Department of Psychiatry and Psychotherapy, LMU University Hospital Munich, Nußbaumstraße 7, 80336, Munich, Germany.
Medical Park Chiemseeblick, Bernau-Felden, Germany.
Eur Arch Psychiatry Clin Neurosci. 2024 Jun;274(4):1001-1011. doi: 10.1007/s00406-023-01705-8. Epub 2023 Nov 13.
Non-invasive brain stimulation methods are currently being evaluated for treatment of addictive disorders. Some evidence indicates that modulating left and right prefrontal brain activity by transcranial direct current stimulation (tDCS) can reduce craving and relapse rates in tobacco addiction. Therefore, this study investigated the effects of active and sham tDCS as an add-on treatment to a standardized brief intervention for smoking cessation. This randomized, double-blind study included 36 participants (22 women and 14 men) with nicotine dependence according to ICD-10 criteria. At five visits on alternate days, participants underwent a 20-min active or sham tDCS over the left dorsolateral prefrontal cortex and subsequently participated in a 10-min brief intervention for smoking cessation. Patients were followed up after 3 months. On each treatment day and at follow-up, abstinence was assessed as the smoking status nonsmoker and craving was assessed with the German version of the Questionnaire on Smoking Urges. At each visit, the number of cigarettes smoked per day was recorded and carbon monoxide in expired air and cotinine in saliva were measured. At follow-up, a study-specific questionnaire was used to assess tobacco use. All 36 participants completed the treatment sessions, but one participant in each group was lost to follow-up. Abstinence rates were not significantly different between the groups at any of the study visits, but craving was significantly lower in the active group at tDCS session 5 compared with session 1. tDCS combined with a brief intervention may support smoking cessation, but studies need to evaluate whether longer and more intensive treatment can achieve significant, sustainable effects.
目前正在评估非侵入性脑刺激方法治疗成瘾障碍。一些证据表明，经颅直流电刺激（tDCS）调节左、右前额叶脑活动可以降低烟草成瘾的渴求感和复发率。因此，本研究调查了主动和假 tDCS 作为附加治疗方案对戒烟标准化简短干预的影响。这项随机、双盲研究纳入了 36 名符合 ICD-10 标准的尼古丁依赖患者（22 名女性和 14 名男性）。在隔一天的五次就诊中，参与者接受了 20 分钟的主动或假 tDCS 治疗，治疗部位为左背外侧前额叶皮质，随后参加了 10 分钟的戒烟简短干预。患者在 3 个月后进行随访。在每次治疗日和随访时，通过询问吸烟状态来评估是否戒烟，通过德语版吸烟渴求问卷来评估渴求感。在每次就诊时，记录每天吸烟的数量，并测量呼出空气中的一氧化碳和唾液中的可替宁。随访时，使用特定于研究的问卷评估烟草使用情况。所有 36 名参与者都完成了治疗，但每组中有一名参与者失访。在任何研究就诊时，两组的戒烟率均无显著差异，但在 tDCS 第 5 次治疗时，主动组的渴求感显著低于第 1 次治疗时。tDCS 联合简短干预可能有助于戒烟，但需要研究评估更长和更强化的治疗是否能实现显著和持续的效果。
