Effect Of Transcranial Direct Current Stimulation On Craving In Patients Of Uncomplicated Alcohol Dependence Syndrome : A Single Blind, Randomized Controlled Study

BACKGROUND: Craving is attributed as one of the main reasons for relapse in alcohol dependence syndrome. Neurostimulation techniques targeting craving in SUD is being researched . Dorsolateral prefrontal cortex(DLPFC) is the area responsible for craving. OBJECTIVES: To study the effect of tDCS on craving in patients of alcohol dependence syndrome. MATERIALS AND METHODS: We performed a single-blind, sham-controlled study involving 76 patients with alcohol dependence syndrome (according to ICD-10 DCR), with Clinical Institute of Withdrawal Assessment in Alcohol Withdrawal (CIWA-Ar) scores less than 10, not receiving any anti-craving medications. Patients were allocated to active and sham tDCS in a ratio of 1:1, such that 38 patients received active and 38 patients sham tDCS ; with anode as right DLPFC and cathode as left DLPFC receiving 2mA current (twice daily session, total 10 sessions). The Alcohol Craving Questionnaire (ACQ-NOW) was administered to measure the severity of alcohol craving at baseline and after the last tDCS session. RESULTS: Mann Whitney U test was applied that showed significant reduction in the post-tDCS ACQ-NOW Scores as compared to sham tDCS . There was also significant reduction in compulsivity domain of craving after tDCS. The effect size for treatment with time interaction was (0.58). CONCLUSIONS: Right dorsolateral pre-frontal tDCS was found to have significant anticraving effects in alcohol dependence. The results highlight the potential of tDCS which, combined with other anticraving drugs, can act as an effective strategy in reducing craving and subsequent relapse in alcohol dependence.