Laureate Institute for Brain Research, Tulsa, Oklahoma, USA.
Department of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran.
Hum Brain Mapp. 2022 Dec 1;43(17):5340-5357. doi: 10.1002/hbm.26007. Epub 2022 Aug 1.
Transcranial direct current stimulation (tDCS) has been studied as a therapeutic option to alter maladaptive brain functions associated with chronic substance use. We present a randomized, triple-blind, sham-controlled, clinical trial to determine the neural substrates of tDCS effects on drug craving. Sixty participants with methamphetamine use disorder were assigned to two groups: active tDCS (5 x 7 cm , 2 mA, 20 min, anode/cathode over the F4/Fp1) and sham stimulation. Neuroimaging data of a methamphetamine cue reactivity task were collected immediately before and after stimulation. There was a significant reduction in self-reported craving after stimulation without any significant effect of time-by-group interaction. Our whole-brain analysis demonstrated that there was a global decrease in brain reactivity to cues following sham but not active tDCS. There were significant time-by-group interactions in five main clusters in middle and inferior frontal gyri, anterior insula, inferior parietal lobule, and precuneus with higher activations after active stimulation. There was a significant effect of stimulation type in the relationship between electrical current at the individual level and changes in task-modulated activation. Brain regions with the highest electric current in the prefrontal cortex showed a significant time-by-group interaction in task-modulated connectivity in the frontoparietal network. In this trial, there was no significant effect of the one session of active-F4/Fp1 tDCS on drug craving self-report compared to sham stimulation. However, activation and connectivity differences induced by active compared to sham stimulation suggested some potential mechanisms of tDCS to modulate neural response to drug cues.
经颅直流电刺激（tDCS）已被研究作为一种治疗选择，以改变与慢性物质使用相关的适应不良的大脑功能。我们提出了一项随机、三盲、假刺激对照的临床试验，以确定 tDCS 对药物渴求影响的神经基础。60 名患有甲基苯丙胺使用障碍的参与者被分配到两组：主动 tDCS（5×7cm，2mA，20 分钟，阳极/阴极置于 F4/Fp1 上）和假刺激。刺激前后立即采集甲基苯丙胺线索反应任务的神经影像学数据。刺激后自我报告的渴求明显减少，而时间-组间交互作用没有任何显著影响。我们的全脑分析表明，在假刺激后，大脑对线索的反应性普遍降低，但在主动 tDCS 后没有。在中、下额回、前岛叶、下顶叶和楔前叶的五个主要簇中有显著的时间-组间交互作用，主动刺激后激活度更高。刺激类型对个体水平电流与任务调节激活变化之间的关系有显著影响。在额叶皮质的电流最高的大脑区域，在前顶叶网络中，任务调节连接的时间-组间交互作用显著。在这项试验中，与假刺激相比，单次 F4/Fp1 主动 tDCS 对药物渴求自我报告没有显著影响。然而，与假刺激相比，主动刺激引起的激活和连接差异表明 tDCS 调节对药物线索的神经反应的一些潜在机制。
