Salmani Ali, Basharpoor Sajjad, Vaziri Zahra, Salehinejad Mohammad Ali
Department of Psychology, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran.
Department of Neuroscience and Behavior, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
Addict Behav Rep. 2025 May 8;21:100614. doi: 10.1016/j.abrep.2025.100614. eCollection 2025 Jun.
Individuals with substance use disorder (iSUD) often show diminished motivation toward treatment-seeking and adherence, resulting in a higher relapse rate, especially during the abstinence phase. A key cognitive correlate of substance use and treatment-seeking behavior is the ability to regulate emotion. While transcranial direct current stimulation (tDCS) shows potential for treating SUD, most studies have focused on craving or cognitive deficits. This randomized, placebo-controlled study examines the effects of 15 daily sessions of prefrontal tDCS on treatment motivation and cognitive emotion regulation in iSUD during the abstinence phase.
Thirty-two young male iSUDs (mean age= 22.80±1.92) were randomly assigned to the experimental (n=16) or placebo (n=16) groups. The experimental group underwent 15 sessions of anodal left and cathodal right dlPFC stimulation (2 mA, 20 min), while the placebo group received sham stimulation over the same period. Assessments of readiness, eagerness, motivation for treatment, and cognitive emotion regulation were conducted before and after the intervention.
The active repeated prefrontal tDCS significantly boosted motivation for change and treatment in iSUD in comparison to sham tDCS. This intervention specifically improved participants' recognition of issues related to their substance use and reduced ambivalence about it. Additionally, active prefrontal tDCS enhanced adaptive cognitive emotion regulation while reducing maladaptive cognitive emotion regulation strategies in iSUD.
Repeated prefrontal tDCS can help iSUD during the abstinence phase to improve adaptive emotion regulation strategies, thereby boosting motivation for treatment seeking. Up and downregulation of left and right dlPFCs is a promising approach for cognitively and motivationally preparing iSUD for treatment-seeking.
患有物质使用障碍（iSUD）的个体往往表现出寻求治疗和坚持治疗的动机减弱，导致复发率较高，尤其是在戒断阶段。物质使用和寻求治疗行为的一个关键认知相关因素是调节情绪的能力。虽然经颅直流电刺激（tDCS）显示出治疗物质使用障碍的潜力，但大多数研究都集中在渴望或认知缺陷上。这项随机、安慰剂对照研究考察了在戒断阶段，每天15次前额叶tDCS对iSUD患者治疗动机和认知情绪调节的影响。
32名年轻男性iSUD患者（平均年龄=22.80±1.92）被随机分为实验组（n=16）或安慰剂组（n=16）。实验组接受15次阳极刺激左侧和阴极刺激右侧背外侧前额叶皮质（2毫安，20分钟），而安慰剂组在同一时期接受假刺激。在干预前后对准备度、急切度、治疗动机和认知情绪调节进行评估。
与假tDCS相比，主动重复的前额叶tDCS显著提高了iSUD患者改变和治疗的动机。这种干预特别提高了参与者对与其物质使用相关问题的认识，并减少了对此的矛盾心理。此外，主动前额叶tDCS增强了适应性认知情绪调节，同时减少了iSUD患者的适应不良认知情绪调节策略。
重复的前额叶tDCS可以帮助iSUD患者在戒断阶段改善适应性情绪调节策略，从而增强寻求治疗的动机。左右背外侧前额叶皮质的上调和下调是一种很有前景的方法，可以在认知和动机上为iSUD患者寻求治疗做好准备。
