Abstract
Prefrontal dysfunction is a hallmark in drug addiction, yet interventions exploring modulation of prefrontal cortex function in drug addiction have not been fully investigated with regard to physiological alterations. We tested the hypothesis that non-invasive prefrontal stimulation would change neural activity in crack-cocaine addiction, investigating the effects of transcranial Direct Current Stimulation (tDCS) of Dorsolateral Prefrontal Cortex (DLPFC) induced cortical excitability modulation on the visual P3 Event Related Potentials (ERP) component under neutral and drug cue exposition in crack-cocaine addicts. Thirteen crack-cocaine users were randomly distributed to receive five applications (once a day, every other day) of bilateral (left cathodal/right anodal) tDCS (20 min, 2 mA, 35 cm2) or sham tDCS over the DLPFC. Brain activity was measured under crack-related or neutral visual-cued ERPs. There were significant differences in P3-related parameters when comparing group of stimulation (active vs. sham tDCS) and number of sessions (single vs. repetitive tDCS). After a single session of tDCS, P3 current intensity in the left DLPFC increased during neutral cues and decreased during crack-related cues. This effect was opposite to what was observed in the sham-tDCS group. In contrast, repetitive tDCS increased current density not only in the DLPFC, but also in a wider array of prefrontal areas, including presumably the frontopolar cortex (FPC) orbitofrontal cortex (OFC) and anterior cingulate cortex (ACC), when subjects were visualizing crack-related cues. Thus, single and repetitive application of tDCS can impact cognitive processing of neutral and especially crack-related visual cues in prefrontal areas, which may be of importance for treatment of crack-cocaine addiction.
Highlights
Alcohol dependence has become one of the most important risk factors for disease and disability (Navarro et al, 2011; Proescholdt et al, 2012)
We subsequently showed that single (Nakamura-Palacios et al, 2012) and repetitive anodal transcranial direct current stimulation (tDCS) over the left dorsolateral prefrontal cortex (dlPFC) reduced craving and depressive symptoms and improved frontal executive functions in severe alcoholics
The most important result of this study is that alcoholics submitted to once-daily sessions of bilateral dlPFC tDCS for five consecutive days relapsed significantly less when compared to alcoholics who received placebo treatment
Summary
Alcohol dependence has become one of the most important risk factors for disease and disability (Navarro et al, 2011; Proescholdt et al, 2012). Well-established pharmacologic treatments and bio-psychosocial therapies have been used, they have only modest or mixed success in clinical trials (Assanangkornchai and Srisurapanont, 2007; Miller et al, 2011). These approaches are often focused on managing acute or protracted. One potential target is the dorsolateral prefrontal cortex (dlPFC) as frontal dysfunction is a hallmark of alcoholism (Moselhy et al, 2001; Duka et al, 2011), even in alcoholic subjects with no major clinical and global cognitive deficits (Moselhy et al, 2001; NakamuraPalacios et al, 2013).
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