Effects of repeated transcranial direct current stimulation on smoking, craving and brain reactivity to smoking cues

Abstract

Recent studies have shown that transcranial direct current stimulation (tDCS) may reduce craving and smoking. However, little is known regarding brain correlates of these behavioral changes. We aimed to evaluate whether 10 sessions of tDCS modulate cigarette consumption, craving and brain reactivity to smoking cues in subjects with tobacco use disorder (TUD). In a double blind parallel-arms study, 29 subjects with TUD who wished to quit smoking were randomly assigned to receive 10 sessions of either active or sham tDCS applied with the anode over the right dorsolateral prefrontal cortex (DLPFC) and a large cathode over the left occipital region. As compared to sham, active tDCS significantly reduced smoking craving and increased brain reactivity to smoking-cues within the right posterior cingulate, as measured with a functional magnetic resonance imaging event-related paradigm. However, we failed to find a significant difference between active and sham groups regarding the self-reported number of cigarettes smoked and the exhaled carbon monoxide during one month. These findings suggested that 10 sessions of tDCS over the right DLPFC may reduce craving by modulating activity within the resisting-to-smoke network but might not be significantly more effective than sham to decrease cigarette consumption.

The effects of transcranial direct current stimulation compared to standard bupropion for the treatment of tobacco dependence: A randomized sham-controlled trial

“…Over the past decade, transcranial Direct Current Stimulation (tDCS) has been employed as a safe [9], non-invasive brain stimulation method, for addiction treatment and research on this topic is expanding [10]. Research on the effect of tDCS on smokers was mainly focused on the reduction of cue-induced craving [11, 12], ability to resist smoking [13], reduction of negative affect but not cigarette craving in overnight abstinent smokers [14], and motivate smokers to quit smoking [15]. Furthermore, with repeated five sessions of stimulation per week, its cumulative effect decreased craving and even the number of cigarettes smoked [16].…”

Lack of effect of transcranial direct current stimulation (tDCS) on short-term smoking cessation: Results of a randomized, sham-controlled clinical trial

“…It is possible that more sessions are necessary in order to observe a persistent effect. However, other studies have observed no effect of five sessions of active 2mA tDCS (versus sham) on craving or cigarette consumption in smokers with schizophrenia who were not instructed to alter their smoking behavior (Smith et al, 2015) and no effect of 10 sessions of 2mA tDCS on cigarette consumption in healthy smokers who were highly motivated to quit (but not specifically instructed to do so) (Mondino et al, 2018). Within-subject designs also show mixed results: although several studies report decreased craving following active tDCS compared to sham (Fecteau et al, 2014; Fregni et al, 2008; Yang et al, 2017), others show no changes (Pripfl and Lamm, 2015; Xu et al, 2013).…”

“…However, fMRI studies using this montage have shown widespread changes in activation and functional connectivity beyond the DLPFC (Keeser et al., 2011; Stagg et al, 2013). In addition, some studies which have demonstrated beneficial effects of anodal stimulation of the left DLPFC for smoking behavior have varied in the placement of the cathodal electrode; for example, some have used a larger cathodal electrode to reduce the current density in underlying regions (Boggio et al, 2009; Mondino et al, 2018), others placed the cathode over the right DLPFC for bilateral stimulation (Fregni et al, 2008), and others used a reversed bilateral (anodal right, cathodal left) montage (Fecteau et al, 2014). Further research is necessary in order to understand the effects of tDCS montage on stimulation of the targeted region and nearby regions (Bikson et al, 2018; Tremblay et al, 2014).…”

“…Initial studies suggest that active anodal tDCS targeted to the right or left DLPFC can reduce cravings to smoke (Fregni et al, 2008; Yang et al, 2017) as well as latency to smoke in the laboratory (Falcone et al, 2016) and daily smoking rates (Boggio et al., 2009; Fecteau et al, 2014; Vitor de Souza Brangioni et al, 2018). However, other studies found no changes in craving (Kroczek et al, 2016; Pripfl and Lamm, 2015; Smith et al, 2015; Xu et al, 2013) or found that reductions in craving did not transfer to changes in smoking behavior (Mondino et al, 2018). Variation in reported outcomes may be related to small sample sizes (n ≈ 10–40 subjects per trial), differences in baseline smoking rates (studies with non-significant outcomes may include more light or non-daily smokers than those which reported significant effects), or differences in treatment protocols (i.e., intensity, duration, and number of sessions).…”

Addiction: Brain and Cognitive Stimulation for Better Cognitive Control and Far Beyond

“…However, this craving reduction, which may be due DOI: http://dx.doi.org /10.5772/intechopen.88869 to increased control on cue reactivity, could be too small to positively impact cigarette use. Indeed, as compared to sham, active tDCS significantly reduced smoking craving and increased brain reactivity to smoking cues within the right posterior cingulate, as measured with a functional magnetic resonance imaging event-related paradigm, but failed to diminish the number of cigarettes smoked (see also [160]) and the exhaled carbon monoxide 1 month following the stimulation [161].…”