Multi-session electrical neuromodulation effects on craving, relapse and cognitive functions in cocaine use disorder: A randomized, sham-controlled tDCS study. (1st December 2020)

• Record Type: Journal Article
• Authors: Verveer, Ilse; van der Veen, Frederik M.; Shahbabaie, Alireza; Remmerswaal, Danielle; Franken, Ingmar H.A.
• Is Part Of: Drug and alcohol dependence. Volume 217(2020)
• Publication Date: 2020-12-01
• Subjects: Cocaine use disorder -- tDCS -- Relapse -- Inhibitory control -- Go-NoGo -- Risky decision-making; Drug abuse -- Periodicals; Alcoholism -- Periodicals; 616.86
• DOI: 10.1016/j.drugalcdep.2020.108429
• Languages: English
• ISSNs: 0376-8716

Abstract

Highlights: We investigated beneficial effects of Multi-Session transcranial Direct Current Stimulation in cocaine use disorder. Ten sessions of 2 mA transcranial Direct Current Stimulation (vs. sham) had no effect on number of relapse days, craving, and cognitive functions. Ten sessions of 2 mA transcranial Direct Current Stimulation (vs. sham) reduced relapse rates in patients with crack-cocaine use disorder. Abstract: Background: The use of transcranial Direct Current Stimulation (tDCS) has previously shown promising results for reducing craving in cocaine use disorder. In this study we further explored the potential of tDCS as add-on intervention in the treatment of cocaine use disorder. Methods: In a randomized, placebo-controlled, between subject study, we applied tDCS bilaterally with the anodal electrode targeting the right dorsolateral prefrontal cortex (DLPFC; https://clinicaltrials.gov/ct2/show/NCT03025321 ). Patients with cocaine use disorder were allocated to ten sessions of either active tDCS ( n = 29) or sham ( n = 30) on five consecutive days. Inhibitory control and risky decision-making were measured via a Go-NoGo task and a two-choice gambling task, respectively, each at baseline, one day after all tDCS sessions and after three months. Relapse at follow-up and craving were also assessed. Results: There was no significant effect of active tDCS on the number of cocaine use days and craving. Relapse was frequent among patients who had received either active or sham tDCS (48.0 % and 69.2 %, respectively), despite an overall decrease in craving during the first two weeks of treatment. No effects were found on cognitive functions. An exploratory analysis for crack cocaine use only revealed that relapse rates were significantly reduced after active tDCS ( n = 17) as compared to sham ( n = 19). Conclusions: No beneficial effects of tDCS on number of cocaine use days, craving and cognitive functions were found in the present study, but somewhat promising results were obtained regarding relapse rates among crack-cocaine users specifically. Further research is required to determine the efficacy of tDCS as a complementary treatment in cocaine use disorder.