{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T11:37:40Z","timestamp":1787312260379,"version":"build-2736575974"},"reference-count":68,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,11,27]],"date-time":"2024-11-27T00:00:00Z","timestamp":1732665600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,11,27]],"date-time":"2024-11-27T00:00:00Z","timestamp":1732665600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum W\u00fcrzburg"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Anxiety disorders are the most prevalent mental health conditions. Besides psycho-pharmacotherapy, cognitive behavioral therapy with an exposure-based approach is considered the gold standard. However, not all patients benefit from this approach. Here, we aimed to translate laboratory findings on enhanced fear extinction with repetitive transcranial magnetic stimulation (TMS) to the clinic. In this double-blind, randomized, placebo-controlled clinical trial, 76 participants with acrophobia received an activating intermittent theta burst stimulation (iTBS) targeting the left posterior prefrontal cortex immediately before two virtual reality exposure therapy sessions. Phobic symptoms were assessed at baseline, post-intervention, and a 6-month follow-up. Results revealed a significant reduction in phobic symptoms from baseline to post-assessment and follow-up and confirmed the efficacy of virtual reality exposure therapy as a treatment for specific phobias. Interestingly, no additional effect was observed for active iTBS compared to sham iTBS. Our post-hoc analyses argue for an individualized TMS application. Further research is needed to determine optimal TMS parameters and validate these results in clinical trials, accounting for methodological and inter- and intra-individual variability, as well as alternative therapeutic processes.<\/jats:p>","DOI":"10.1038\/s41598-024-80832-1","type":"journal-article","created":{"date-parts":[[2024,11,27]],"date-time":"2024-11-27T03:46:22Z","timestamp":1732679182000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Intermittent theta burst stimulation over the left prefrontal cortex: no additional effect for virtual reality exposure therapy in acrophobia\u2014a randomized trial"],"prefix":"10.1038","volume":"14","author":[{"given":"L. M.","family":"Cybinski","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Bohmeier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Rolle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Gromer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Raij","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Gundelach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Erhardt-Lehmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"M\u00fchlberger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Deckert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Polak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Pauli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. J.","family":"Herrmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,11,27]]},"reference":[{"key":"80832_CR1","doi-asserted-by":"publisher","first-page":"e00497","DOI":"10.1002\/brb3.497","volume":"6","author":"O Remes","year":"2016","unstructured":"Remes, O., Brayne, C., van der Linde, R. & Lafortune, L. A systematic review of reviews on the prevalence of anxiety disorders in adult populations. Brain Behav. 6, e00497 (2016).","journal-title":"Brain Behav"},{"key":"80832_CR2","unstructured":"World Health Organization. International Classification of Diseases, Eleventh Revision (ICD-11). (Geneva, 2019)."},{"key":"80832_CR3","doi-asserted-by":"publisher","first-page":"655","DOI":"10.1016\/j.euroneuro.2011.07.018","volume":"21","author":"HU Wittchen","year":"2011","unstructured":"Wittchen, H. U. et al. The size and burden of mental disorders and other disorders of the brain in Europe 2010. Eur. Neuropsychopharmacol. 21, 655\u2013679 (2011).","journal-title":"Eur. Neuropsychopharmacol."},{"key":"80832_CR4","doi-asserted-by":"publisher","first-page":"194","DOI":"10.1016\/j.cpr.2009.11.001","volume":"30","author":"RW Gunter","year":"2010","unstructured":"Gunter, R. W. & Whittal, M. L. Dissemination of cognitive-behavioral treatments for anxiety disorders: Overcoming barriers and improving patient access. Clin. Psychol. Rev. 30, 194\u2013202 (2010).","journal-title":"Clin. Psychol. Rev."},{"key":"80832_CR5","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1002\/wps.20941","volume":"21","author":"F Leichsenring","year":"2022","unstructured":"Leichsenring, F., Steinert, C., Rabung, S. & Ioannidis, J. P. A. The efficacy of psychotherapies and pharmacotherapies for mental disorders in adults: An umbrella review and meta-analytic evaluation of recent meta-analyses. World Psychiatry 21, 133\u2013145. https:\/\/doi.org\/10.1002\/wps.20941 (2022).","journal-title":"World Psychiatry"},{"key":"80832_CR6","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1001\/jamapsychiatry.2019.3986","volume":"77","author":"EAM Van Dis","year":"2020","unstructured":"Van Dis, E. A. M. et al. Long-term outcomes of cognitive behavioral therapy for anxiety-related disorders. JAMA Psychiatry 77, 265\u2013273 (2020).","journal-title":"JAMA Psychiatry"},{"key":"80832_CR7","doi-asserted-by":"publisher","first-page":"502","DOI":"10.1002\/da.22728","volume":"35","author":"JK Carpenter","year":"2018","unstructured":"Carpenter, J. K. et al. Cognitive behavioral therapy for anxiety and related disorders: A meta-analysis of randomized placebo-controlled trials. Depress. Anxiety 35, 502\u2013514 (2018).","journal-title":"Depress. Anxiety"},{"key":"80832_CR8","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1037\/0033-2909.99.1.20","volume":"99","author":"EB Foa","year":"1986","unstructured":"Foa, E. B. & Kozak, M. J. Emotional processing of fear: Exposure to corrective information. Psychol. Bull. 99, 20\u201335 (1986).","journal-title":"Psychol. Bull."},{"key":"80832_CR9","doi-asserted-by":"publisher","first-page":"20170025","DOI":"10.1098\/rstb.2017.0025","volume":"373","author":"MG Craske","year":"2018","unstructured":"Craske, M. G., Hermans, D. & Vervliet, B. State-of-the-art and future directions for extinction as a translational model for fear and anxiety. Philos. Trans. R. Soc. B Biol. Sci. 373, 20170025 (2018).","journal-title":"Philos. Trans. R. Soc. B Biol. Sci."},{"key":"80832_CR10","doi-asserted-by":"publisher","first-page":"164","DOI":"10.3390\/brainsci9070164","volume":"9","author":"JK Carpenter","year":"2019","unstructured":"Carpenter, J. K., Pinaire, M. & Hofmann, S. G. From extinction learning to anxiety treatment: Mind the gap. Brain Sci. 9, 164 (2019).","journal-title":"Brain Sci."},{"key":"80832_CR11","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2022.104229","volume":"160","author":"D Adolph","year":"2023","unstructured":"Adolph, D., Teismann, T., Wannem\u00fcller, A. & Margraf, J. Fear conditioning and extinction learning in the mood and anxiety disorders spectrum\u2014Associations with the outcome of cognitive behavior therapy. Behav. Res. Ther. 160, 104229 (2023).","journal-title":"Behav. Res. Ther."},{"key":"80832_CR12","doi-asserted-by":"publisher","first-page":"897","DOI":"10.1016\/j.neuron.2004.08.042","volume":"43","author":"EA Phelps","year":"2004","unstructured":"Phelps, E. A., Delgado, M. R., Nearing, K. I. & LeDoux, J. E. Extinction learning in humans: Role of the amygdala and vmPFC. Neuron 43, 897\u2013905 (2004).","journal-title":"Neuron"},{"key":"80832_CR13","doi-asserted-by":"publisher","first-page":"446","DOI":"10.1016\/j.biopsych.2006.10.011","volume":"62","author":"MR Milad","year":"2007","unstructured":"Milad, M. R. et al. Recall of fear extinction in humans activates the ventromedial prefrontal cortex and hippocampus in concert. Biol. Psychiatry 62, 446\u2013454 (2007).","journal-title":"Biol. Psychiatry"},{"key":"80832_CR14","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1016\/j.neubiorev.2018.03.002","volume":"88","author":"MA Fullana","year":"2018","unstructured":"Fullana, M. A. et al. Fear extinction in the human brain: A meta-analysis of fMRI studies in healthy participants. Neurosci. Biobehav. Rev. 88, 16\u201325 (2018).","journal-title":"Neurosci. Biobehav. Rev."},{"key":"80832_CR15","doi-asserted-by":"publisher","first-page":"276","DOI":"10.1016\/j.biopsych.2014.02.014","volume":"77","author":"JC Motzkin","year":"2015","unstructured":"Motzkin, J. C., Philippi, C. L., Wolf, R. C., Baskaya, M. K. & Koenigs, M. Ventromedial prefrontal cortex is critical for the regulation of amygdala activity in humans. Biol. Psychiatry 77, 276\u2013284 (2015).","journal-title":"Biol. Psychiatry"},{"key":"80832_CR16","doi-asserted-by":"publisher","first-page":"651","DOI":"10.1038\/nrn3301","volume":"13","author":"CT Gross","year":"2012","unstructured":"Gross, C. T. & Canteras, N. S. The many paths to fear. Nat. Rev. Neurosci. 13, 651\u2013658 (2012).","journal-title":"Nat. Rev. Neurosci."},{"key":"80832_CR17","doi-asserted-by":"publisher","first-page":"462","DOI":"10.1101\/lm.044115.116","volume":"24","author":"R Garcia","year":"2017","unstructured":"Garcia, R. Neurobiology of fear and specific phobias. Learn. Mem. 24, 462\u2013471 (2017).","journal-title":"Learn. Mem."},{"key":"80832_CR18","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1146\/annurev.psych.121208.131631","volume":"63","author":"MR Milad","year":"2012","unstructured":"Milad, M. R. & Quirk, G. J. Fear extinction as a model for translational neuroscience: Ten years of progress. Annu. Rev. Psychol. 63, 129\u2013151 (2012).","journal-title":"Annu. Rev. Psychol."},{"key":"80832_CR19","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1038\/sj.npp.1301555","volume":"33","author":"GJ Quirk","year":"2008","unstructured":"Quirk, G. J. & Mueller, D. Neural mechanisms of extinction learning and retrieval. Neuropsychopharmacology 33, 56\u201372 (2008).","journal-title":"Neuropsychopharmacology"},{"key":"80832_CR20","doi-asserted-by":"publisher","first-page":"320","DOI":"10.1038\/npp.2015.255","volume":"41","author":"JA Greco","year":"2016","unstructured":"Greco, J. A. & Liberzon, I. Neuroimaging of fear-associated learning. Neuropsychopharmacology 41, 320\u2013334 (2016).","journal-title":"Neuropsychopharmacology"},{"key":"80832_CR21","first-page":"115","volume":"11","author":"ER Duval","year":"2015","unstructured":"Duval, E. R., Javanbakht, A. & Liberzon, I. Neural circuits in anxiety and stress disorders: A focused review. Ther. Clin. Risk Manag. 11, 115\u2013126 (2015).","journal-title":"Ther. Clin. Risk Manag."},{"key":"80832_CR22","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1002\/da.22353","volume":"32","author":"P Duits","year":"2015","unstructured":"Duits, P. et al. Updated meta-analysis of classical fear conditioning in the anxiety disorders. Depress Anxiety 32, 239\u2013253 (2015).","journal-title":"Depress Anxiety"},{"key":"80832_CR23","doi-asserted-by":"publisher","first-page":"796","DOI":"10.1016\/j.neubiorev.2019.12.009","volume":"108","author":"J B\u00f6hnlein","year":"2020","unstructured":"B\u00f6hnlein, J. et al. Factors influencing the success of exposure therapy for specific phobia: A systematic review. Neurosci. Biobehav. Rev. 108, 796\u2013820 (2020).","journal-title":"Neurosci. Biobehav. Rev."},{"key":"80832_CR24","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1016\/j.cpr.2015.08.004","volume":"42","author":"AG Loerinc","year":"2015","unstructured":"Loerinc, A. G. et al. Response rates for CBT for anxiety disorders: Need for standardized criteria. Clin. Psychol. Rev. 42, 72\u201382 (2015).","journal-title":"Clin. Psychol. Rev."},{"key":"80832_CR25","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1590\/S1516-44462010005000005","volume":"33","author":"E Heldt","year":"2011","unstructured":"Heldt, E. et al. Predictors of relapse in the second follow-up year post cognitive-behavior therapy for panic disorder. Braz. J. Psychiatry 33, 23\u201329 (2011).","journal-title":"Braz. J. Psychiatry"},{"key":"80832_CR26","doi-asserted-by":"publisher","first-page":"E592","DOI":"10.1503\/jpn.210050","volume":"46","author":"A Vergallito","year":"2021","unstructured":"Vergallito, A. et al. Effectiveness of noninvasive brain stimulation in the treatment of anxiety disorders: A meta-analysis of sham or behaviour-controlled studies. J. Psychiatry Neurosci. 46, E592\u2013E614 (2021).","journal-title":"J. Psychiatry Neurosci."},{"key":"80832_CR27","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1016\/j.neuron.2007.06.026","volume":"55","author":"M Hallett","year":"2007","unstructured":"Hallett, M. Transcranial magnetic stimulation: A primer. Neuron 55, 187\u2013199 (2007).","journal-title":"Neuron"},{"key":"80832_CR28","doi-asserted-by":"publisher","first-page":"987","DOI":"10.1016\/j.brs.2020.04.009","volume":"13","author":"D Agboada","year":"2020","unstructured":"Agboada, D., Mosayebi-Samani, M., Kuo, M. F. & Nitsche, M. A. Induction of long-term potentiation-like plasticity in the primary motor cortex with repeated anodal transcranial direct current stimulation\u2014Better effects with intensified protocols?. Brain Stimul. 13, 987\u2013997 (2020).","journal-title":"Brain Stimul."},{"key":"80832_CR29","doi-asserted-by":"publisher","first-page":"174","DOI":"10.1038\/s41593-017-0054-4","volume":"21","author":"R Polan\u00eda","year":"2018","unstructured":"Polan\u00eda, R., Nitsche, M. A. & Ruff, C. C. Studying and modifying brain function with non-invasive brain stimulation. Nat. Neurosci. 21, 174\u2013187 (2018).","journal-title":"Nat. Neurosci."},{"key":"80832_CR30","doi-asserted-by":"publisher","first-page":"2150","DOI":"10.1016\/j.clinph.2014.05.021","volume":"125","author":"JP Lefaucheur","year":"2014","unstructured":"Lefaucheur, J. P. et al. Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS). Clin. Neurophysiol. 125, 2150\u20132206 (2014).","journal-title":"Clin. Neurophysiol."},{"key":"80832_CR31","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1038\/nature01138","volume":"420","author":"MR Milad","year":"2002","unstructured":"Milad, M. R. & Quirk, G. J. Neurons in medial prefrontal cortex signal memory for fear extinction. Nature 420, 70\u201374 (2002).","journal-title":"Nature"},{"key":"80832_CR32","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1037\/0735-7044.118.2.389","volume":"118","author":"MR Milad","year":"2004","unstructured":"Milad, M. R., Vidal-Gonzalez, I. & Quirk, G. J. Electrical stimulation of medial prefrontal cortex reduces conditioned fear in a temporally specific manner. Behav. Neurosci. 118, 389\u2013394 (2004).","journal-title":"Behav. Neurosci."},{"key":"80832_CR33","doi-asserted-by":"publisher","first-page":"e35853","DOI":"10.1371\/journal.pone.0035853","volume":"7","author":"M Maroun","year":"2012","unstructured":"Maroun, M., Kavushansky, A., Holmes, A., Wellman, C. & Motanis, H. Enhanced extinction of aversive memories by high-frequency stimulation of the rat infralimbic cortex. PLoS One 7, e35853 (2012).","journal-title":"PLoS One"},{"key":"80832_CR34","doi-asserted-by":"publisher","DOI":"10.3389\/fnhum.2021.655947","volume":"15","author":"V Markovi\u0107","year":"2021","unstructured":"Markovi\u0107, V., Vicario, C. M., Yavari, F., Salehinejad, M. A. & Nitsche, M. A. A systematic review on the effect of transcranial direct current and magnetic stimulation on fear memory and extinction. Front. Hum. Neurosci. 15, 655947 (2021).","journal-title":"Front. Hum. Neurosci."},{"key":"80832_CR35","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1016\/j.biopsych.2017.10.022","volume":"84","author":"T Raij","year":"2018","unstructured":"Raij, T. et al. Prefrontal cortex stimulation enhances fear extinction memory in humans. Biol. Psychiatry 84, 129\u2013137 (2018).","journal-title":"Biol. Psychiatry"},{"key":"80832_CR36","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1016\/j.janxdis.2018.08.003","volume":"61","author":"E Carl","year":"2019","unstructured":"Carl, E. et al. Virtual reality exposure therapy for anxiety and related disorders: A meta-analysis of randomized controlled trials. J. Anxiety Disord. 61, 27\u201336 (2019).","journal-title":"J. Anxiety Disord."},{"key":"80832_CR37","doi-asserted-by":"publisher","first-page":"1758","DOI":"10.3389\/fpsyg.2019.01758","volume":"10","author":"TF Wechsler","year":"2019","unstructured":"Wechsler, T. F., K\u00fcmpers, F. & M\u00fchlberger, A. Inferiority or even superiority of virtual reality exposure therapy in phobias?\u2014A systematic review and quantitative meta-analysis on randomized controlled trials specifically comparing the efficacy of virtual reality exposure to gold standard in vivo exposure in agoraphobia, specific phobia and social phobia. Front. Psychol. 10, 1758 (2019).","journal-title":"Front. Psychol."},{"key":"80832_CR38","doi-asserted-by":"publisher","unstructured":"Margraf, J., Cwik, J. C., Suppiger, A. & Schneider, S. DIPS Open Access: Diagnostic Interview for Mental Disorders. [DIPS Open Access: Diagnostisches Interview Bei Psychischen St\u00f6rungen.]. (2017) https:\/\/doi.org\/10.13154\/rub.100.89.","DOI":"10.13154\/rub.100.89"},{"key":"80832_CR39","unstructured":"Margraf, J. & Cwik, J. C. Mini-DIPS Open Access: Diagnostic Short-Interview for Mental Disorders. [Mini-DIPS Open Access: Diagnostisches Kurzinterview Bei Psychischen St\u00f6rungen. (2017)."},{"key":"80832_CR40","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1016\/j.brs.2016.11.007","volume":"10","author":"MJ Herrmann","year":"2017","unstructured":"Herrmann, M. J. et al. Medial prefrontal cortex stimulation accelerates therapy response of exposure therapy in acrophobia. Brain Stimul. 10, 291\u2013297 (2017).","journal-title":"Brain Stimul."},{"key":"80832_CR41","doi-asserted-by":"publisher","first-page":"774","DOI":"10.1016\/j.neuroimage.2012.01.021","volume":"62","author":"B Fischl","year":"2012","unstructured":"Fischl, B. FreeSurfer. Neuroimage 62, 774\u2013781 (2012).","journal-title":"Neuroimage"},{"key":"80832_CR42","doi-asserted-by":"publisher","first-page":"272","DOI":"10.1002\/(SICI)1097-0193(1999)8:4<272::AID-HBM10>3.0.CO;2-4","volume":"8","author":"B Fischl","year":"1999","unstructured":"Fischl, B., Sereno, M. I., Tootell, R. B. H. & Dale, A. M. High-resolution intersubject averaging and a coordinate system for the cortical surface. Hum. Brain Mapp. 8, 272\u2013284 (1999).","journal-title":"Hum. Brain Mapp."},{"key":"80832_CR43","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1016\/j.neuron.2004.12.033","volume":"45","author":"Y-Z Huang","year":"2005","unstructured":"Huang, Y.-Z., Edwards, M. J., Rounis, E., Bhatia, K. P. & Rothwell, J. C. Theta burst stimulation of the human motor cortex. Neuron 45, 201\u2013206 (2005).","journal-title":"Neuron"},{"key":"80832_CR44","doi-asserted-by":"publisher","first-page":"372","DOI":"10.3389\/fnhum.2018.00372","volume":"12","author":"D Gromer","year":"2018","unstructured":"Gromer, D. et al. Height simulation in a virtual reality CAVE system: Validity of fear responses and effects of an immersion manipulation. Front. Hum. Neurosci. 12, 372 (2018).","journal-title":"Front. Hum. Neurosci."},{"key":"80832_CR45","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1016\/S0005-7894(77)80116-0","volume":"8","author":"DC Cohen","year":"1977","unstructured":"Cohen, D. C. Comparison of self-report and overt-behavioral procedures for assessing acrophobia. Behav. Ther. 8, 17\u201323 (1977).","journal-title":"Behav. Ther."},{"key":"80832_CR46","doi-asserted-by":"publisher","first-page":"561","DOI":"10.1016\/0005-7967(89)90091-0","volume":"27","author":"JL Abelson","year":"1989","unstructured":"Abelson, J. L. & Curtis, G. C. Cardiac and neuroendocrine responses to exposure therapy in height phobics: Desynchrony within the \u2018physiological response system\u2019. Behav. Res. Ther. 27, 561\u2013567 (1989).","journal-title":"Behav. Res. Ther."},{"key":"80832_CR47","doi-asserted-by":"publisher","first-page":"176","DOI":"10.1037\/1040-3590.19.2.176","volume":"19","author":"S Taylor","year":"2007","unstructured":"Taylor, S. et al. Robust dimensions of anxiety sensitivity: Development and initial validation of the anxiety sensitivity index-3. Psychol. Assess 19, 176\u2013188 (2007).","journal-title":"Psychol. Assess"},{"key":"80832_CR48","volume-title":"Allgemeine Depressions-Skala","author":"M Hautzinger","year":"1993","unstructured":"Hautzinger, M. & Bailer, M. Allgemeine Depressions-Skala (Beltz Test, 1993)."},{"key":"80832_CR49","volume-title":"State-Trait-Angstinventar (STAI)","author":"L Laux","year":"1981","unstructured":"Laux, L., Glanzmann, P., Schaffner, P. & Spielberger, C. D. State-Trait-Angstinventar (STAI) (Beltz, 1981)."},{"key":"80832_CR50","doi-asserted-by":"publisher","first-page":"268","DOI":"10.1037\/h0036681","volume":"83","author":"A Tellegen","year":"1974","unstructured":"Tellegen, A. & Atkinson, G. Openness to absorbing and self-altering experiences (\u2018absorption\u2019), a trait related to hypnotic susceptibility. J. Abnorm. Psychol. 83, 268\u2013277 (1974).","journal-title":"J. Abnorm. Psychol."},{"key":"80832_CR51","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1207\/s15327108ijap0303_3","volume":"3","author":"RS Kennedy","year":"1993","unstructured":"Kennedy, R. S., Lane, N. E., Berbaum, K. S. & Lilienthal, M. G. Simulator sickness questionnaire: An enhanced method for quantifying simulator sickness. Int. J. Aviat. Psychol. 3, 203\u2013220 (1993).","journal-title":"Int. J. Aviat. Psychol."},{"key":"80832_CR52","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1026\/\/1617-6383.15.2.69","volume":"2","author":"TW Schubert","year":"2003","unstructured":"Schubert, T. W. The sense of presence in virtual environments: A three-component scale measuring spatial presence, involvement, and realness Medienpsychologische Methoden. Zeitschrift f\u00fcr Medienpsychologie 2, 69\u201371 (2003).","journal-title":"Zeitschrift f\u00fcr Medienpsychologie"},{"key":"80832_CR53","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1007\/s00278-019-0349-x","volume":"64","author":"MJ Herrmann","year":"2019","unstructured":"Herrmann, M. J., Cybinski, L. M., Unterecker, S., Deckert, J. & Polak, T. Nichtinvasive Hirnstimulation in Kombination mit Psychotherapie bei Angsterkrankungen. Psychotherapeut (Berl) 64, 220\u2013224 (2019).","journal-title":"Psychotherapeut (Berl)"},{"key":"80832_CR54","doi-asserted-by":"publisher","first-page":"4","DOI":"10.4324\/9780429318405","volume-title":"New Methods in Cognitive Psychology","author":"H Singmann","year":"2019","unstructured":"Singmann, H. & Kellen, D. An introduction to mixed models for experimental psychology. In New Methods in Cognitive Psychology (eds Spieler, D. H. & Schumacher, E.) 4\u201331 (Routledge, New York, 2019). https:\/\/doi.org\/10.4324\/9780429318405."},{"key":"80832_CR55","doi-asserted-by":"publisher","first-page":"418","DOI":"10.1016\/j.jneumeth.2011.10.006","volume":"203","author":"Z-X Zang","year":"2012","unstructured":"Zang, Z.-X., Yan, C.-G., Dong, Z.-Y., Huang, J. & Zang, Y.-F. Granger causality analysis implementation on MATLAB: A graphic user interface toolkit for fMRI data processing. J. Neurosci. Methods 203, 418\u2013426 (2012).","journal-title":"J. Neurosci. Methods"},{"key":"80832_CR56","doi-asserted-by":"publisher","first-page":"823158","DOI":"10.3389\/fpsyt.2022.823158","volume":"13","author":"MK Leuchter","year":"2022","unstructured":"Leuchter, M. K. et al. Treatment of spider phobia using repeated exposures and adjunctive repetitive transcranial magnetic stimulation: A proof-of-concept study. Front. Psychiatry 13, 823158 (2022).","journal-title":"Front. Psychiatry"},{"key":"80832_CR57","doi-asserted-by":"publisher","first-page":"896","DOI":"10.1016\/j.janxdis.2011.05.001","volume":"25","author":"SA Steinman","year":"2011","unstructured":"Steinman, S. A. & Teachman, B. A. Cognitive processing and acrophobia: Validating the heights interpretation questionnaire. J. Anxiety Disord. 25, 896\u2013902 (2011).","journal-title":"J. Anxiety Disord."},{"key":"80832_CR58","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3389\/fnbeh.2014.00044","volume":"8","author":"A Guhn","year":"2014","unstructured":"Guhn, A. et al. Medial prefrontal cortex stimulation modulates the processing of conditioned fear. Front. Behav. Neurosci. 8, 1\u201311 (2014).","journal-title":"Front. Behav. Neurosci."},{"key":"80832_CR59","doi-asserted-by":"publisher","first-page":"4301","DOI":"10.1002\/hbm.24703","volume":"40","author":"P Riedel","year":"2019","unstructured":"Riedel, P. et al. Modulating functional connectivity between medial frontopolar cortex and amygdala by inhibitory and excitatory transcranial magnetic stimulation. Hum. Brain Mapp. 40, 4301\u20134315 (2019).","journal-title":"Hum. Brain Mapp."},{"key":"80832_CR60","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1016\/j.neuroscience.2011.09.050","volume":"200","author":"K Baek","year":"2012","unstructured":"Baek, K., Chae, J.-H. & Jeong, J. The effect of repetitive transcranial magnetic stimulation on fear extinction in rats. Neuroscience 200, 159\u2013165 (2012).","journal-title":"Neuroscience"},{"key":"80832_CR61","doi-asserted-by":"publisher","first-page":"E292","DOI":"10.1503\/jpn.200053","volume":"46","author":"J Deng","year":"2021","unstructured":"Deng, J. et al. Augmentation of fear extinction by theta-burst transcranial magnetic stimulation of the prefrontal cortex in humans. J. Psychiatry Neurosci. 46, E292\u2013E302 (2021).","journal-title":"J. Psychiatry Neurosci."},{"key":"80832_CR62","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1016\/j.biopsycho.2015.10.003","volume":"112","author":"S Notzon","year":"2015","unstructured":"Notzon, S. et al. Psychophysiological effects of an iTBS modulated virtual reality challenge including participants with spider phobia. Biol. Psychol. 112, 66\u201376 (2015).","journal-title":"Biol. Psychol."},{"key":"80832_CR63","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s10048-014-0393-1","volume":"15","author":"L Chaieb","year":"2014","unstructured":"Chaieb, L., Antal, A., Ambrus, G. G. & Paulus, W. Brain-derived neurotrophic factor: Its impact upon neuroplasticity and neuroplasticity inducing transcranial brain stimulation protocols. Neurogenetics 15, 1\u201311 (2014).","journal-title":"Neurogenetics"},{"key":"80832_CR64","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s10548-008-0067-0","volume":"21","author":"J Silvanto","year":"2008","unstructured":"Silvanto, J. & Pascual-Leone, A. State-dependency of transcranial magnetic stimulation. Brain Topogr. 21, 1\u201310 (2008).","journal-title":"Brain Topogr."},{"key":"80832_CR65","first-page":"311","volume":"29","author":"N Thirugnanasambandam","year":"2011","unstructured":"Thirugnanasambandam, N. et al. Isometric contraction interferes with transcranial direct current stimulation (tDCS) induced plasticity\u2014Evidence of state-dependent neuromodulation in human motor cortex. Restor. Neurol. Neurosci. 29, 311\u2013320 (2011).","journal-title":"Restor. Neurol. Neurosci."},{"key":"80832_CR66","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1016\/j.beth.2010.06.002","volume":"42","author":"MA Laborda","year":"2011","unstructured":"Laborda, M. A. & Miller, R. R. S-R associations, their extinction, and recovery in an animal model of anxiety: A new associative account of phobias without recall of original trauma. Behav. Ther. 42, 153\u2013169 (2011).","journal-title":"Behav. Ther."},{"key":"80832_CR67","doi-asserted-by":"publisher","first-page":"1095","DOI":"10.1038\/nn1968","volume":"10","author":"A Olsson","year":"2007","unstructured":"Olsson, A. & Phelps, E. A. Social learning of fear. Nat. Neurosci. 10, 1095\u20131102 (2007).","journal-title":"Nat. Neurosci."},{"key":"80832_CR68","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.cub.2020.06.091","volume":"30","author":"S Borgomaneri","year":"2020","unstructured":"Borgomaneri, S. et al. State-dependent TMS over prefrontal cortex disrupts fear-memory reconsolidation and prevents the return of fear. Curr. Biol. 30, 1\u20138 (2020).","journal-title":"Curr. Biol."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-024-80832-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-024-80832-1","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-024-80832-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,27]],"date-time":"2024-11-27T05:18:04Z","timestamp":1732684684000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-024-80832-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,27]]},"references-count":68,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["80832"],"URL":"https:\/\/doi.org\/10.1038\/s41598-024-80832-1","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,27]]},"assertion":[{"value":"4 September 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 November 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 November 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"PP and AM are shareholders in VTplus GmbH, a commercial company specializing in the development research systems for virtual environments. There are no other potential financial and non-financial competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"29450"}}