Transcranial direct current stimulation (tDCS) has been shown to modulate subjective craving ratings in drug dependents by modification of cortical excitability in dorsolateral prefrontal cortex (DLPFC). Given the mechanism of craving in methamphetamine (meth) users, we aimed to test whether tDCS of DLPFC could also alter self-reported craving in abstinent meth users while being exposed to meth cues. In this double-blinded, crossover, sham-controlled study, thirty two right-handed abstinent male meth users were recruited. We applied 20 min 'anodal' tDCS (2 mA) or 'sham' tDCS over right DLPFC in a random sequence while subjects performed a computerized cue-induced craving task (CICT) starting after 10 min of stimulation. Immediate craving was assessed before the stimulation, after 10 min of tDCS, and after tDCS termination by visual analog scale (VAS) of 0 to 100. Anodal tDCS of rDLPFC altered craving ratings significantly. We found a significant reduction of craving at rest in real tDCS relative to the sham condition (p = 0.016) after 10 min of stimulation. On the other hand, cue-induced VAS craving was rated significantly higher in the real condition in comparison with sham stimulation (p = 0.012). Our findings showed a state dependent effect of tDCS: while active prefrontal tDCS acutely reduced craving at rest in the abstinent meth users, it increased craving during meth-related cue exposure. These findings reflect the important role of the prefrontal cortex in both cue saliency evaluation and urge to meth consumption.

BackgroundTranscranial 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).MethodsFifteen 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.ResultsSubjective 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.DiscussionGiven 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.

Nurses deal with many crises at work. It is obvious that being exposed to stress for long, results in severe physical and mental complications and affects individual is welfare. This study was aimed at determining the quality of life (QOL) of nurses and whether there is any relation between occupational stress and QOL. This analytical-descriptive cross sectional study was carried out in University hospitals of Zanjan, Iran. 241 nurses were sampled using proportional to size stratified method. The data were collected by means of Iranian version of the Short Form Health Survey (SF-36) and a questionnaire on demographic information and work factors. Occupational stress was measured by Toft Gray and Anderson’s tool. The questionnaires were filled by nurses themselves and the data were analyzed by Spearman’s Correlation test, Kruskal-Wallis and one-way ANOVA and Enter-method Regression with SPSS 16.0 software. The results showed a high level of occupational stress among nurses, which adversely affected their quality of life. According to the results QOL of male and female nurses differ with men having a higher QOL and less occupational stress. 2 work factors, satisfaction and others positive attitude towards nursing, affected all dimensions of QOL and occupational stress. There was no significant correlation between QOL or occupational stress and factors like position, shift, ward, experience, time off, overtime hours, interest in desertion and education. According to harmful effects of occupational stress on nurses, cognitive-behavioral interventions, learning coping strategies are proposed.

DMD is a rare disorder characterized by progressive muscle degeneration and premature death. Therapy development is delayed by difficulties to monitor efficacy non‐invasively in clinical trials. In this study, we used RNA‐sequencing to describe the pathophysiological changes in skeletal muscle of 3 dystrophic mouse models. We show how dystrophic changes in muscle are reflected in blood by analyzing paired muscle and blood samples. Analysis of repeated blood measurements followed the dystrophic signature at five equally spaced time points over a period of seven months. Treatment with two antisense drugs harboring different levels of dystrophin recovery identified genes associated with safety and efficacy. Evaluation of the blood gene expression in a cohort of DMD patients enabled the comparison between preclinical models and patients, and the identification of genes associated with physical performance, treatment with corticosteroids and body measures. The presented results provide evidence that blood RNA‐sequencing can serve as a tool to evaluate disease progression in dystrophic mice and patients, as well as to monitor response to (dystrophin‐restoring) therapies in preclinical drug development and in clinical trials.