for iTBS targeting the left posterior PFC in enhancing extinction memory consolidation. Further research is needed to determine optimal stimulation parameters for clinical application.

Item Type: Article
Uncontrolled Keywords: TRANSCRANIAL MAGNETIC STIMULATION; FEAR EXTINCTION; ANXIETY DISORDERS; BRAIN-STIMULATION; EXPOSURE THERAPY; METAANALYSIS; NEUROSCIENCE; VALIDATION; ACTIVATION; RELAPSE; Theta burst stimulation; Transcranial magnetic stimulation; Left prefrontal cortex; Neuronavigation; Fear extinction
Subjects: 100 Philosophy & psychology > 150 Psychology
Divisions: Human Sciences > Institut für Psychologie > Lehrstuhl für Klinische Psychologie und Psychotherapie - Lehrstuhl für Psychologie VIII - Prof. Dr. Andreas Mühlberger
Depositing User: Dr. Gernot Deinzer
Date Deposited: 24 Mar 2026 08:00
Last Modified: 24 Mar 2026 08:00
URI: https://pred.uni-regensburg.de/id/eprint/64760

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