Braz J Psychiatry. 2025 Oct 31. doi: 10.47626/1516-4446-2025-4514. Online ahead of print.
ABSTRACT
BACKGROUND: tDCS effects over the prefrontal cortex on reactive aggressive behavior are unclear. We aimed to perform an updated systematic review and meta-analysis of randomized controlled trials (RCTs) comparing anodal tDCS versus sham stimulation on reactive aggressive behavior in healthy volunteers experimentally induced to aggressive behavior.
METHODS: We systematically searched PubMed, Cochrane, Embase, and PsychInfo databases for RCTs that compared tDCS to sham stimulation over the prefrontal cortex on reactive aggressive behavior. We computed standardized mean difference (SMD) with 95% confidence intervals (CIs) for all statistical models. Heterogeneity was assessed using I² statistics. Statistical analyses were performed using R softwere, version 4.5.1.
RESULTS: We included nine trials with 547 participants, of whom 272 (49,7%) underwent anodal tDCS. There was not significant difference between anodal tDCS and Sham stimulation in reactive aggressive (SMD -0,24; 95% Cl [-0.54; 0.05]; p = 0.09; I² = 52,4%). However, subgroup analysis showed significant effects of online tDCS (SMD -0.41; 95% Cl [-0,61; -0.20]; I² = 0%), and unilateral tDCS (SMD -0.44; 95% Cl [-63; -0.25]; I² = 0%), when compared to sham stimulation.
CONCLUSION: While the overall analysis did not show a significant effect of anodal on reactive aggressive behavior in healthy volunteers, the results suggest that online tDCS and unilateral tDCS may have a potential impact. Given the heterogeneity of the studies and outcome measures, further research is needed to confirm these findings and better understand the role of tDCS in modulating reactive aggressive behavior.
PMID:41172252 | DOI:10.47626/1516-4446-2025-4514
