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Wu LL, Potenza MN, Zhou N, Kober H, Shi XH, Yip SW, Xu JH, Zhu L, Wang R, Liu GQ, Zhang JT. Efficacy of single-session transcranial direct current stimulation on addiction-related inhibitory control and craving: a randomized trial in males with Internet gaming disorder. J Psychiatry Neurosci 2021; 46:E111-E118. [PMID: 33119491 PMCID: PMC7955853 DOI: 10.1503/jpn.190137] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Transcranial direct current stimulation (tDCS) of the dorsolateral prefrontal cortex (dlPFC) may reduce substance use and other addictive behaviours. However, the cognitive mechanisms that underpin such effects remain unclear. Impaired inhibitory control linked to hypoactivation of the prefrontal cortex may allow craving-related motivations to lead to compulsive addictive behaviours. However, very few studies have examined whether increasing the activation of the dlPFC via anodal tDCS could enhance inhibitory control over addiction-related distractors. The current study aimed to enrich empirical evidence related to this issue. METHODS Thirty-three males with Internet gaming disorder underwent active (1.5 mA for 20 minutes) and sham tDCS 1 week apart, in randomized order. We assessed inhibitory control over gaming-related distractors and craving pre- and post-stimulation. RESULTS Relative to sham treatment, active tDCS reduced interference from gaming-related (versus non-gaming) distractors and attenuated background craving, but did not affect cue-induced craving. LIMITATIONS This study was limited by its relatively small sample size and the fact that it lacked assessments of tDCS effects on addictive behaviour. Future tDCS studies with multiple sessions in larger samples are warranted to examine the effects on addictive behaviours of alterations in addiction-related inhibitory control. CONCLUSION These findings demonstrate that stimulation of the dlPFC influences inhibitory control over addiction-related cues and addiction-related motivation. This is the first empirical study to suggest that enhanced inhibitory control may be a cognitive mechanism underlying the effects of tDCS on addictions like Internet gaming disorder. Our finding of attenuated background craving replicated previous tDCS studies. Intriguingly, our finding of distinct tDCS effects on 2 forms of craving suggests that they may have disparate underlying mechanisms or differential sensitivity to tDCS. CLINICAL TRIALS # NCT03352973.
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Affiliation(s)
- Lu-Lu Wu
- From the State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China (Wu, Xu, Shi, Zhu, Wang, Liu, Zhang); the Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA (Potenza, Kober, Yip); the Child Study Center, Yale University School of Medicine, New Haven, CT, USA (Potenza); the Department of Neuroscience, Yale University School of Medicine, Connecticut Mental Health Center, New Haven, Connecticut Council on Problem Gambling, Wethersfield, CT, USA (Potenza); the Connecticut Council on Problem Gambling, Wethersfield, CT, USA (Potenza); the Connecticut Mental Health Center, New Haven, CT, USA (Potenza); the Faculty of Education, Beijing Normal University, Beijing 100875, China (Zhou); and the Department of Psychology, Yale University School of Medicine, New Haven, CT, USA (Kober)
| | - Marc N Potenza
- From the State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China (Wu, Xu, Shi, Zhu, Wang, Liu, Zhang); the Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA (Potenza, Kober, Yip); the Child Study Center, Yale University School of Medicine, New Haven, CT, USA (Potenza); the Department of Neuroscience, Yale University School of Medicine, Connecticut Mental Health Center, New Haven, Connecticut Council on Problem Gambling, Wethersfield, CT, USA (Potenza); the Connecticut Council on Problem Gambling, Wethersfield, CT, USA (Potenza); the Connecticut Mental Health Center, New Haven, CT, USA (Potenza); the Faculty of Education, Beijing Normal University, Beijing 100875, China (Zhou); and the Department of Psychology, Yale University School of Medicine, New Haven, CT, USA (Kober)
| | - Nan Zhou
- From the State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China (Wu, Xu, Shi, Zhu, Wang, Liu, Zhang); the Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA (Potenza, Kober, Yip); the Child Study Center, Yale University School of Medicine, New Haven, CT, USA (Potenza); the Department of Neuroscience, Yale University School of Medicine, Connecticut Mental Health Center, New Haven, Connecticut Council on Problem Gambling, Wethersfield, CT, USA (Potenza); the Connecticut Council on Problem Gambling, Wethersfield, CT, USA (Potenza); the Connecticut Mental Health Center, New Haven, CT, USA (Potenza); the Faculty of Education, Beijing Normal University, Beijing 100875, China (Zhou); and the Department of Psychology, Yale University School of Medicine, New Haven, CT, USA (Kober)
| | - Hedy Kober
- From the State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China (Wu, Xu, Shi, Zhu, Wang, Liu, Zhang); the Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA (Potenza, Kober, Yip); the Child Study Center, Yale University School of Medicine, New Haven, CT, USA (Potenza); the Department of Neuroscience, Yale University School of Medicine, Connecticut Mental Health Center, New Haven, Connecticut Council on Problem Gambling, Wethersfield, CT, USA (Potenza); the Connecticut Council on Problem Gambling, Wethersfield, CT, USA (Potenza); the Connecticut Mental Health Center, New Haven, CT, USA (Potenza); the Faculty of Education, Beijing Normal University, Beijing 100875, China (Zhou); and the Department of Psychology, Yale University School of Medicine, New Haven, CT, USA (Kober)
| | - Xin-Hui Shi
- From the State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China (Wu, Xu, Shi, Zhu, Wang, Liu, Zhang); the Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA (Potenza, Kober, Yip); the Child Study Center, Yale University School of Medicine, New Haven, CT, USA (Potenza); the Department of Neuroscience, Yale University School of Medicine, Connecticut Mental Health Center, New Haven, Connecticut Council on Problem Gambling, Wethersfield, CT, USA (Potenza); the Connecticut Council on Problem Gambling, Wethersfield, CT, USA (Potenza); the Connecticut Mental Health Center, New Haven, CT, USA (Potenza); the Faculty of Education, Beijing Normal University, Beijing 100875, China (Zhou); and the Department of Psychology, Yale University School of Medicine, New Haven, CT, USA (Kober)
| | - Sarah W Yip
- From the State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China (Wu, Xu, Shi, Zhu, Wang, Liu, Zhang); the Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA (Potenza, Kober, Yip); the Child Study Center, Yale University School of Medicine, New Haven, CT, USA (Potenza); the Department of Neuroscience, Yale University School of Medicine, Connecticut Mental Health Center, New Haven, Connecticut Council on Problem Gambling, Wethersfield, CT, USA (Potenza); the Connecticut Council on Problem Gambling, Wethersfield, CT, USA (Potenza); the Connecticut Mental Health Center, New Haven, CT, USA (Potenza); the Faculty of Education, Beijing Normal University, Beijing 100875, China (Zhou); and the Department of Psychology, Yale University School of Medicine, New Haven, CT, USA (Kober)
| | - Jia-Hua Xu
- From the State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China (Wu, Xu, Shi, Zhu, Wang, Liu, Zhang); the Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA (Potenza, Kober, Yip); the Child Study Center, Yale University School of Medicine, New Haven, CT, USA (Potenza); the Department of Neuroscience, Yale University School of Medicine, Connecticut Mental Health Center, New Haven, Connecticut Council on Problem Gambling, Wethersfield, CT, USA (Potenza); the Connecticut Council on Problem Gambling, Wethersfield, CT, USA (Potenza); the Connecticut Mental Health Center, New Haven, CT, USA (Potenza); the Faculty of Education, Beijing Normal University, Beijing 100875, China (Zhou); and the Department of Psychology, Yale University School of Medicine, New Haven, CT, USA (Kober)
| | - Lei Zhu
- From the State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China (Wu, Xu, Shi, Zhu, Wang, Liu, Zhang); the Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA (Potenza, Kober, Yip); the Child Study Center, Yale University School of Medicine, New Haven, CT, USA (Potenza); the Department of Neuroscience, Yale University School of Medicine, Connecticut Mental Health Center, New Haven, Connecticut Council on Problem Gambling, Wethersfield, CT, USA (Potenza); the Connecticut Council on Problem Gambling, Wethersfield, CT, USA (Potenza); the Connecticut Mental Health Center, New Haven, CT, USA (Potenza); the Faculty of Education, Beijing Normal University, Beijing 100875, China (Zhou); and the Department of Psychology, Yale University School of Medicine, New Haven, CT, USA (Kober)
| | - Rui Wang
- From the State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China (Wu, Xu, Shi, Zhu, Wang, Liu, Zhang); the Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA (Potenza, Kober, Yip); the Child Study Center, Yale University School of Medicine, New Haven, CT, USA (Potenza); the Department of Neuroscience, Yale University School of Medicine, Connecticut Mental Health Center, New Haven, Connecticut Council on Problem Gambling, Wethersfield, CT, USA (Potenza); the Connecticut Council on Problem Gambling, Wethersfield, CT, USA (Potenza); the Connecticut Mental Health Center, New Haven, CT, USA (Potenza); the Faculty of Education, Beijing Normal University, Beijing 100875, China (Zhou); and the Department of Psychology, Yale University School of Medicine, New Haven, CT, USA (Kober)
| | - Guan-Qun Liu
- From the State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China (Wu, Xu, Shi, Zhu, Wang, Liu, Zhang); the Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA (Potenza, Kober, Yip); the Child Study Center, Yale University School of Medicine, New Haven, CT, USA (Potenza); the Department of Neuroscience, Yale University School of Medicine, Connecticut Mental Health Center, New Haven, Connecticut Council on Problem Gambling, Wethersfield, CT, USA (Potenza); the Connecticut Council on Problem Gambling, Wethersfield, CT, USA (Potenza); the Connecticut Mental Health Center, New Haven, CT, USA (Potenza); the Faculty of Education, Beijing Normal University, Beijing 100875, China (Zhou); and the Department of Psychology, Yale University School of Medicine, New Haven, CT, USA (Kober)
| | - Jin-Tao Zhang
- From the State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China (Wu, Xu, Shi, Zhu, Wang, Liu, Zhang); the Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA (Potenza, Kober, Yip); the Child Study Center, Yale University School of Medicine, New Haven, CT, USA (Potenza); the Department of Neuroscience, Yale University School of Medicine, Connecticut Mental Health Center, New Haven, Connecticut Council on Problem Gambling, Wethersfield, CT, USA (Potenza); the Connecticut Council on Problem Gambling, Wethersfield, CT, USA (Potenza); the Connecticut Mental Health Center, New Haven, CT, USA (Potenza); the Faculty of Education, Beijing Normal University, Beijing 100875, China (Zhou); and the Department of Psychology, Yale University School of Medicine, New Haven, CT, USA (Kober)
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