title: Transcranial direct current stimulation of the prefrontal cortex reduces cue-reactivity in alcohol-dependent patients.
abstract: Alcohol craving has been shown to be an important factor for relapses in alcohol-dependent patients. Furthermore, brain activity in reward-related areas in response to alcohol-related cues is positively related to the amount of post-relapse alcohol consumption. On the other hand, it has been shown that cue-exposure based extinction training (CET) leads to larger decrease of striatal and left dorsolateral prefrontal cortex (dLPFC) cue-induced activation compared to standard clinical day-care treatment, but the effect sizes are relatively small. The question of this study was, whether it is possible to change cue-reactivity and subjective craving by applying bilateral prefrontal transcranial direct current stimulation (tDCS). We stimulated 30 detoxified alcohol-dependent patients (50 % with a sham and 50 % with left cathodal/right anodal stimulation) and presented emotional as well as alcohol-related pictures. We measured the emotional startle modulation and found significantly increased startle amplitudes in the verum stimulation condition for alcohol-related cues, indicating a more negative processing of this cues in alcohol-dependent patients after verum tDCS stimulation. Additionally we found tendencies for stronger reduction in subjective craving in verum-stimulated patients. Therefore our study underscores the positive value of DCS in reducing craving and might help to improve the understanding and therapy of alcohol dependence.
authors.affiliation: Department of Psychiatry, Psychosomatics and Psychotherapy, University Clinic Würzburg, University of Würzburg, Füchsleinstr. 15, 97080, Würzburg, Germany.
authors.forename: Katharina
authors.initials: K
authors.lastname: Wietschorke
authors.affiliation: Department of Psychiatry, Psychosomatics and Psychotherapy, University Clinic Würzburg, University of Würzburg, Füchsleinstr. 15, 97080, Würzburg, Germany.
authors.forename: Julian
authors.initials: J
authors.lastname: Lippold
authors.affiliation: Department of Psychiatry, Psychosomatics and Psychotherapy, University Clinic Würzburg, University of Würzburg, Füchsleinstr. 15, 97080, Würzburg, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Jacob
authors.affiliation: Department of Psychiatry, Psychosomatics and Psychotherapy, University Clinic Würzburg, University of Würzburg, Füchsleinstr. 15, 97080, Würzburg, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Polak
authors.affiliation: Department of Psychiatry, Psychosomatics and Psychotherapy, University Clinic Würzburg, University of Würzburg, Füchsleinstr. 15, 97080, Würzburg, Germany. Herrmann_M@klinik.uni-wuerzburg.de.
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Herrmann
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000523:psychology / Q000628:therapy*; D066249:Craving / Q000502:physiology*; D003463:Cues; D004311:Double-Blind Method; D004576:Electromyography; D004644:Emotions / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D017397:Prefrontal Cortex / Q000502:physiology*; D065908:Transcranial Direct Current Stimulation / Q000379:methods*; D064232:Visual Analog Scale
keywords: Craving; Emotional-startle; Non-invasive brain stimulation; tDCS