Treating Self Injurious Behavior: A Novel Brain Stimulation Approach
Condition: Self-Injurious Behavior; Self Harm; Self-injury; Self-inflicted Injury; Self Injurious Behavior Without Suicidal Intent; Non-Suicidal Self Injury; Non Suicidal Self Inflicted Injury; Cutting; Depression; Bipolar Disorder; Borderline Personality Disorder
MeSH terms: Wounds and Injuries; Self Mutilation; Bipolar Disorder; Personality Disorders; Borderline Personality Disorder; Self-Injurious Behavior
Study type: Interventional

Summary: 
      The purpose of this study is to explore the tolerability and effectiveness of transcranial
      direct current stimulation (tDCS) as a potential treatment for non-suicidal self-injury
      (NSSI). NSSI is the deliberate attempt to harm oneself, most often through cutting or
      burning, without suicidal intent. NSSI is a maladaptive emotion-regulation strategy often
      triggered by negative emotions, especially those involving feelings of rejection. tDCS is a
      low-cost, portable, well-tolerated, non-invasive form of brain stimulation that delivers a
      low current to a specific area of the brain via electrodes. Several studies have demonstrated
      its effectiveness in treating an array of conditions, depending on electrode placement,
      including depression and chronic pain. tDCS may also facilitate adaptive emotion regulation;
      researchers have also successfully used tDCS to reduce negative emotions and aggressive
      responses to social rejection. The investigators therefore seek to explore tDCS as a
      potential treatment for NSSI. This pilot feasibility study seeks 1) to examine how at-home,
      self-administered tDCS is tolerated in a sample of individuals who engage in frequent NSSI;
      2) to gather pilot data regarding changes in emotional and neural responses during a social
      task after a series of tDCS sessions in this clinical population of individuals who engage in
      NSSI; 3) to gather pilot data on the effects of tDCS on NSSI behaviors and urges. The
      investigators seek to recruit a sample of 22 individuals who engage in frequent NSSI to
      complete all study procedures. Individuals will be randomized to receive active- or sham-tDCS
      for two twenty-minute applications on each of six alternating days over approximately two
      weeks. Participants will be trained on tDCS self-administration, which will be supervised
      during each session over a videoconferencing platform by a researcher. Functional MRI (fMRI)
      may be performed at baseline and again after the completion of 12 sessions of tDCS. Subjects'
      NSSI and urges to engage in NSSI will be recorded for four weeks in real-time, using an iPod-
      based system that reminds subjects to stop at certain times during the day to record their
      thoughts, feelings, and behaviors. This will allow measurement of NSSI urges and behaviors
      for one week before, two weeks during, and one week after the tDCS intervention. The
      long-term goal of this study is to identify a novel form of treatment for NSSI and to better
      understand NSSI pathophysiology.
    


Intervention name(s): Transcranial direct current stimulation
Intervention type(s): Device
Intervention description(s): tDCS is a low-cost, portable, well-tolerated, non-invasive form of brain stimulation that delivers a low current to a specific area of the brain via electrodes.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Transcranial direct current stimulation; Transcranial electric stimulation; non-invasive brain stimulation; tDCS