Review article| Volume 62, P7-13, April 2019

The effects of trans-cranial direct current stimulation intervention on fear: A systematic review of literature

Published:January 16, 2019DOI:


      • Cathodal tDCS may reduce fear and disrupt the fear memory more than anodal tDCS.
      • Phase of fear memory is important factor in determining polarity of tDCS electrodes.
      • The brain region is important factor in determining polarity of tDCS electrodes.
      • The assessed fear parameters are important to show the effect of the tDCS intervention.


      Intensifying fear and fear of pain may lead to some diseases such as panic disorder, phobias, post-traumatic stress disorder (PTSD), anxiety disorders, depression, etc. A number of studies indicated positive effect of transcranial direct current stimulation (tDCS) on controlling fear and some studies did not observe any effect or even negative effect on decreasing fear. Due to lack of consensus in the findings of research, we aimed to systematically review studies, which investigated the effect of tDCS on fear. A literature search was conducted using the databases of PubMed, Science Direct, OVID, CINAHL, PEDro, Cochrane, Scopus and MEDLINE. Fear, fear memory, fear of pain, anxiety, post-traumatic stress disorder, electrical brain stimulation were applied as keywords. The valid assessment scale was used to evaluate the methodological quality of the included studies. The results of this systematic review revealed that the cathodal tDCS (c-tDCS) on the left dorsolateral prefrontal cortex (DLPFC) as compared to anodal tDCS (a-tDCS) could significantly reduce fear and modulate the fear memory. In addition, the findings of this study showed that the c-tDCS has positive effect on behavioural parameters of fear, while it cannot change biochemical parameters of fear during limited sessions of intervention. Application of c-tDCS on the left DLPFC could significantly reduce fear and modulate the fear memory.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Clinical Neuroscience
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Mungee A.
        • Kazzer P.
        • Feeser M.
        • Nitsche M.A.
        • Schiller D.
        • Bajbouj M.
        direct current stimulation of the prefrontal cortex: a means to modulate fear memories.
        NeuroReport. 2014; 25: 480-484
        • Manteghi F.
        • Nasehi M.
        • Zarrindast M.R.
        Precondition of right frontal region with anodal tDCS can restore the fear memory impairment induced by ACPA in male mice.
        EXCLI J. 2017;
        • Layton B.
        • Krikorian R.
        Memory mechanisms in posttraumatic stress disorder.
        J Neuropsychiatry Clin Neurosci. 2002; 14: 254-261
        • Nader K.
        • Schafe G.E.
        • Le Doux J.E.
        Fear memories require protein synthesis in the amygdala for reconsolidation after retrieval.
        Nature. 2000; 406: 722-726
        • McKenzie S.
        • Eichenbaum H.
        Consolidation and reconsolidation: two lives of memories?.
        Neuron. 2011; 71: 224-233
        • Berardelli A.
        • Inghilleri M.
        • Rothwell J.C.
        • Romeo S.
        • Curra A.
        • Gilio F.
        Facilitation of muscle evoked responses after repetitive cortical stimulation in man.
        Exp Brain Res. 1998; 122: 79-84
        • Pascual-Leone A.
        • Tormos J.M.
        • Keenan J.
        • Tarazona F.
        • Canete C.
        • Catala M.D.
        Study and modulation of human cortical excitability with transcranial magnetic stimulation.
        J Clin Neurophysiol. 1998; 15: 333-343
        • Jeffery D.T.
        • Norton J.A.
        • Roy F.D.
        • Gorassini M.A.
        Effects of transcranial direct current stimulation on the excitability of the leg motor cortex.
        Exp Brain Res. 2007; 182: 281-287
        • Kuo M.F.
        • Paulus W.
        • Nitsche M.A.
        Therapeutic effects of non-invasive brain stimulation with direct currents (tDCS) in neuropsychiatric diseases.
        Neuroimage. 2014; 85: 948-960
        • Brunoni A.R.
        • Valiengo L.
        • Baccaro A.
        • Zanao T.A.
        • de Oliveira J.F.
        • Goulart A.
        The sertraline vs. electrical current therapy for treating depression clinical study: results from a factorial, randomized, controlled trial.
        JAMA Psychiatry. 2013; 70: 383-391
        • Herrmann M.J.
        • Beier J.S.
        • Simons B.
        • Polak T.
        Transcranial direct current stimulation (tDCS) of the right inferior frontal gyrus attenuates skin conductance responses to unpredictable threat conditions.
        Front Hum Neurosci. 2016; 10: 352
        • Nasehi M.
        • Khani-Abyaneh M.
        • Ebrahimi-Ghiri M.
        • Zarrindast M.R.
        The effect of left frontal transcranial direct-current stimulation on propranolol-induced fear memory acquisition and consolidation deficits.
        Behav Brain Res. 2017; 331: 76-83
        • Van't Wout M.
        • Longo S.M.
        • Reddy M.K.
        • Philip N.S.
        • Bowker M.T.
        • Greenberg B.D.
        Transcranial direct current stimulation may modulate extinction memory in posttraumatic stress disorder.
        Brain Behav. 2017; 7e00681
        • Mungee A.
        • Burger M.
        • Bajbouj M.
        No effect of cathodal transcranial direct current stimulation on fear memory in healthy human subjects.
        Brain Sci. 2016; 6: 55
        • Moseley A.M.
        • Herbert R.D.
        • Sherrington C.
        • Maher C.G.
        Evidence for physiotherapy practice: a survey of the physiotherapy evidence database (PEDro).
        Austr J Physiother. 2002; 48: 43-49
        • Asthana M.
        • Nueckel K.
        • Muhlberger A.
        • Neueder D.
        • Polak T.
        • Domschke K.
        Effects of transcranial direct current stimulation on consolidation of fear memory.
        Front Psychiatry. 2013; 4: 107
        • Weigand A.
        • Richtermeier A.
        • Feeser M.
        • Guo J.S.
        • Briesemeister B.B.
        • Grimm S.
        State-dependent effects of prefrontal repetitive transcranial magnetic stimulation on emotional working memory.
        Brain Stimul. 2013; 6: 905-912
        • Antal A.
        • Fischer T.
        • Saiote C.
        • Miller R.
        • Chaieb L.
        • Wang D.J.
        Transcranial electrical stimulation modifies the neuronal response to psychosocial stress exposure.
        Hum Brain Mapp. 2014; 35: 3750-3759
        • Bogdanov M.
        • Schwabe L.
        Transcranial stimulation of the dorsolateral prefrontal cortex prevents stress-induced working memory deficits.
        J Neurosci. 2016; 36: 1429-1437
        • Hawco C.
        • Berlim M.T.
        • Lepage M.
        The dorsolateral prefrontal cortex plays a role in self-initiated elaborative cognitive processing during episodic memory encoding: rTMS evidence.
        PLoS One. 2013; 8e73789
        • Cunillera T.
        • Fuentemilla L.
        • Brignani D.
        • Cucurell D.
        • Miniussi C.
        A simultaneous modulation of reactive and proactive inhibition processes by anodal tDCS on the right inferior frontal cortex.
        PLoS One. 2014; 9e113537