tDCS reduces cigarette consumption and modulates craving-related brain network
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1
CH le vinatier, CH le Vinatier, Lyon 1 university, France
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2
Institut Universitaire en Santé Mentale de Montréal Research Center, Québec, QC, Canada, Department of Psychiatry,, Canada
Background Tobacco use disorder (TUD) is one of the leading causes of disease and premature death in the world. Despite several approaches to help smokers quit (e.g., substitution therapy), about 80% of patients will relapse in the 3 months after a quit attempt.
Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation technique that can safely modulate brain activity and connectivity (Keeser et al., 2011). A recent meta-analysis reported that tDCS targeting the dorsolateral prefrontal cortex (DLPFC) may significantly decrease craving in patients with Substance Use Disorder whatever the substance of abuse (Jansen et al., 2013).
The goal of this study was to test whether repeated sessions of tDCS over the DLPFC modulates cigarette consumption and brain reactivity to smoking cues in subjects with TUD who wished to quit smoking. We hypothesized that 10 sessions of tDCS may decrease cigarette consumption by modulating activity within the craving-related network.
Methods 23 participants with TUD who wanted to quit smoking were randomly allocated to receive either 10 sessions of active (n=13) or sham (n=10) tDCS (2 sessions per day over 5 consecutive days) in a controlled clinical trial (identifier: NCT01288183). tDCS was delivered with the anode (35 cm2) placed over the right DLPFC and the cathode (100 cm2) over the left occipital cortex at 2 mA during 20 min. Cigarette consumption was measured as the self reported number of cigarettes smoked per day during 4 weeks. Before the first and after the last tDCS session, brain reactivity to smoking cues was measured as patterns of elicited BOLD signals during presentation of smoking-related versus neutral pictures using event-related functional magnetic resonance imaging (fMRI). Images were realigned, then normalized into the MNI stereotaxic space and smoothed with a 8-mm Gaussian filter. After the pre-processing, the [smoking-related > neutral] contrast was generated for each participant. Finally, first-level contrasts were entered in a mixed effect model with three factors: subjects (23 levels), groups (2 levels) and sessions (2 levels). A group by sessions F-test was generated to visualize the interaction. Post-hoc t-tests were done between pre and post tDCS sessions in active and sham groups.
Results Compared to sham, patients receiving active tDCS demonstrated a significant reduction of cigarette intake (F(1, 21) = 6.19, p = 0.021). The reduction was around 50% diminution in the active group after 5 days of tDCS (38% in the sham group) and outlasted the stimulation period. At one-month follow up, a 30% reduction was still reported in the active group (10% in sham group). This reduction of cigarette intake was associated with modulation of brain activity within the craving-related network.
The treatment was well tolerated and no adverse event was reported.
Conclusions Repeated sessions of tDCS over the right DLPFC may be beneficial to reduce cigarette consumption during four weeks. By combining tDCS with fMRI, we show evidence of how tDCS modulates brain activity to reduce cigarette smoking. tDCS could be a suitable and safe approach to help patients quit smoking.
Acknowledgements
The authors thank Dr F Galvao for his help in recruiting participants.
References
Jansen JM, Daams JG, Koeter MW, Veltman DJ, van den Brink W, Goudriaan AE. Effects of non-invasive neurostimulation on craving: a meta-analysis. Neurosci Biobehav Rev. 2013;37(10 Pt 2):2472-80.
Keeser D, Meindl T, Bor J, Palm U, Pogarell O, Mulert C, Brunelin J, Möller HJ, Reiser M, Padberg F. Prefrontal transcranial direct current stimulation changes activity of resting-state networks during functional magnetic resonance imaging. J Neuroscience, 2011;31(43):15284-93.
Keywords:
tDCS;,
Smoking Cessation,
craving,
MRI and fMRI,
Tobacco Use Disorder,
Brain Stimulation
Conference:
SAN2016 Meeting, Corfu, Greece, 6 Oct - 9 Oct, 2016.
Presentation Type:
Poster Presentation in SAN2016 Conference
Topic:
Posters
Citation:
Mondino
M,
Luck
D,
Grot
S,
Poulet
E and
Brunelin
J
(2016). tDCS reduces cigarette consumption and modulates craving-related brain network.
Conference Abstract:
SAN2016 Meeting.
doi: 10.3389/conf.fnhum.2016.220.00105
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Received:
29 Jul 2016;
Published Online:
01 Aug 2016.
*
Correspondence:
Dr. Jerome Brunelin, CH le vinatier, CH le Vinatier, Lyon 1 university, bron, 69677, France, jerome.brunelin@ch-le-vinatier.fr