Frontal tDCS reduces alcohol relapse rates by increasing connections from left dorsolateral prefrontal cortex to addiction networks

Jazmin Camchong; Donovan Roediger; Mark Fiecas; Casey S Gilmore; Matt Kushner; Erich Kummerfeld; Bryon A Mueller; Kelvin O Lim

doi:10.1016/j.brs.2023.06.011

Frontal tDCS reduces alcohol relapse rates by increasing connections from left dorsolateral prefrontal cortex to addiction networks

Brain Stimul. 2023 Jul-Aug;16(4):1032-1040. doi: 10.1016/j.brs.2023.06.011. Epub 2023 Jun 20.

Authors

Jazmin Camchong¹, Donovan Roediger², Mark Fiecas³, Casey S Gilmore⁴, Matt Kushner², Erich Kummerfeld⁵, Bryon A Mueller², Kelvin O Lim⁴

Affiliations

¹ University of Minnesota Department of Psychiatry and Behavioral Sciences, 2312 S. 6th St., Floor 2, Suite F-275, Minneapolis, MN, 55454, USA. Electronic address: camch002@umn.edu.
² University of Minnesota Department of Psychiatry and Behavioral Sciences, 2312 S. 6th St., Floor 2, Suite F-275, Minneapolis, MN, 55454, USA.
³ University of Minnesota School of Public Health, 420 Delaware St SE, Minneapolis, MN, 55455, USA.
⁴ University of Minnesota Department of Psychiatry and Behavioral Sciences, 2312 S. 6th St., Floor 2, Suite F-275, Minneapolis, MN, 55454, USA; Minneapolis VA Health Care System, Geriatrics Research Education and Clinical Center (GRECC), 1 Veterans Dr., Minneapolis, MN, 55417, USA.
⁵ University of Minnesota Institute for Health Informatics, 8-100 Phillips-Wangensteen Building, 516 Delaware Street SE, Minneapolis, MN, 55455, USA.

Abstract

Background: Brain-based interventions are needed to address persistent relapse in alcohol use disorder (AUD). Neuroimaging evidence suggests higher frontal connectivity as well as higher within-network connectivity of theoretically defined addiction networks are associated with reduced relapse rates and extended abstinence during follow-up periods.

Objective: /Hypothesis: A longitudinal randomized double-blind sham-controlled clinical trial investigated whether a non-invasive neuromodulation intervention delivered during early abstinence can (i) modulate connectivity of addiction networks supporting abstinence and (ii) improve relapse rates.

Hypotheses: Active transcranial direct current stimulation (tDCS) will (i) increase connectivity of addiction networks known to support abstinence and (ii) reduce relapse rates.

Methods: Short-term abstinent AUD participants (n = 60) were assigned to 5 days of either active tDCS or sham during cognitive training. Causal discovery analysis (CDA) examined the directional influence from left dorsolateral prefrontal cortex (LDLPFC, stimulation site) to addiction networks that support abstinence.

Results: Active tDCS had an effect on the average strength of CDA-determined connectivity from LDLPFC to the incentive salience and negative emotionality addiction networks - increasing in the active tDCS group only. Active tDCS had an effect on relapse rates following the intervention, with lower probability of relapse in the active tDCS vs. sham. Active tDCS showed an unexpected sex-dependent effect on relapse rates.

Conclusion: Our results suggest that LDLPFC stimulation delivered during early abstinence has an effect on addiction networks supporting abstinence and on relapse rates. The unexpected sex-dependent neuromodulation effects need to be further examined in larger clinical trials.

Keywords: Alcohol use disorder; Causal connectivity; Dorsolateral prefrontal cortex; Incentive salience; Relapse; Transcranial direct current stimulation.

Publication types

Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Alcohol Drinking
Behavior, Addictive* / therapy
Chronic Disease
Dorsolateral Prefrontal Cortex
Double-Blind Method
Female
Humans
Male
Prefrontal Cortex / physiology
Transcranial Direct Current Stimulation* / methods

Abstract

Publication types

MeSH terms

Grants and funding