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The Effects of Repetitive tDCS on Relapse in Cocaine Addiction: An Ecological Momentary Assessment (EMA) Study (NCT03025321)

Repetitive bilateral (left cathodal/ right anodal) transcranial Direct Current Stimulation (tDCS) over the dorsolateral prefrontal cortex (DLPFC) seems to reduce craving and relapse risk. However, little is known about the relapse rates in cocaine addiction after tDCS, despite the need for new treatment interventions to reduce the high relapse rates in cocaine addiction. The investigators aim to explore the effects of repetitive tDCS in a larger sample (N=80) of cocaine addicted patients on number of relapse days after three months. In addition, the underlying working mechanism will be explored (e.g. cognitive control functioning). Ecological momentary assessment (EMA) will be used to measure relapse, craving and mood since retrospective self-reports seem to be less reliable in this respect.
  • Device: transcranial Direct Current Stimulation (tDCS)
    tDCS is an electrical brain stimulation method Participants will receive real-tDCS or sham twice daily for 13 min with an interval of 20 min for five consecutive days.
    Ages eligible for Study
    18 Years to 65 Years
    Genders eligible for Study
    All
    Accepts Healthy Volunteers
    No
    Inclusion Criteria:
    • Aged between 18 and 65 years
    • Meeting the DSM-V criteria for cocaine dependence
    • The ability to speak, read, and write in Dutch at an eight-grade literacy level
    • No severe withdrawal signs or symptoms at baseline
    Exclusion Criteria:
    • Indications of severe psychopathology (psychosis, severe mood disorder) as assessed by a physician
    • A diagnosis of epilepsy, convulsions or delirium tremens during abstinence of cocaine use
    • Any contraindication for electrical brain stimulation procedures such as electronic implants or metal implants
    • Pregnancy or breast-feeding.
    For this study, 80 cocaine addicted patients will receive real or sham bilateral tDCS (left cathodal/right anodal) over the DLPFC after one week in detox. The participants will receive this two times daily for 5 consecutive days. It is expected that this particular tDCS method will reduce relapse probability, as was previously seen in alcohol addicted patients. Furthermore, it is hypothesized that this therapeutic effect is associated with diminished craving and enhanced cognitive control. Craving, temptations and relapse, will be explored by means of Ecological Momentary Assessment (EMA). The mixed results in previous studies of tDCS on craving may be explained by the fact that craving in addiction is a momentary phenomenon which is difficult to reliably measure with more traditional methods like retrospective self-reports, for which EMA provides a solution. Cognitive control will be measured by means of inhibitory control during a Go/NoGo task and reward processing during a gambling task. The tasks will be performed at baseline, one day after the tDCS sessions and at three months follow up.
    Status:
    not yet recruiting
    Type:
    Interventional
    Phase:
    -
    Start:
    31 December, 2016
    Updated:
    15 January, 2017
    Participants:
    80
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