Multi-session electrical neuromodulation effects on craving, relapse and cognitive functions in cocaine use disorder: A randomized, sham-controlled tDCS study
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 crackcocaine users specifically. Further research is required to determine the efficacy of tDCS as a complementary
treatment in cocaine use disorde
