Transcranial Direct Current Brain Stimulation Increases Ability to Resist Smoking

Abstract

Background The ability to exert self-control over temptation is a fundamental component of smoking behavior change. Transcranial direct current stimulation (tDCS) of the dorsolateral prefrontal cortex (DLPFC) has been shown to modulate cognitive control circuits. Although prior studies show that stimulation reduces cigarette craving and self-reported smoking, effects on ability to resist smoking have not been investigated directly. Objectives We assessed effects of a single 20-minute session of 1.0 mA anodal stimulation over the left DLPFC with cathodal stimulation over the right supra-orbital area (vs. sham stimulation) on ability to resist smoking in a validated smoking lapse paradigm. Methods Twenty-five participants completed two tDCS sessions (active and sham stimulation) in a within-subject, double-blind, randomized and counterbalanced order with a two-week washout period. Following overnight abstinence, participants received tDCS in the presence of smoking related cues; they had the option to smoke at any time or receive $1 for every 5 minutes they abstained. After 50 minutes, they participated in a one hour ad libitum smoking session. Primary and secondary outcomes were time to first cigarette and cigarette consumption, respectively. Results In multiple regression models, active tDCS (compared to sham) significantly increased latency to smoke (p = 0.02) and decreased the total number of cigarettes smoked (p = 0.014) during the session. Conclusion These findings suggest that acute anodal stimulation over the left DLPFC (with cathodal stimulation over the right supra-orbital area) can improve ability to resist smoking, supporting the therapeutic potential of tDCS for smoking cessation treatment.

A review of brain stimulation methods to treat substance use disorders

“…Eight studies have examined the effects of tDCS on nicotine craving in dependent participants. All studies applied 2.0 mA stimulation for 15–30 minutes, except one by Falcone et al, who used a stimulation intensity of 1.0 mA for 20 minutes.…”

“…Eight studies have examined the effects of tDCS on nicotine craving in dependent participants. All studies applied 2.0 mA stimulation for 15–30 minutes, except one by Falcone et al, who used a stimulation intensity of 1.0 mA for 20 minutes. Five of the aforementioned studies demonstrated positive effects on nicotine cravings and/or consumption, with significant reductions seen across participants.…”

“…All studies applied 2.0 mA stimulation for 15–30 minutes, except one by Falcone et al, who used a stimulation intensity of 1.0 mA for 20 minutes. Five of the aforementioned studies demonstrated positive effects on nicotine cravings and/or consumption, with significant reductions seen across participants. In contrast, three additional studies observed no significant effect on craving or consumption of tobacco; two of these studies used a single stimulation session of tDCS, and the third used a sample that consisted of patients with a diagnosis of schizophrenia or schizoaffective disorder, which may have contributed to the negative findings, as this population tends to be more highly nicotine dependent than non‐psychiatric populations.…”

Modulation of Brain Activity with Noninvasive Transcranial Direct Current Stimulation (tDCS): Clinical Applications and Safety Concerns

“…For example, Falcone et al (2016) investigated the effect of a single 20-min session of 1.0 mA anodal stimulation over the left DLPFC on 25 smokers. They found that the stimulation could improve their ability to resist smoking.…”

A Randomized Trial of Combined tDCS Over Right Inferior Frontal Cortex and Cognitive Bias Modification: Null Effects on Drinking and Alcohol Approach Bias

“…The precise mechanisms by which tDCS works are currently unclear, although there are some data that suggest anodal tDCS increases synchrony of neuronal firing as a result of reduced GABA (Kim et al., ) and increased glutamate activity (Clark et al., ). Prior research has shown that application of anodal tDCS over dorsolateral prefrontal cortex (DLPFC) reduces craving for alcohol (Boggio et al., ; Klauss et al., ), cigarettes (Boggio et al., ; Falcone et al., ), marijuana (Boggio et al., ), and food (Fregni et al., ). A recent treatment trial in which anodal tDCS was applied over right DLPFC (with cathode placed on left DLPFC) in alcohol‐dependent patients in a series of 10 sessions showed reduced craving and increased 3‐month abstinence in the verum tDCS group compared to the sham group (Klauss et al., ).…”