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Denomme WJ, Simard I, Shane MS. Neuroimaging Metrics of Drug and Food Processing in Cocaine-Dependence, as a Function of Psychopathic Traits and Substance Use Severity. Front Hum Neurosci 2018; 12:350. [PMID: 30233344 PMCID: PMC6132024 DOI: 10.3389/fnhum.2018.00350] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 08/15/2018] [Indexed: 12/13/2022] Open
Abstract
Previous studies suggest that psychopathic traits commonly present as comorbid with substance use disorders. Moreover, neuroimaging and psychometric findings suggest that psychopathic traits may predispose individuals to a sensitized reward response to drugs. Given that substance use disorders are characterized by a neurocognitive bias toward drug-reward relative to non-drug reward, it is possible that heightened psychopathic characteristics may further predispose to this processing bias. To evaluate this possibility, we assessed psychopathic traits (measured using the PCL-R; Hare, 2003) in 105 probationers/parolees and evaluated the relationship between PCL-R scores, lifetime duration of drug use, and biases in neural response to drug- compared to food-related videos. Psychopathic traits (potentially driven by interpersonal/affective traits) were positively correlated with drug > food reactivity within the right insula and left amygdala. In addition, psychopathic traits modulated the relationship between drug use and drug > food reactivity within the left dorsomedial prefrontal cortex, right insula, and left caudate nucleus. Specifically, lifetime duration of drug use correlated positively with drug > food reactivity in participants with lower levels of psychopathic traits and correlated negatively with drug > food reactivity in individuals with higher levels of psychopathic traits. These results help reconcile prior studies on psychopathy and drug-stimulus processing and provide neurocognitive support for the notion that psychopathic traits serve as an underlying risk factor for substance use disorders. These results suggest that different treatment regimens for substance abuse for individuals with higher or lower levels of psychopathy may be beneficial and suggest that reduction of neurocognitive biases to drug-related stimuli may offer useful targets for future treatment protocols.
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Affiliation(s)
- William J. Denomme
- The Clinical Affective Neuroscience Laboratory for Discovery and Innovation, Faculty of Social Science and Humanities, University of Ontario Institute of Technology, Oshawa, ON, Canada
| | - Isabelle Simard
- The Clinical Affective Neuroscience Laboratory for Discovery and Innovation, Faculty of Social Science and Humanities, University of Ontario Institute of Technology, Oshawa, ON, Canada
| | - Matthew S. Shane
- The Clinical Affective Neuroscience Laboratory for Discovery and Innovation, Faculty of Social Science and Humanities, University of Ontario Institute of Technology, Oshawa, ON, Canada
- The Mind Research Network, The University of New Mexico, Albuquerque, NM, United States
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Abstract
The study of addiction and impulsion control disorders has shown that behaviors of seeking and consumption of addictive substances are subserved by neurobiological alterations specifically related to brain networks for reward, stress, and executive control, representing the brain's adaptation to the continued use of an addictive substance. In parallel, studies using neuromodulation techniques such as transcranial direct current stimulation (tDCS) have demonstrated promising effects in modulating cognitive and motor functions. This review aims to describe the neurobiology of addiction and some of the most relevant cognitive models of addictive behavior and to clarify how tDCS application modulates the intake and craving for several addictive substances, such as food, alcohol, nicotine, cocaine, crack, methamphetamine, and cannabis. We also discuss the positive and null outcomes of the use of this neuromodulatory technique in the treatment of addiction disorders resulting from the use of these substances. The reviewed findings lead us to conclude that tDCS interventions hold several promising clinical avenues in addiction and impulsive control. However, methodological investigations are necessary for undercover optimal parameters before implementing its clinical application.
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Shahbabaie A, Hatami J, Farhoudian A, Ekhtiari H, Khatibi A, Nitsche MA. Optimizing Electrode Montages of Transcranial Direct Current Stimulation for Attentional Bias Modification in Early Abstinent Methamphetamine Users. Front Pharmacol 2018; 9:907. [PMID: 30147655 PMCID: PMC6096722 DOI: 10.3389/fphar.2018.00907] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 07/24/2018] [Indexed: 01/31/2023] Open
Abstract
Introduction: Chronic use of most psychoactive drugs may lead to substance dependence and drug addiction. Drug addiction is a chronically relapsing disorder, and current pharmacological and behavioral therapies are not fully efficient. Attentional bias (AB) is hypothesized to have a causal contribution to substance abuse, addiction development and, maintenance. Transcranial direct current stimulation (tDCS) has been of increasing interest in the past few years as a means for modulating neuroplasticity of the human brain. Although several studies have reported promising therapeutic effects for tDCS in drug abusers, there is no consensus about optimal electrode montages and target brain regions. This study was aimed to compare effectiveness of several electrode montages in modifying AB. Methods and Materials: Ninety early-abstinent methamphetamine users were recruited from several residential drug-rehabilitation centers in Tehran province. They were randomly assigned to six groups with different electrode montages, targeting the left or right dorsolateral prefrontal cortex (DLPFC) as follows: Two conditions with anodal tDCS over the right DLPFC (return electrode placed over the left shoulder or left supraorbital ridge), three conditions with the anode positioned over the left DLPFC (return electrode over the right shoulder, right supraorbital ridge, or contralateral DLPFC), and one sham condition. Active stimulation intensity was 2 mA DC, delivered for 13 min followed by a 20-min rest and another 13 min of stimulation. The probe detection task (PDT) was performed to assess AB. The positive and negative affect scale (PANAS), and the depression anxiety stress scales (DASS) were used to assess baseline affective status before the intervention. Results: Mixed model analysis showed that the left DLPFC/right shoulder and left DLPFC/right DLPFC montages reduced AB toward drug-cues in comparison with sham stimulation. Conclusion: Our findings indicate that anodal stimulation over the left DLPFC reduces AB in methamphetamine users. This study offers promising findings for further studies investigating tDCS as a clinical device to modify AB in drug users.
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Affiliation(s)
- Alireza Shahbabaie
- Department of Psychology and Neurosciences, Leibniz Research Center for Working Environment and Human Factors, Dortmund, Germany
- Institute for Cognitive Science Studies, Tehran, Iran
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
| | - Javad Hatami
- Institute for Cognitive Science Studies, Tehran, Iran
- Faculty of Psychology and Educational Sciences, University of Tehran, Tehran, Iran
| | - Ali Farhoudian
- Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
- Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamed Ekhtiari
- Institute for Cognitive Science Studies, Tehran, Iran
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Khatibi
- Department of Psychology, Bilkent University, Ankara, Turkey
- Interdisciplinary Program in Neuroscience, Bilkent University, Ankara, Turkey
| | - Michael A. Nitsche
- Department of Psychology and Neurosciences, Leibniz Research Center for Working Environment and Human Factors, Dortmund, Germany
- Department of Neurology, University Medical Hospital Bergmannsheil, Bochum, Germany
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Shahbabaie A, Ebrahimpoor M, Hariri A, Nitsche MA, Hatami J, Fatemizadeh E, Oghabian MA, Ekhtiari H. Transcranial DC stimulation modifies functional connectivity of large-scale brain networks in abstinent methamphetamine users. Brain Behav 2018; 8:e00922. [PMID: 29541538 PMCID: PMC5840443 DOI: 10.1002/brb3.922] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 12/06/2017] [Accepted: 12/18/2017] [Indexed: 12/14/2022] Open
Abstract
Background Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation tool suited to alter cortical excitability and activity via the application of weak direct electrical currents. An increasing number of studies in the addiction literature suggests that tDCS modulates subjective self-reported craving through stimulation of dorsolateral prefrontal cortex (DLPFC). The major goal of this study was to explore effects of bilateral DLPFC stimulation on resting state networks (RSNs) in association with drug craving modulation. We targeted three large-scale RSNs; the default mode network (DMN), the executive control network (ECN), and the salience network (SN). Methods Fifteen males were recruited after signing written informed consent. We conducted a double-blinded sham-controlled crossover study. Twenty-minute "real" and "sham" tDCS (2 mA) were applied over the DLPFC on two separate days in random order. Each subject received both stimulation conditions with a 1-week washout period. The anode and cathode electrodes were located over the right and left DLPFC, respectively. Resting state fMRI was acquired before and after real and sham stimulation. Subjective craving was assessed before and after each fMRI scan. The RSNs were identified using seed-based analysis and were compared using a generalized linear model. Results Subjective craving decreased significantly after real tDCS compared to sham stimulation (p = .03). Moreover, the analysis shows significant modulation of DMN, ECN, and SN after real tDCS compared to sham stimulation. Additionally, alteration of subjective craving score was correlated with modified activation of the three networks. Discussion Given the observed alteration of the targeted functional brain networks in methamphetamine users, new potentials are highlighted for tDCS as a network intervention strategy and rsfMRI as a suitable monitoring method for these interventions.
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Affiliation(s)
- Alireza Shahbabaie
- Institute for Cognitive Science StudiesTehranIran
- Neuroimaging and Analysis GroupResearch Center for Cellular and Molecular ImagingTehran University of Medical SciencesTehranIran
- Iranian National Center for Addiction StudiesTehran University of Medical SciencesTehranIran
- Department of Psychology and NeurosciencesLeibniz Research Center for Working Environment and Human FactorsDortmundGermany
| | - Mitra Ebrahimpoor
- Neuroimaging and Analysis GroupResearch Center for Cellular and Molecular ImagingTehran University of Medical SciencesTehranIran
- Department of Medical Statistics and BioinformaticsLeiden University Medical CenterLeidenthe Netherlands
| | - Ali Hariri
- Department of NanoEngineering and Materials Science and Engineering ProgramUniversity of California San DiegoLa JollaCAUSA
- Department of Electrical EngineeringSharif University of TechnologyTehranIran
| | - Michael A. Nitsche
- Department of Psychology and NeurosciencesLeibniz Research Center for Working Environment and Human FactorsDortmundGermany
| | - Javad Hatami
- Institute for Cognitive Science StudiesTehranIran
- Department of Psychology and Educational SciencesUniversity of TehranTehranIran
| | - Emad Fatemizadeh
- Department of Electrical EngineeringSharif University of TechnologyTehranIran
| | - Mohammad Ali Oghabian
- Neuroimaging and Analysis GroupResearch Center for Cellular and Molecular ImagingTehran University of Medical SciencesTehranIran
| | - Hamed Ekhtiari
- Institute for Cognitive Science StudiesTehranIran
- Neuroimaging and Analysis GroupResearch Center for Cellular and Molecular ImagingTehran University of Medical SciencesTehranIran
- Iranian National Center for Addiction StudiesTehran University of Medical SciencesTehranIran
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Coles AS, Kozak K, George TP. A review of brain stimulation methods to treat substance use disorders. Am J Addict 2018; 27:71-91. [PMID: 29457674 DOI: 10.1111/ajad.12674] [Citation(s) in RCA: 90] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 11/26/2017] [Accepted: 12/16/2017] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Substance use disorders (SUDs) are a leading cause of disability worldwide. While several pharmacological and behavioral treatments for SUDs are available, these may not be effective for all patients. Recent studies using non-invasive neuromodulation techniques including Repetitive Transcranial Magnetic Stimulation (rTMS), Transcranial Direct Current Stimulation (tDCS), and Deep Brain Stimulation (DBS) have shown promise for SUD treatment. OBJECTIVE Multiple studies were evaluated investigating the therapeutic potential of non-invasive brain stimulation techniques in treatment of SUDs. METHOD Through literature searches (eg, PubMed, Google Scholar), 60 studies (2000-2017) were identified examining the effect of rTMS, tDCS, or DBS on cravings and consumption of SUDs, including tobacco, alcohol, cannabis, opioids, and stimulants. RESULTS rTMS and tDCS demonstrated decreases in drug craving and consumption, while early studies with DBS suggest similar results. Results are most encouraging when stimulation is targeted to the Dorsolateral Prefrontal Cortex (DLPFC). CONCLUSIONS Short-term treatment with rTMS and tDCS may have beneficial effects on drug craving and consumption. Future studies should focus on extending therapeutic benefits by increasing stimulation frequency and duration of treatment. SCIENTIFIC SIGNIFICANCE The utility of these methods in SUD treatment and prevention are unclear, and warrants further study using randomized, controlled designs. (Am J Addict 2018;27:71-91).
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Affiliation(s)
- Alexandria S Coles
- Addictions Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Karolina Kozak
- Addictions Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Institute of Medical Sciences (IMS), University of Toronto, Toronto, Ontario, Canada
| | - Tony P George
- Addictions Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Institute of Medical Sciences (IMS), University of Toronto, Toronto, Ontario, Canada.,Division of Brain and Therapeutics, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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De Nobrega AK, Lyons LC. Drosophila: An Emergent Model for Delineating Interactions between the Circadian Clock and Drugs of Abuse. Neural Plast 2017; 2017:4723836. [PMID: 29391952 PMCID: PMC5748135 DOI: 10.1155/2017/4723836] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 08/13/2017] [Indexed: 01/12/2023] Open
Abstract
Endogenous circadian oscillators orchestrate rhythms at the cellular, physiological, and behavioral levels across species to coordinate activity, for example, sleep/wake cycles, metabolism, and learning and memory, with predictable environmental cycles. The 21st century has seen a dramatic rise in the incidence of circadian and sleep disorders with globalization, technological advances, and the use of personal electronics. The circadian clock modulates alcohol- and drug-induced behaviors with circadian misalignment contributing to increased substance use and abuse. Invertebrate models, such as Drosophila melanogaster, have proven invaluable for the identification of genetic and molecular mechanisms underlying highly conserved processes including the circadian clock, drug tolerance, and reward systems. In this review, we highlight the contributions of Drosophila as a model system for understanding the bidirectional interactions between the circadian system and the drugs of abuse, alcohol and cocaine, and illustrate the highly conserved nature of these interactions between Drosophila and mammalian systems. Research in Drosophila provides mechanistic insights into the corresponding behaviors in higher organisms and can be used as a guide for targeted inquiries in mammals.
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Affiliation(s)
- Aliza K. De Nobrega
- Department of Biological Science, Program in Neuroscience, Florida State University, Tallahassee, FL 32306, USA
| | - Lisa C. Lyons
- Department of Biological Science, Program in Neuroscience, Florida State University, Tallahassee, FL 32306, USA
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57
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Transcranial Direct Current Stimulation in Substance Use Disorders: A Systematic Review of Scientific Literature. J ECT 2017; 33:203-209. [PMID: 28272095 DOI: 10.1097/yct.0000000000000401] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION New treatment options such as noninvasive brain stimulation have been recently explored in the field of substance use disorders (SUDs), including transcranial direct current stimulation (tDCS). OBJECTIVES In light of this, we have performed a review of the scientific literature to assess efficacy and technical and methodological issues resulting from applying tDCS to the field of SUDs. METHODS Our analysis highlighted the following selection criteria: clinical studies on tDCS and SUDs (alcohol, caffeine, cannabis, cocaine, heroin, methamphetamine, and nicotine). Study selection, data analysis, and reporting were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Exclusion criteria were as follows: clinical studies about tDCS among behavioral addiction; review and didactic articles; physiopathological studies; and case reports. RESULTS Eighteen scientific papers were selected out of 48 articles. Among these, 16 studied the efficacy of tDCS applied to the dorsolateral prefrontal cortex, and 8 suggested the efficacy of tDCS in reducing substance craving. CONCLUSIONS In light of these data, it is premature to conclude that tDCS over the dorsolateral prefrontal cortex is a very efficient technique in reducing craving. Small sample size, different stimulation protocols, and study duration were the main limitations. However, the efficacy of tDCS in treating SUDs requires further investigation.
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58
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Philip NS, Nelson BG, Frohlich F, Lim KO, Widge AS, Carpenter LL. Low-Intensity Transcranial Current Stimulation in Psychiatry. Am J Psychiatry 2017; 174:628-639. [PMID: 28231716 PMCID: PMC5495602 DOI: 10.1176/appi.ajp.2017.16090996] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Neurostimulation is rapidly emerging as an important treatment modality for psychiatric disorders. One of the fastest-growing and least-regulated approaches to noninvasive therapeutic stimulation involves the application of weak electrical currents. Widespread enthusiasm for low-intensity transcranial electrical current stimulation (tCS) is reflected by the recent surge in direct-to-consumer device marketing, do-it-yourself enthusiasm, and an escalating number of clinical trials. In the wake of this rapid growth, clinicians may lack sufficient information about tCS to inform their clinical practices. Interpretation of tCS clinical trial data is aided by familiarity with basic neurophysiological principles, potential mechanisms of action of tCS, and the complicated regulatory history governing tCS devices. A growing literature includes randomized controlled trials of tCS for major depression, schizophrenia, cognitive disorders, and substance use disorders. The relative ease of use and abundant access to tCS may represent a broad-reaching and important advance for future mental health care. Evidence supports application of one type of tCS, transcranial direct current stimulation (tDCS), for major depression. However, tDCS devices do not have regulatory approval for treating medical disorders, evidence is largely inconclusive for other therapeutic areas, and their use is associated with some physical and psychiatric risks. One unexpected finding to arise from this review is that the use of cranial electrotherapy stimulation devices-the only category of tCS devices cleared for use in psychiatric disorders-is supported by low-quality evidence.
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Affiliation(s)
- Noah S. Philip
- From the Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, and the Center of Excellence for Neurorestoration and Neurotechnology, Providence VA Medical Center, Providence, R.I.; the Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, Mass., and the Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, Mass.; the Department of Psychiatry, the Department of Biomedical Engineering, the
| | - Brent G. Nelson
- From the Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, and the Center of Excellence for Neurorestoration and Neurotechnology, Providence VA Medical Center, Providence, R.I.; the Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, Mass., and the Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, Mass.; the Department of Psychiatry, the Department of Biomedical Engineering, the
| | - Flavio Frohlich
- From the Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, and the Center of Excellence for Neurorestoration and Neurotechnology, Providence VA Medical Center, Providence, R.I.; the Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, Mass., and the Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, Mass.; the Department of Psychiatry, the Department of Biomedical Engineering, the
| | - Kelvin O. Lim
- From the Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, and the Center of Excellence for Neurorestoration and Neurotechnology, Providence VA Medical Center, Providence, R.I.; the Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, Mass., and the Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, Mass.; the Department of Psychiatry, the Department of Biomedical Engineering, the
| | - Alik S. Widge
- From the Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, and the Center of Excellence for Neurorestoration and Neurotechnology, Providence VA Medical Center, Providence, R.I.; the Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, Mass., and the Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, Mass.; the Department of Psychiatry, the Department of Biomedical Engineering, the
| | - Linda L. Carpenter
- From the Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, and the Center of Excellence for Neurorestoration and Neurotechnology, Providence VA Medical Center, Providence, R.I.; the Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, Mass., and the Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, Mass.; the Department of Psychiatry, the Department of Biomedical Engineering, the
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Zhao H, Qiao L, Fan D, Zhang S, Turel O, Li Y, Li J, Xue G, Chen A, He Q. Modulation of Brain Activity with Noninvasive Transcranial Direct Current Stimulation (tDCS): Clinical Applications and Safety Concerns. Front Psychol 2017; 8:685. [PMID: 28539894 PMCID: PMC5423956 DOI: 10.3389/fpsyg.2017.00685] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Accepted: 04/19/2017] [Indexed: 11/13/2022] Open
Abstract
Transcranial direct current stimulation (tDCS) is a widely-used tool to induce neuroplasticity and modulate cortical function by applying weak direct current over the scalp. In this review, we first introduce the underlying mechanism of action, the brief history from discovery to clinical scientific research, electrode positioning and montages, and parameter setup of tDCS. Then, we review tDCS application in clinical samples including people with drug addiction, major depression disorder, Alzheimer's disease, as well as in children. This review covers the typical characteristics and the underlying neural mechanisms of tDCS treatment in such studies. This is followed by a discussion of safety, especially when the current intensity is increased or the stimulation duration is prolonged. Given such concerns, we provide detailed suggestions regarding safety procedures for tDCS operation. Lastly, future research directions are discussed. They include foci on the development of multi-tech combination with tDCS such as with TMS and fMRI; long-term behavioral and morphological changes; possible applications in other research domains, and more animal research to deepen the understanding of the biological and physiological mechanisms of tDCS stimulation.
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Affiliation(s)
- Haichao Zhao
- Faculty of Psychology, Southwest UniversityChongqing, China
| | - Lei Qiao
- Faculty of Psychology, Southwest UniversityChongqing, China
| | - Dongqiong Fan
- Faculty of Psychology, Southwest UniversityChongqing, China
| | - Shuyue Zhang
- School of Education, Guangxi UniversityNanning, China
| | - Ofir Turel
- Department of Information systems and Decision Sciences, College of Business and Economics, California State University, FullertonFullerton, CA, USA
| | - Yonghui Li
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of SciencesBeijing, China
| | - Jun Li
- National Key Laboratory of Cognitive Neuroscience and Learning, IDG/McGovern Institute for Brain Research, Beijing Normal UniversityBeijing, China
| | - Gui Xue
- National Key Laboratory of Cognitive Neuroscience and Learning, IDG/McGovern Institute for Brain Research, Beijing Normal UniversityBeijing, China
| | - Antao Chen
- Faculty of Psychology, Southwest UniversityChongqing, China
| | - Qinghua He
- Faculty of Psychology, Southwest UniversityChongqing, China.,Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of SciencesBeijing, China.,Southwest University Branch, Collaborative Innovation Center of Assessment toward Basic Education Quality at Beijing Normal UniversityChongqing, China
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Spagnolo PA, Goldman D. Neuromodulation interventions for addictive disorders: challenges, promise, and roadmap for future research. Brain 2017; 140:1183-1203. [PMID: 28082299 PMCID: PMC6059187 DOI: 10.1093/brain/aww284] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 08/24/2016] [Accepted: 09/12/2016] [Indexed: 01/27/2023] Open
Abstract
Addictive disorders are a major public health concern, associated with high relapse rates, significant disability and substantial mortality. Unfortunately, current interventions are only modestly effective. Preclinical studies as well as human neuroimaging studies have provided strong evidence that the observable behaviours that characterize the addiction phenotype, such as compulsive drug consumption, impaired self-control, and behavioural inflexibility, reflect underlying dysregulation and malfunction in specific neural circuits. These developments have been accompanied by advances in neuromodulation interventions, both invasive as deep brain stimulation, and non-invasive such as repetitive transcranial magnetic stimulation and transcranial direct current stimulation. These interventions appear particularly promising as they may not only allow us to probe affected brain circuits in addictive disorders, but also seem to have unique therapeutic applications to directly target and remodel impaired circuits. However, the available literature is still relatively small and sparse, and the long-term safety and efficacy of these interventions need to be confirmed. Here we review the literature on the use of neuromodulation in addictive disorders to highlight progress limitations with the aim to suggest future directions for this field.
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Affiliation(s)
- Primavera A Spagnolo
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, USA
| | - David Goldman
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, USA
- Laboratory of Neurogenetics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, USA
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Abstract
Neuroplasticity represents the dynamic structural and functional reorganization of the central nervous system, including its connectivity, due to environmental and internal demands. It is recognized as a major physiological basis for adaption of cognition and behaviour, and, thus, of utmost importance for normal brain function. Cognitive dysfunctions are major symptoms in psychiatric disorders, which are often associated with pathological alteration of neuroplasticity. Transcranial direct current stimulation (tDCS), a recently developed non-invasive brain stimulation technique, is able to induce and modulate cortical plasticity in humans via the application of relatively weak current through the scalp of the head. It has the potential to alter pathological plasticity and restore dysfunctional cognitions in psychiatric diseases. In the last decades, its efficacy to treat psychiatric disorders has been explored increasingly. This review will give an overview of pathological alterations of plasticity in psychiatric diseases, gather clinical studies involving tDCS to ameliorate symptoms, and discuss future directions of application, with an emphasis on optimizing stimulation effects.
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Affiliation(s)
- Min-Fang Kuo
- a Department of Psychology and Neurosciences , Leibniz Research Centre for Working Environment and Human Factors , Dortmund , Germany
| | - Po-See Chen
- b Department of Psychiatry , National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University , Tainan , Taiwan.,c Addiction Research Centre, National Cheng Kung University , Tainan , Taiwan
| | - Michael A Nitsche
- a Department of Psychology and Neurosciences , Leibniz Research Centre for Working Environment and Human Factors , Dortmund , Germany.,d Department of Neurology , University Medical Hospital Bergmannsheil , Bochum , Germany
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62
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Lee JC, Lewis CP, Daskalakis ZJ, Croarkin PE. Transcranial Direct Current Stimulation: Considerations for Research in Adolescent Depression. Front Psychiatry 2017; 8:91. [PMID: 28638351 PMCID: PMC5461263 DOI: 10.3389/fpsyt.2017.00091] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Adolescent depression is a prevalent disorder with substantial morbidity and mortality. Current treatment interventions do not target relevant pathophysiology and are frequently ineffective, thereby leading to a substantial burden for individuals, families, and society. During adolescence, the prefrontal cortex undergoes extensive structural and functional changes. Recent work suggests that frontolimbic development in depressed adolescents is delayed or aberrant. The judicious application of non-invasive brain stimulation techniques to the prefrontal cortex may present a promising opportunity for durable interventions in adolescent depression. Transcranial direct current stimulation (tDCS) applies a low-intensity, continuous current that alters cortical excitability. While this modality does not elicit action potentials, it is thought to manipulate neuronal activity and neuroplasticity. Specifically, tDCS may modulate N-methyl-d-aspartate receptors and L-type voltage-gated calcium channels and effect changes through long-term potentiation or long-term depression-like mechanisms. This mini-review considers the neurobiological rationale for developing tDCS protocols in adolescent depression, reviews existing work in adult mood disorders, surveys the existing tDCS literature in adolescent populations, reviews safety studies, and discusses distinct ethical considerations in work with adolescents.
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Affiliation(s)
- Jonathan C Lee
- Temerty Centre for Therapeutic Brain Intervention, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Faculty of Medicine, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Charles P Lewis
- Mayo Clinic Depression Center, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
| | - Zafiris J Daskalakis
- Temerty Centre for Therapeutic Brain Intervention, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Faculty of Medicine, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Paul E Croarkin
- Mayo Clinic Depression Center, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
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Kroczek AM, Häußinger FB, Rohe T, Schneider S, Plewnia C, Batra A, Fallgatter AJ, Ehlis AC. Effects of transcranial direct current stimulation on craving, heart-rate variability and prefrontal hemodynamics during smoking cue exposure. Drug Alcohol Depend 2016; 168:123-127. [PMID: 27639130 DOI: 10.1016/j.drugalcdep.2016.09.006] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2016] [Revised: 09/02/2016] [Accepted: 09/03/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Drug-related cue exposure elicits craving and risk for relapse during recovery. Transcranial direct current stimulation is a promising research tool and possible treatment for relapse prevention. Enhanced functional neuroconnectivity is discussed as a treatment target. The goal of this research was to examine whether transcranial direct current stimulation affected cortical hemodynamic indicators of functional connectivity, craving, and heart rate variability during smoking-related cue exposure in non-treatment-seeking smokers. METHOD In vivo smoking cue exposure supported by a 2mA transcranial direct current stimulation (anode: dorsolateral prefrontal cortex, cathode: orbitofrontal cortex; placebo-controlled, randomized, double-blind) in 29 (age: M=25, SD=5) German university students (smoking at least once a week). Cue reactivity was assessed on an autonomous (heart rate variability) and a subjective level (craving ratings). Functional near-infrared spectroscopy measured changes in the concentration of deoxygenated hemoglobin, and seed-based correlation analysis was used to quantify prefrontal connectivity of brain regions involved in cue reactivity. RESULTS Cue exposure elicited increased subjective craving and heart rate variability changes in smokers. Connectivity between the orbitofrontal and dorsolateral prefrontal cortex was increased in subjects receiving verum compared to placebo stimulation (d=0.66). Hemodynamics in the left dorsolateral prefrontal cortex, however, increased in the group receiving sham stimulation (η2=0.140). Transcranial direct current stimulation did not significantly alter craving or heart rate variability during cue exposure. CONCLUSION Prefrontal connectivity - between regions involved in the processing of reinforcement value and cognitive control - was increased by anodal transcranial direct current stimulation during smoking cue exposure. Possible clinical implications should be considered in future studies.
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Affiliation(s)
- A M Kroczek
- Department of Psychiatry and Psychotherapy Tuebingen, University of Tuebingen, Germany; Graduate School of Neural and Behavioural Sciences Tuebingen, Germany.
| | - F B Häußinger
- Department of Psychiatry and Psychotherapy Tuebingen, University of Tuebingen, Germany; Graduate School of Neural and Behavioural Sciences Tuebingen, Germany
| | - T Rohe
- Department of Psychiatry and Psychotherapy Tuebingen, University of Tuebingen, Germany
| | - S Schneider
- Department of Psychiatry and Psychotherapy Tuebingen, University of Tuebingen, Germany
| | - C Plewnia
- Department of Psychiatry and Psychotherapy Tuebingen, University of Tuebingen, Germany; Werner Reichardt Centre for Integrative Neuroscience, Tuebingen, Germany
| | - A Batra
- Department of Psychiatry and Psychotherapy Tuebingen, University of Tuebingen, Germany
| | - A J Fallgatter
- Department of Psychiatry and Psychotherapy Tuebingen, University of Tuebingen, Germany; LEAD Graduate School Tuebingen, Germany; Werner Reichardt Centre for Integrative Neuroscience, Tuebingen, Germany
| | - A-C Ehlis
- Department of Psychiatry and Psychotherapy Tuebingen, University of Tuebingen, Germany; LEAD Graduate School Tuebingen, Germany
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Shariatirad S, Vaziri A, Hassani-Abharian P, Sharifi Fardshad M, Molavi N, Fitzgerald PB. Cumulative and booster effects of tdcs sessions on drug cravings, lapse, and cognitive impairment in methamphetamine use disorder: A case study report. Am J Addict 2016; 25:264-6. [PMID: 27219624 DOI: 10.1111/ajad.12373] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 03/15/2016] [Accepted: 03/15/2016] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Transcranial Direct Current Stimulation (tDCS) is a non-invasive brain stimulation method, which shows promising therapeutic effects in controlling drug cravings. METHODS In this study, we present cumulative and booster effects of tDCS sessions on methamphetamine cravings, lapse, and cognitive impairment in a methamphetamine dependent subject. RESULTS Our study shows cumulative effects of continuous anodal tDCS sessions on right dorsolateral prefrontal cortex (DLPFC) could reduce drug cravings and their consequences. DISCUSSION AND CONCLUSIONS Moreover, booster tDCS treatments might be helpful in controlling psychological stress and drug cravings. (Am J Addict 2016;25:264-266).
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Affiliation(s)
- Schwann Shariatirad
- Students Research Center of International Campus, Tehran University of Medical Sciences, Tehran, Iran.,Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Alaleh Vaziri
- Students Research Center of International Campus, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mona Sharifi Fardshad
- Department of General Psychology, Karaj Branch, Islamic Azad University, Karaj, Iran
| | - Nader Molavi
- Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.,Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Paul B Fitzgerald
- Monash Alfred Psychiatry Research Centre, Monash University Central Clinical School and the Alfred, Melbourne, Australia
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Trojak B, Soudry-Faure A, Abello N, Carpentier M, Jonval L, Allard C, Sabsevari F, Blaise E, Ponavoy E, Bonin B, Meille V, Chauvet-Gelinier JC. Efficacy of transcranial direct current stimulation (tDCS) in reducing consumption in patients with alcohol use disorders: study protocol for a randomized controlled trial. Trials 2016; 17:250. [PMID: 27188795 PMCID: PMC4869375 DOI: 10.1186/s13063-016-1363-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Accepted: 04/24/2016] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Approximately 15 million persons in the European Union and 10 million persons in the USA are alcohol-dependent. The global burden of disease and injury attributable to alcohol is considerable: worldwide, approximately one in 25 deaths in 2004 was caused by alcohol. At the same time, alcohol use disorders remain seriously undertreated. In this context, alternative or adjunctive therapies such as brain stimulation may play a prominent role. The early results of studies using transcranial direct current stimulation found that stimulations delivered to the dorsolateral prefrontal cortex result in a significant reduction of craving and an improvement of the decision-making processes in various additive disorders. We, therefore, hypothesize that transcranial direct current stimulation can lead to a decrease in alcohol consumption in patients suffering from alcohol use disorders. METHODS/DESIGN We report the protocol of a randomized, double-blind, placebo-controlled, parallel-group trial, to evaluate the efficacy of transcranial direct current stimulation on alcohol reduction in patients with an alcohol use disorder. The study will be conducted in 14 centers in France and Monaco. Altogether, 340 subjects over 18 years of age and diagnosed with an alcohol use disorder will be randomized to receive five consecutive twice-daily sessions of either active or placebo transcranial direct current stimulation. One session consists in delivering a current flow continuously (anode F4; cathode F3) twice for 13 minutes, with treatments separated by a rest interval of 20 min. Efficacy will be evaluated using the change from baseline (alcohol consumption during the 4 weeks before randomization) to 24 weeks in the total alcohol consumption and number of heavy drinking days. Secondary outcome measures will include alcohol craving, clinical and biological improvements, and the effects on mood and quality of life, as well as cognitive and safety assessments, and, for smokers, an assessment of the effects of transcranial direct current stimulation on tobacco consumption. DISCUSSION Several studies have reported a beneficial effect of transcranial direct current stimulation on substance use disorders by reducing craving, impulsivity, and risk-taking behavior, and suggest that transcranial direct current stimulation may be a promising treatment in addiction. However, to date, no studies have included sufficiently large samples and sufficient follow-up to confirm the hypothesis. Results from this large randomized controlled trial will give a better overview of the therapeutic potential of transcranial direct current stimulation in alcohol use disorders. TRIAL REGISTRATION Clinical Trials Gov, NCT02505126 (registration date: July 15 2015).
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Affiliation(s)
- Benoit Trojak
- Department of Psychiatry and Addictology, University Hospital of Dijon, 21079, Dijon Cedex, France.
| | - Agnès Soudry-Faure
- Unité de Soutien Méthodologique, DRCI, University Hospital of Dijon, 21079, Dijon Cedex, France
| | - Nicolas Abello
- Direction of Clinical Research, University Hospital of Dijon, 21079, Dijon Cedex, France
| | - Maud Carpentier
- Direction of Clinical Research, University Hospital of Dijon, 21079, Dijon Cedex, France
| | - Lysiane Jonval
- Direction of Clinical Research, University Hospital of Dijon, 21079, Dijon Cedex, France
| | - Coralie Allard
- Department of Psychiatry and Addictology, University Hospital of Dijon, 21079, Dijon Cedex, France.,Direction of Clinical Research, University Hospital of Dijon, 21079, Dijon Cedex, France
| | - Foroogh Sabsevari
- Department of Psychiatry and Addictology, University Hospital of Dijon, 21079, Dijon Cedex, France
| | - Emilie Blaise
- Department of Psychiatry and Addictology, University Hospital of Dijon, 21079, Dijon Cedex, France
| | - Eddy Ponavoy
- Department of Psychiatry and Addictology, University Hospital of Dijon, 21079, Dijon Cedex, France
| | - Bernard Bonin
- Department of Psychiatry and Addictology, University Hospital of Dijon, 21079, Dijon Cedex, France
| | - Vincent Meille
- Department of Psychiatry and Addictology, University Hospital of Dijon, 21079, Dijon Cedex, France
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Wang D, Zhou C, Zhao M, Wu X, Chang YK. Dose-response relationships between exercise intensity, cravings, and inhibitory control in methamphetamine dependence: An ERPs study. Drug Alcohol Depend 2016; 161:331-9. [PMID: 26946990 DOI: 10.1016/j.drugalcdep.2016.02.023] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 02/11/2016] [Accepted: 02/12/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND The present study integrated behavioral and neuroelectric approaches for determining the dose-response relationships between exercise intensity and methamphetamine (MA) craving and between exercise intensity and inhibitory control in individuals with MA dependence. METHODS Ninety-two individuals with MA dependence were randomly assigned to an exercise group (light, moderate, or vigorous intensity) or to a reading control group. The participants then completed a craving self-report at four time points: before exercise, during exercise, immediately after exercise, and 50 min after exercise. Event-related potentials were also recorded while the participants completed a standard Go/NoGo task and an MA-related Go/NoGo task approximately 20 min after exercise cessation. RESULTS The reduction in self-reported MA craving scores of the moderate and vigorous intensity groups was greater than that of the light intensity and control groups during acute exercise as well as immediately and 50 min following exercise termination. Additionally, an inverted-U-shaped relationship between exercise intensity and inhibitory control was generally observed for the behavioral and neuroelectric indices, with the moderate intensity group exhibiting shorter Go reaction times, increased NoGo accuracy, and larger NoGo-N2 amplitudes. CONCLUSIONS Acute exercise may provide benefits for MA-associated craving and inhibitory control in MA-dependent individuals, as revealed by behavioral and neuroelectric measures. Moderate-intensity exercise may be associated with more positive effects, providing preliminary evidence for the establishment of an exercise prescription regarding intensity for MA dependence.
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Affiliation(s)
- Dongshi Wang
- Faculty of Physical Education, Ningbo University, Ningbo 315211, People's Republic of China; School of Kinesiology, Shanghai University of Sport, Shanghai 200438, People's Republic of China
| | - Chenglin Zhou
- School of Kinesiology, Shanghai University of Sport, Shanghai 200438, People's Republic of China
| | - Min Zhao
- Shanghai Mental Health Center, Shanghai 200030, People's Republic of China
| | - Xueping Wu
- College of Physical Education and Training, Shanghai University of Sport, Shanghai 200438, People's Republic of China.
| | - Yu-Kai Chang
- Graduate Institute of Athletics and Coaching Science, National Taiwan Sport University, 333, Taiwan.
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A systematic review of the clinical efficacy of transcranial direct current stimulation (tDCS) in psychiatric disorders. J Psychiatr Res 2016; 74:70-86. [PMID: 26765514 DOI: 10.1016/j.jpsychires.2015.12.018] [Citation(s) in RCA: 122] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 12/17/2015] [Accepted: 12/18/2015] [Indexed: 11/23/2022]
Abstract
Transcranial direct current stimulation (tDCS) is a non-invasive neuromodulation technique, which can be used to selectively disrupt patterns of neural activity that are associated with symptoms of mental illness. tDCS has been implemented in numerous therapeutic trials across a range of patient populations, with a rapidly increasing number of studies being published each year. This systematic review aimed to evaluate the efficacy of tDCS in the treatment of psychiatric disorders. Four electronic databases were searched from inception until December 2015 by two independent reviewers, and 66 eligible studies were identified. Depression was the most extensively researched condition, followed by schizophrenia and substance use disorders. Data on obsessive compulsive disorder, generalised anxiety disorder, and anorexia nervosa were also obtained. The quality of included studies was appraised using a standardised assessment framework, which yielded a median score corresponding to "weak" on the three-point scale. This improved to "moderate" when case reports/series were excluded from the analysis. Overall, data suggested that tDCS interventions comprising multiple sessions can ameliorate symptoms of several major psychiatric disorders, both acutely and in the long-term. Nevertheless, the tDCS field is still in its infancy, and several methodological and ethical issues must be addressed before clinical efficacy can truly be determined. Studies probing the mechanisms of action of tDCS and those facilitating the definition of optimised stimulation protocols are warranted. Furthermore, evidence from large-scale, multi-centre randomised controlled trials is required if the transition of this therapy from the laboratory to the clinic is to be considered.
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Pérez C, Leite J, Carvalho S, Fregni F. Transcranial Electrical Stimulation (tES) for the Treatment of Neuropsychiatric Disorders Across Lifespan. EUROPEAN PSYCHOLOGIST 2016. [DOI: 10.1027/1016-9040/a000252] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Abstract. Transcranial electrical stimulation (tES) is a safe, painless, and inexpensive noninvasive brain stimulation (NIBS) technique. tES has been shown to reduce symptoms in a variety of neuropsychiatric conditions such as depression, schizophrenia, anxiety, autism, and craving. There are many factors that can influence the effects of tES, such as current intensity, duration, baseline level of activity, gender, and age. Age is a critical variable, since the human brain undergoes several anatomic and functional changes across the lifespan. Therefore, tES-induced effects may not be the same across the lifespan. In this review we summarize the effects of tES, including tDCS, tACS, and tRNS, on clinical outcomes in several neuropsychiatric conditions, using a framework in which studies are organized according to the age of subjects. The use of tES in neuropsychiatric disorders has yielded promising results with mild, if any, adverse effects. Most of the published studies with tES have been conducted with tDCS in adult population. Future studies should focus on interventions guided by surrogate outcomes of neuroplasticity. A better understanding of neuroplasticity across the lifespan will help optimize current tES stimulation parameters, especially for use with children and elderly populations.
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Affiliation(s)
- Carolina Pérez
- Spaulding Neuromodulation Center, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Jorge Leite
- Spaulding Neuromodulation Center, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Neuropsychophysiology Laboratory, CIPsi, School of Psychology (EPsi), University of Minho, Braga, Portugal
| | - Sandra Carvalho
- Spaulding Neuromodulation Center, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Neuropsychophysiology Laboratory, CIPsi, School of Psychology (EPsi), University of Minho, Braga, Portugal
| | - Felipe Fregni
- Spaulding Neuromodulation Center, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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71
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Neuroscience of drug craving for addiction medicine: From circuits to therapies. PROGRESS IN BRAIN RESEARCH 2015; 223:115-41. [PMID: 26806774 DOI: 10.1016/bs.pbr.2015.10.002] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Drug craving is a dynamic neurocognitive emotional-motivational response to a wide range of cues, from internal to external environments and from drug-related to stressful or affective events. The subjective feeling of craving, as an appetitive or compulsive state, could be considered a part of this multidimensional process, with modules in different levels of consciousness and embodiment. The neural correspondence of this dynamic and complex phenomenon may be productively investigated in relation to regional, small-scale networks, large-scale networks, and brain states. Within cognitive neuroscience, this approach has provided a long list of neural and cognitive targets for craving modulations with different cognitive, electrical, or pharmacological interventions. There are new opportunities to integrate different approaches for carving management from environmental, behavioral, psychosocial, cognitive, and neural perspectives. By using cognitive neuroscience models that treat drug craving as a dynamic and multidimensional process, these approaches may yield more effective interventions for addiction medicine.
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Hone-Blanchet A, Ciraulo DA, Pascual-Leone A, Fecteau S. Noninvasive brain stimulation to suppress craving in substance use disorders: Review of human evidence and methodological considerations for future work. Neurosci Biobehav Rev 2015; 59:184-200. [PMID: 26449761 PMCID: PMC5365234 DOI: 10.1016/j.neubiorev.2015.10.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Revised: 09/10/2015] [Accepted: 10/01/2015] [Indexed: 12/19/2022]
Abstract
Substance use disorders (SUDs) can be viewed as a pathology of neuroadaptation. The pharmacological overstimulation of neural mechanisms of reward, motivated learning and memory leads to drug-seeking behavior. A critical characteristic of SUDs is the appearance of craving, the motivated desire and urge to use, which is a main focus of current pharmacological and behavioral therapies. Recent proof-of-concept studies have tested the effects of noninvasive brain stimulation on craving. Although its mechanisms of action are not fully understood, this approach shows interesting potential in tuning down craving and possibly consumption of diverse substances. This article reviews available results on the use of repetitive transcranial magnetic stimulation (rTMS) and transcranial electrical stimulation (tES) in SUDs, specifically tobacco, alcohol and psychostimulant use disorders. We discuss several important factors that need to be addressed in future works to improve clinical assessment and effects of noninvasive brain stimulation in SUDs. Factors discussed include brain stimulation devices and parameters, study designs, brain states and subjects' characteristics.
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Affiliation(s)
- Antoine Hone-Blanchet
- Laboratory of Canada Research Chair in Cognitive Neuroplasticity, Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale, Centre de Recherche de l'Institut Universitaire en Santé Mentale de Québec, Faculté de Médecine, Université Laval, Québec, QC, Canada
| | - Domenic A Ciraulo
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Alvaro Pascual-Leone
- Berenson-Allen Center for Noninvasive Brain Stimulation and Division of Translational Cognitive Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Shirley Fecteau
- Laboratory of Canada Research Chair in Cognitive Neuroplasticity, Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale, Centre de Recherche de l'Institut Universitaire en Santé Mentale de Québec, Faculté de Médecine, Université Laval, Québec, QC, Canada; Berenson-Allen Center for Noninvasive Brain Stimulation and Division of Translational Cognitive Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
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Notzon S, Deppermann S, Fallgatter A, Diemer J, Kroczek A, Domschke K, Zwanzger P, Ehlis AC. Psychophysiological effects of an iTBS modulated virtual reality challenge including participants with spider phobia. Biol Psychol 2015; 112:66-76. [DOI: 10.1016/j.biopsycho.2015.10.003] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Revised: 09/28/2015] [Accepted: 10/08/2015] [Indexed: 12/21/2022]
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Yavari F, Shahbabaie A, Leite J, Carvalho S, Ekhtiari H, Fregni F. Noninvasive brain stimulation for addiction medicine: From monitoring to modulation. PROGRESS IN BRAIN RESEARCH 2015; 224:371-99. [PMID: 26822367 DOI: 10.1016/bs.pbr.2015.08.007] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Addiction is a chronic relapsing brain disease with significant economical and medical burden on the societies but with limited effectiveness in the available treatment options. Better understanding of the chemical, neuronal, regional, and network alterations of the brain due to drug abuse can ultimately lead to tailoring individualized and more effective interventions. To this end, employing new assessment and intervention procedures seems crucial. Noninvasive brain stimulation (NIBS) techniques including transcranial electrical and magnetic stimulations (tES and TMS) have provided promising opportunities for the addiction medicine in two main domains: (1) providing new insights into neurochemical and neural circuit changes in the human brain cortex and (2) understanding the role of different brain regions by using NIBS and modulating cognitive functions, such as drug craving, risky decision making, inhibitory control and executive functions to obtain specific treatment outcomes. In spite of preliminary positive results, there are several open questions, which need to be addressed before routine clinical utilization of NIBS techniques in addiction to medicine, such as how to account for interindividual differences, define optimal cognitive and neural targets, optimize stimulation protocols, and integrate NIBS with other therapeutic methods. Therefore, in this chapter we revise the available literature on the use of NIBS (TMS and tES) in the diagnostic, prognostic, and therapeutic aspects of the addiction medicine.
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Affiliation(s)
- Fatemeh Yavari
- Neurocognitive Laboratory, Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Shahbabaie
- Neurocognitive Laboratory, Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran; Translational Neuroscience Program, Institute for Cognitive Science Studies (ICSS), Tehran, Iran; Neuroimaging and Analysis Group, Research Center for Molecular and Cellular Imaging (RCMCI), Tehran University of Medical Sciences, Tehran, Iran
| | - Jorge Leite
- Department of Physical Medicine and Rehabilitation, Laboratory of Neuromodulation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Neuropsychophysiology Laboratory, CIPsi, School of Psychology (EPsi), University of Minho, Braga, Portugal
| | - Sandra Carvalho
- Department of Physical Medicine and Rehabilitation, Laboratory of Neuromodulation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Neuropsychophysiology Laboratory, CIPsi, School of Psychology (EPsi), University of Minho, Braga, Portugal
| | - Hamed Ekhtiari
- Neurocognitive Laboratory, Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran; Translational Neuroscience Program, Institute for Cognitive Science Studies (ICSS), Tehran, Iran; Neuroimaging and Analysis Group, Research Center for Molecular and Cellular Imaging (RCMCI), Tehran University of Medical Sciences, Tehran, Iran.
| | - Felipe Fregni
- Department of Physical Medicine and Rehabilitation, Laboratory of Neuromodulation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
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Krook-Magnuson E, Gelinas JN, Soltesz I, Buzsáki G. Neuroelectronics and Biooptics: Closed-Loop Technologies in Neurological Disorders. JAMA Neurol 2015; 72:823-9. [PMID: 25961887 DOI: 10.1001/jamaneurol.2015.0608] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Brain-implanted devices are no longer a futuristic idea. Traditionally, therapies for most neurological disorders are adjusted based on changes in clinical symptoms and diagnostic measures observed over time. These therapies are commonly pharmacological or surgical, requiring continuous or irreversible treatment regimens that cannot respond rapidly to fluctuations of symptoms or isolated episodes of dysfunction. In contrast, closed-loop systems provide intervention only when needed by detecting abnormal neurological signals and modulating them with instantaneous feedback. Closed-loop systems have been applied to several neurological conditions (most notably epilepsy and movement disorders), but widespread use is limited by conceptual and technical challenges. Herein, we discuss how advances in experimental closed-loop systems hold promise for improved clinical benefit in patients with neurological disorders.
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Affiliation(s)
| | - Jennifer N Gelinas
- New York University Neuroscience Institute, Langone Medical Center, New York3New York University Center for Neural Sciences, New York
| | - Ivan Soltesz
- Department of Anatomy and Neurobiology, University of California, Irvine
| | - György Buzsáki
- New York University Neuroscience Institute, Langone Medical Center, New York3New York University Center for Neural Sciences, New York
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Non-invasive Human Brain Stimulation in Cognitive Neuroscience: A Primer. Neuron 2015; 87:932-45. [DOI: 10.1016/j.neuron.2015.07.032] [Citation(s) in RCA: 172] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Revised: 06/07/2015] [Accepted: 07/16/2015] [Indexed: 11/21/2022]
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Alam-mehrjerdi Z, Mokri A, Dolan K. Methamphetamine use and treatment in Iran: A systematic review from the most populated Persian Gulf country. Asian J Psychiatr 2015; 16:17-25. [PMID: 26123235 DOI: 10.1016/j.ajp.2015.05.036] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Revised: 05/11/2015] [Accepted: 05/19/2015] [Indexed: 11/26/2022]
Abstract
AIM Methamphetamine use is a new health concern in Iran, the most populated Persian Gulf country. However, there is no well-documented literature. The current study objectives were to systematically review all published English and Persian studies of the prevalence of methamphetamine use, the general physical and psychiatric-related harms and the availability of methamphetamine treatment and harm reduction services for adult users in Iran. MATERIALS AND METHODS A comprehensive search of the international peer-reviewed and gray literature was undertaken. Multiple electronic and scientific English and Persian databases were systematically searched from January 2002 to September 2014. Additionally, English and Persian gray literature on methamphetamine use was sought using online gray literature databases, library databases and general online searches over the same period of time. RESULTS Nineteen thousand and two hundred and eight studies, reports and conference papers were identified but only 42 studies were relevant to the study objectives. They were mainly published in 2010-2014. The search results confirmed the seizures of methamphetamine (six studies), the prevalence of methamphetamine use among the general population (three studies), drug users (four studies), women (nine studies) and opiate users in opiate treatment programs (five studies). In addition, methamphetamine use had resulted in blood-borne viral infections (one study), psychosis and intoxication (ten studies). Different reasons had facilitated methamphetamine use. However, the Matrix Model, community therapy and harm reduction services (four studies) had been provided for methamphetamine users in some cities. CONCLUSION The current situation of methamphetamine use necessitates more research on the epidemiology and health-related implications. These studies should help in identifying priorities for designing and implementing prevention and educational programs. More active models of engagement with Persian methamphetamine users and the provision of services that meet their specific treatment needs are required.
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Affiliation(s)
- Zahra Alam-mehrjerdi
- Program of International Research and Training, National Drug and Alcohol Research Centre, Faculty of Public Health and Community Medicine, University of New South Wales, Sydney, Australia.
| | - Azarakhsh Mokri
- Department of Psychiatry, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Kate Dolan
- Program of International Research and Training, National Drug and Alcohol Research Centre, Faculty of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
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Batista EK, Klauss J, Fregni F, Nitsche MA, Nakamura-Palacios EM. A Randomized Placebo-Controlled Trial of Targeted Prefrontal Cortex Modulation with Bilateral tDCS in Patients with Crack-Cocaine Dependence. Int J Neuropsychopharmacol 2015; 18:pyv066. [PMID: 26065432 PMCID: PMC4675977 DOI: 10.1093/ijnp/pyv066] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 06/03/2015] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Transcranial direct current stimulation over the dorsolateral prefrontal cortex has been shown to be clinically useful in the treatment of drug addiction. METHODS We conducted a double-blind randomized clinical trial aiming to assess the effects of bilateral dorsolateral prefrontal cortex transcranial direct current stimulation (left cathodal/right anodal) on crack-cocaine addiction. We defined craving as the primary outcome, and other clinical measurements, including depressive and anxiety symptoms, and quality of life, as secondary outcomes. Seventeen male crack-cocaine users (mean age 30.4 ± 9.8 SD) were randomized to receive 5 sessions of active transcranial direct current stimulation (2 mA, 35 cm(2), for 20 minutes), every other day, and 19 males (mean age 30.3 ± 8.4 SD) to receive sham-transcranial direct current stimulation (placebo) as control group. RESULTS Craving scores were significantly reduced in the transcranial direct current stimulation group after treatment when compared with sham-transcranial direct current stimulation (P = .028) and baseline values (P = .003), and decreased linearly over 4 weeks (before, during, and after treatment) in the transcranial direct current stimulation group only (P = .047). Changes of anxiety scores towards increase in the sham-transcranial direct current stimulation and decrease in the transcranial direct current stimulation group (P = .03), and of the overall perception of quality of life (P = .031) and of health (P = .048) towards decrease in the sham-transcranial direct current stimulation group and increase in the transcranial direct current stimulation group differed significantly between groups. CONCLUSIONS Repetitive bilateral transcranial direct current stimulation over the dorsolateral prefrontal cortex reduced craving for crack-cocaine use, decreased anxiety, and improved quality of life. We hypothesize that transcranial direct current stimulation effects may be associated with increased prefrontal processing and regulation of craving behavior.
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Affiliation(s)
| | | | | | | | - Ester Miyuki Nakamura-Palacios
- Laboratory of Cognitive Sciences and Neuropsychopharmacology, Program of Post-Graduation in Physiological Sciences, Federal University of Espírito Santo, Vitória-ES, Brazil (Dr Batista, Ms Klauss, and Dr Palacios); Spaulding Neuromodulation Center, Department of Physical Medicine & Rehabilitation, Massachusetts General Hospital, Spaulding Neuromodulation Center, Harvard Medical School, Boston, MA (Dr Fregni); Berenson-Allen Center for Non-invasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (Dr Fregni); Laboratory of Neuroplasticity, University Medical Center, Department of Clinical Neurophysiology, Georg-August-University, Göttingen, Germany (Dr Nitsche); Leibniz Research Centre for Working Environment and Human Resources, Dortmund, Germany (Dr Nitsche); Department of Neurology, University Medical Hospital Bergmannsheil, Bochum, Germany (Dr Nitsche).
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Li LM, Uehara K, Hanakawa T. The contribution of interindividual factors to variability of response in transcranial direct current stimulation studies. Front Cell Neurosci 2015; 9:181. [PMID: 26029052 PMCID: PMC4428123 DOI: 10.3389/fncel.2015.00181] [Citation(s) in RCA: 292] [Impact Index Per Article: 32.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2015] [Accepted: 04/25/2015] [Indexed: 01/08/2023] Open
Abstract
There has been an explosion of research using transcranial direct current stimulation (tDCS) for investigating and modulating human cognitive and motor function in healthy populations. It has also been used in many studies seeking to improve deficits in disease populations. With the slew of studies reporting “promising results” for everything from motor recovery after stroke to boosting memory function, one could be easily seduced by the idea of tDCS being the next panacea for all neurological ills. However, huge variability exists in the reported effects of tDCS, with great variability in the effect sizes and even contradictory results reported. In this review, we consider the interindividual factors that may contribute to this variability. In particular, we discuss the importance of baseline neuronal state and features, anatomy, age and the inherent variability in the injured brain. We additionally consider how interindividual variability affects the results of motor-evoked potential (MEP) testing with transcranial magnetic stimulation (TMS), which, in turn, can lead to apparent variability in response to tDCS in motor studies.
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Affiliation(s)
- Lucia M Li
- Department of Advanced Neuroimaging, Integrative Brain Imaging Center, National Center of Neurology and Psychiatry Tokyo, Japan ; Computational, Cognitive and Clinical Neuroimaging Laboratory, Division of Restorative Neurosciences, Imperial College London London, UK
| | - Kazumasa Uehara
- Department of Advanced Neuroimaging, Integrative Brain Imaging Center, National Center of Neurology and Psychiatry Tokyo, Japan ; Research Fellow of the Japan Society for the Promotion of Science Tokyo Japan
| | - Takashi Hanakawa
- Department of Advanced Neuroimaging, Integrative Brain Imaging Center, National Center of Neurology and Psychiatry Tokyo, Japan
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