TY - JOUR
T1 - A double-blind sham-controlled phase 1 clinical trial of tDCS of the dorsolateral prefrontal cortex in cocaine inpatients
T2 - Craving, sleepiness, and contemplation to change
AU - Gaudreault, Pierre Olivier
AU - Sharma, Akarsh
AU - Datta, Abhishek
AU - Nakamura-Palacios, Ester M.
AU - King, Sarah
AU - Malaker, Pias
AU - Wagner, Ariella
AU - Vasa, Devarshi
AU - Parvaz, Muhammad A.
AU - Parra, Lucas C.
AU - Alia-Klein, Nelly
AU - Goldstein, Rita Z.
N1 - Funding Information:
This study was supported by NIDA 271201800035C‐0‐0‐1 “tDCS to reduce craving in cocaine addiction” (SBIR Phase I), by R01DA041528 to Dr. Goldstein, and by the Canadian Institutes of Health Research (Postdoctoral research award to Dr. Gaudreault).
Publisher Copyright:
© 2021 Federation of European Neuroscience Societies and John Wiley & Sons Ltd
PY - 2021/5
Y1 - 2021/5
N2 - Impaired inhibitory control accompanied by enhanced salience attributed to drug-related cues, both associated with function of the dorsolateral prefrontal cortex (dlPFC), are hallmarks of drug addiction, contributing to worse symptomatology including craving. dlPFC modulation with transcranial direct current stimulation (tDCS) previously showed craving reduction in inpatients with cocaine use disorder (CUD). Our study aimed at assessing feasibility of a longer tDCS protocol in CUD (15 versus the common five/10 sessions) and replicability of previous results. In a randomized double-blind sham-controlled protocol, 17 inpatients with CUD were assigned to either a real-tDCS (right anodal/left cathodal) or a sham-tDCS condition for 15 sessions. Following the previous report, primary outcome measures were self-reported craving, anxiety, depression, and quality of life. Secondary measures included sleepiness, readiness to change drug use, and affect. We also assessed cognitive function including impulsivity. An 88% retention rate demonstrated feasibility. Partially supporting the previous results, there was a trend for self-reported craving to decrease in the real-tDCS group more than the sham-group, an effect that would reach significance with 15 subjects per group. Quality of life and impulsivity improved over time in treatment in both groups. Daytime sleepiness and readiness to change drug use showed significant Group × Time interactions whereby improvements were noted only in the real-tDCS group. One-month follow-up suggested transient effects of tDCS on sleepiness and craving. These preliminary results suggest the need for including more subjects to show a unique effect of real-tDCS on craving and examine the duration of this effect. After replication in larger sample sizes, increased vigilance and motivation to change drug use in the real-tDCS group may suggest fortification of dlPFC-supported executive functions.
AB - Impaired inhibitory control accompanied by enhanced salience attributed to drug-related cues, both associated with function of the dorsolateral prefrontal cortex (dlPFC), are hallmarks of drug addiction, contributing to worse symptomatology including craving. dlPFC modulation with transcranial direct current stimulation (tDCS) previously showed craving reduction in inpatients with cocaine use disorder (CUD). Our study aimed at assessing feasibility of a longer tDCS protocol in CUD (15 versus the common five/10 sessions) and replicability of previous results. In a randomized double-blind sham-controlled protocol, 17 inpatients with CUD were assigned to either a real-tDCS (right anodal/left cathodal) or a sham-tDCS condition for 15 sessions. Following the previous report, primary outcome measures were self-reported craving, anxiety, depression, and quality of life. Secondary measures included sleepiness, readiness to change drug use, and affect. We also assessed cognitive function including impulsivity. An 88% retention rate demonstrated feasibility. Partially supporting the previous results, there was a trend for self-reported craving to decrease in the real-tDCS group more than the sham-group, an effect that would reach significance with 15 subjects per group. Quality of life and impulsivity improved over time in treatment in both groups. Daytime sleepiness and readiness to change drug use showed significant Group × Time interactions whereby improvements were noted only in the real-tDCS group. One-month follow-up suggested transient effects of tDCS on sleepiness and craving. These preliminary results suggest the need for including more subjects to show a unique effect of real-tDCS on craving and examine the duration of this effect. After replication in larger sample sizes, increased vigilance and motivation to change drug use in the real-tDCS group may suggest fortification of dlPFC-supported executive functions.
KW - cocaine use disorder
KW - dorsolateral prefrontal cortex
KW - drug addiction
KW - self-reported craving
KW - transcranial direct current stimulation
UR - http://www.scopus.com/inward/record.url?scp=85102655236&partnerID=8YFLogxK
U2 - 10.1111/ejn.15172
DO - 10.1111/ejn.15172
M3 - Article
C2 - 33662163
AN - SCOPUS:85102655236
VL - 53
SP - 3212
EP - 3230
JO - European Journal of Neuroscience
JF - European Journal of Neuroscience
SN - 0953-816X
IS - 9
ER -