EEG correlates of the effects of tDCS on cognition and craving in adults with substance use disorder
Poster No:
23
Submission Type:
Abstract Submission
Authors:
Cagdas Türkmen1, Nadja Grundinger1, Alfred Wieland1, Alexandra Seeger1, Haoye Tan1, Tobias Müller1, Yury Shevchenko1, Falk Kiefer1, Sarah Gerhardt1, Sabine Vollstädt-Klein1
Institutions:
1CIMH Mannheim, Mannheim, Baden Wuerttemberg
First Author:
Co-Author(s):
Introduction:
Transcranial direct current stimulation (tDCS) is a potential treatment for substance use disorders (SUD), but its efficacy and specificity remain unclear. To address this, we designed two consecutive randomized controlled studies. The first study investigated the primary effects of active tDCS on cigarette use, craving and executive functions. Building on these findings, an ongoing follow-up study aims to further specify the mode of action of tDCS, focusing on placebo effects, lateralization effects, and general influences on brain metabolism. Underlying neural mechanisms are examined using electroencephalography (EEG) focusing on the event-related potentials (ERP) components N2 and P3, which are suggested biomarkers for executive functions and incentive salience.
Methods:
Stimulation (both studies): 20 minutes of tDCS (2.0 mA) on five consecutive days. Sham tDCS involved a ramp-up/down process (from 0.3mA to 2mA and down to 0.3mA) lasting 34 seconds in total.
Study 1 (NCT03691805): 44 non-treatment-seeking adults with tobacco use disorder were randomized to active (n=24) or sham (n=20) stimulation targeting the left dorsolateral prefrontal cortex (lDLPFC, F3).Craving, cigarette use and executive functions were examined.
Study 2 (registration pending): randomizes 162 abstinent patients with alcohol use disorder into six experimental groups: (1) anodal tDCS over the left DLPFC (F3), (2) anodal tDCS over the right DLPFC (F4), (3) control tDCS targeting the occipital cortex (O1), (4) alcohol-specific computerized inhibition training (Stein et al., 2023), (5) sham tDCS, (6) treatment as usual. Craving and alcohol use are measured using questionnaires and interviews.
EEG: EEG data are recorded with 32 channels with active electrodes, mBrainTrain, Belgrade, Serbia (sampling rate 1000Hz, filtered between 0.016-1000Hz, programmed in Presentation® software (Neurobehavioral Systems, Inc., Berkeley, CA, USA). Data will be analyzed using the toolbox EEGLAB (https://sccn.ucsd.edu/eeglab/index.php) running under MATLAB (The MathWorks, Natick, Massachusetts, USA). Amongst others, filtering, independent component analyses, and segmentation will be conducted. Participants will undergo a modified version of the Go/No-Go task measuring inhibitory control under varying working memory loads (Stock et al., 2016) during which an EEG is recorded.
Study 1 (NCT03691805): 44 non-treatment-seeking adults with tobacco use disorder were randomized to active (n=24) or sham (n=20) stimulation targeting the left dorsolateral prefrontal cortex (lDLPFC, F3).Craving, cigarette use and executive functions were examined.
Study 2 (registration pending): randomizes 162 abstinent patients with alcohol use disorder into six experimental groups: (1) anodal tDCS over the left DLPFC (F3), (2) anodal tDCS over the right DLPFC (F4), (3) control tDCS targeting the occipital cortex (O1), (4) alcohol-specific computerized inhibition training (Stein et al., 2023), (5) sham tDCS, (6) treatment as usual. Craving and alcohol use are measured using questionnaires and interviews.
EEG: EEG data are recorded with 32 channels with active electrodes, mBrainTrain, Belgrade, Serbia (sampling rate 1000Hz, filtered between 0.016-1000Hz, programmed in Presentation® software (Neurobehavioral Systems, Inc., Berkeley, CA, USA). Data will be analyzed using the toolbox EEGLAB (https://sccn.ucsd.edu/eeglab/index.php) running under MATLAB (The MathWorks, Natick, Massachusetts, USA). Amongst others, filtering, independent component analyses, and segmentation will be conducted. Participants will undergo a modified version of the Go/No-Go task measuring inhibitory control under varying working memory loads (Stock et al., 2016) during which an EEG is recorded.
Results:
Study 1 observed reductions across both active and sham groups in cigarette use (F(2.76, 105.00) = 3.34, p = .03) and craving (F(2.99, 125.42) = 15.70, p < .001) over the days (see Figures 1 and 2), with no significant differences between the groups. However, high pre-intervention perceived stress was associated with a smaller amount of cigarettes during the observation period, but only in the active group [t(22) =2.99, p =.01]. Furthermore, also only in this group, lower self-control scores were correlated with a higher decrease in exhaled CO [t (20) =2.82, p =.01]. No significant improvements in executive functions were found for either group. Initial observations (n = 6) support the feasibility of using EEG to assess the effects of tDCS on ERPs, such as the N2 and P3, in relation to executive functions and craving. Findings with a larger sample size will be presented at the conference.
·Reduction in CO levels across both active and sham groups
·Reduction in cigarette craving across both active and sham groups
Conclusions:
Our findings suggest that tDCS over the lDLPFC may not reduce cigarette use or substance craving, or improve executive functions beyond the placebo effect. However, high pre-intervention perceived stress and low self-control may predict reduced cigarette use. The ongoing follow-up study will build upon these findings by shedding light on placebo effects, lateralization effects, and biomarkers in a patient population with alcohol use disorder using EEG.
Brain Stimulation:
Non-invasive Electrical/tDCS/tACS/tRNS 1
Disorders of the Nervous System:
Psychiatric (eg. Depression, Anxiety, Schizophrenia) 2
Higher Cognitive Functions:
Executive Function, Cognitive Control and Decision Making
Modeling and Analysis Methods:
EEG/MEG Modeling and Analysis
Novel Imaging Acquisition Methods:
EEG
Keywords:
Addictions
Electroencephaolography (EEG)
Other - TDCS
1|2Indicates the priority used for review
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Stock, A. K., Riegler, L., Chmielewski, W. X., & Beste, C. (2016). Paradox effects of binge drinking on response inhibition processes depending on mental workload. Arch Toxicol, 90(6), 1429-1436. https://doi.org/10.1007/s00204-015-1565-y