Title:Transcranial Direct Current Stimulation for the Treatment of Addictions: A Systematic Review of Clinical Trials
Volume: 14
Issue: 4
Author(s): Ali Yadollahpour*Tifei Yuan*
Affiliation:
- Department of Medical Physics, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Golestan Blvd., Ahvaz,Iran
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai,China
Keywords:
Transcranial direct current stimulation, addiction, treatment, clinical efficacy, therapeutic efficacy, substance use
disorders.
Abstract: Background and Objective: Addiction is one of the main health issues worldwide.
Severe side effects and nonspecific actions of conventional medications have necessitated the
development of new safe and non-invasive modality for addiction treatment. Transcranial direct
current stimulation (tDCS) has shown potential treatment effects in substance use disorder and
addiction. The present study aims to review the clinical trials on the effects of tDCS for treatment of
addiction and discusses the therapeutic efficacy of the technique.
Method: The databases of PubMed (1980-2018), Web of Sciences (1980-2018), Scopus (1980-
2018), CINAHL (1990-2018), and PsycINFO (1990-2018) were searched using the set terms. The
titles and abstracts of all the retrieved records in the searching step were carefully reviewed by two
authors and the relevant papers with full texts available were collected for further assessments. The
date of the last search was 20 May, 2018. The language of the search was English and only records
in English were included in the study. The clinical trials with randomized controlled design were
included. The addictions to cocaine, alcohol, crack cocaine, heroin, methamphetamine, and nicotine
were included in the study.
Results: Twenty-three clinical trials were selected for full analysis. Five were on alcohol, 8 on
nicotine, 5 on crack-cocaine, 1 on heroin, 1 on cocaine, 1 on marijuana, 1 on methamphetamine,
and 1 two-arm trial simultaneously assessed alcohol and crack-cocaine. The main targets were
dorsolateral prefrontal cortex (DLPFC) and FPT regions and the effective electrodes montage was
bilateral (anode/cathode over left/right or right/left) DLPFC and dual cathodal on FPT regions.
Most of the RCTs showed both polarities in bilateral DLPFC are effective in improving symptoms
of addictions, however, for specific types of addictions, we observed the polarity-dependent treatment
response. For crack-cocaine, we observed polarity dependent outcome where cathodal DLPFC
(cathode over left/anode over right) showed greater therapeutic efficacy than the opposite polarity.
In contrary, for alcohol, nicotine addictions both polarities of bilateral DLPFC showed significant
therapeutic outcomes.
Conclusion: The current literature shows that tDCS, particularly over DLPFC and FPT areas,
may have therapeutic effects in addictions, though the studies are few and suffer heterogeneous
methodology and protocols. However, further studies with greater sample size and longer follow up
should be conducted to reach a definitive conclusion on the efficacy of tDCS for addictions.
