The aim of this project is to investigate the potential of transcranial direct current stimulation (tDCS) to reduce cognitive deficits and substance craving in individuals with substance use disorders (SUD), with a focus on alcohol use disorder (AUD). Patients of any gender between the ages of 18 and 65 are examined who are in our inpatient and day clinic settings for a standard detoxification treatment program. As there are conflicting findings regarding the effective settings for tDCS as an adjunctive treatment in SUD (e.g., effects on inhibitory control seem to be sensitive to current direction), the aim is to examine and compare three different active tDCS conditions, a sham tDCS condition (placebo), inhibition training, and a control group of patients receiving only standard detoxification treatment. The aim is to identify the optimal electrode placement and current direction to positively influence both inhibitory control and craving, leading to improved treatment outcomes such as longer abstinence periods or reduced substance use after relapse.
main diagnosis: alcohol use disorder according to DSM-5
patients of any gender aged 18 to 65
normal vision or correctable visual impairment.
sufficient ability to communicate verbally and in writing
withdrawal of consent
severe internal, neurological, or psychiatric comorbidities (e.g., lifetime schizophrenia, bipolar disorder, or other severe mental disorders according to ICD-10 and DSM-5, such as severe depression or PTSD within the last 12 months).
Exclusion criteria for an EEG/tDCS examination (e.g. metal implants in the head, epilepsy, etc.)
severe withdrawal symptoms (CIWA-R > 7)
Parallel
Transcranial direct current stimulation (tDCS)
DevicetDCS sessions on five consecutive days for 20 minutes.
Inhibition Training
BehavioralComputerized Training of inhibitory control (Go-/No-Go task with pictures of preferred alcohol) on five consecutive days.
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Treatment groupsSee each treatment group below.
Inhibitory Control (Go/No-Go Task)
Change in performance in a modified Go/No-Go task. Measures inhibitory control under varying working memory loads.
Inhibitory Control (EEG)
Change in event-related potentials (ERPs), specifically the P300 and N200 components, measured by EEG during Go-/NO-GO task (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).
Craving
Change in subjective craving according to Alcohol Urge Questionnaire and craving scale. Alcohol Urge Questionnaire: 7-item Likert scale ranging from "strongly disagree" to "strongly agree"). A total score is calculated by averaging the scores for each item. Higher scores indicate stronger craving. Craving scale: Craving from 0-100%. Higher scores indicate stronger cravings.
Relapse/Alcohol Use
Change in number of drinking days, number of abstinent days, number of days with more than 48/60g (women/men) of alcohol, cumulative amount of alcohol in grams.
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Central Institute of Mental Health, Mannheim
Lead sponsor
Wellcome Leap Inc.
Collaborator
