Abstract
Individuals with substance use disorders exhibit risk-taking behaviors, potentially leading to negative consequences and difficulty maintaining recovery. Non-invasive brain stimulation techniques such as transcranial direct current stimulation (tDCS) have yielded mixed effects on risk-taking among healthy controls. Given the importance of risk-taking behaviors among substance-using samples, this study aimed to examine the effects of tDCS on risk-taking among a sample of adults using cannabis. Using a double-blind design, 27 cannabis users [M(SD) age = 32.48 (1.99), 41% female] were randomized, receiving one session of active or sham tDCS over the bilateral dorsolateral prefrontal cortex (dlPFC). Stimulation parameters closely followed prior studies with anodal right dlPFC and cathodal left dlPFC stimulation. Risk-taking—assessed via a modified Cambridge Gambling Task—was measured before and during tDCS. Delay and probability discounting tasks were assessed before and after stimulation. No significant effects of stimulation on risk-taking behavior were found. However, participants chose the less risky option ∼86% of the trials before stimulation which potentially contributed to ceiling effects. These results contradict one prior study showing increased risk-taking among cannabis users following tDCS. There was a significant increase in delay discounting of a $1000 delayed reward during stimulation for the sham group only, but no significant effects for probability discounting. The current study adds to conflicting and inconclusive literature on tDCS and cognition among substance-using samples. In conclusion, results suggest the ineffectiveness of single session dlPFC tDCS using an established stimulation protocol on risk-taking, although ceiling effects at baseline may have also prevented behavior change following tDCS.
Highlights
Cannabis use is relatively common among adults, with 22.2 million people in the United States reporting use in the past month on the 2015 National Survey on Drug Use and Health (Substance Use and Mental Health Administration, 2015), along with 3.18 million Canadians ages 15 and older reporting cannabis use within the past month in 2018 (Statistics Canada, 2020)
Independent samples t-tests revealed no significant differences in demographic and clinical variables across stimulation type, as such, no covariates were included in the repeated measures ANOVAs
A secondary objective was to examine the effects of transcranial direct current stimulation (tDCS) over the right dorsolateral prefrontal cortex (dlPFC) on delay discounting, probability discounting, subjective cannabis craving, and affect
Summary
Cannabis use is relatively common among adults, with 22.2 million people in the United States reporting use in the past month on the 2015 National Survey on Drug Use and Health (Substance Use and Mental Health Administration, 2015), along with 3.18 million Canadians ages 15 and older reporting cannabis use within the past month in 2018 (Statistics Canada, 2020). As such, examining risk-taking among cannabis users is critical given the significant prevalence of cannabis use among the general population. Other studies have found minimal or no difference (Ramaekers et al, 2006; Metrik et al, 2012; Fischer et al, 2015). These discrepancies might be explained by heterogeneity of samples of “cannabis users” across different studies. Not all studies use the same measures to assess use, leading to difficulties in directly comparing samples for risk-taking given the heterogeneity in cannabis users across studies
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