Abstract
Here, we report some electrophysiologic and imaging effects of the transcranial direct current stimulation (tDCS) over the dorsolateral prefrontal cortex (dlPFC) in drug addiction, notably in alcohol and crack-cocaine dependence. The low resolution electromagnetic tomography (LORETA) analysis obtained through event-related potentials (ERPs) under drug-related cues, more specifically in its P3 segment (300–500 ms) in both, alcoholics and crack-cocaine users, showed that the ventral medial prefrontal cortex (vmPFC) was the brain area with the largest change towards increasing activation under drug-related cues in those subjects that kept abstinence during and after the treatment with bilateral tDCS (2 mA, 35 cm2, cathodal left and anodal right) over dlPFC, applied repetitively (five daily sessions). In an additional study in crack-cocaine, which showed craving decreases after repetitive bilateral tDCS, we examined data originating from diffusion tensor imaging (DTI), and we found increased DTI parameters in the left connection between vmPFC and nucleus accumbens (NAcc), such as the number of voxels, fractional anisotropy (FA) and apparent diffusion coefficient (ADC), in tDCS-treated crack-cocaine users when compared to the sham-tDCS group. This increasing of DTI parameters was significantly correlated with craving decreasing after the repetitive tDCS. The vmPFC relates to the control of drug seeking, possibly by extinguishing this behavior. In our studies, the bilateral dlPFC tDCS reduced relapses and craving to the drug use, and increased the vmPFC activation under drug cues, which may be of a great importance in the control of drug use in drug addiction.
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Acknowledgments
I want to thank patients and families who agreed to participate in this study. I also want to thank José Luiz Aranda who acquired the MRI data, the Greenhouse Clinic team, especially to Dr. Luis Henrique Casagrande, who allowed us to run this study in patients from this Clinic for Treatment of Mental Disorders and Drug Dependence, to use its facilities, and made all effort to help us. This work was supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) (Grants numbers 475232/2013-5; 443824/2014-2 and 466650/2014-0 to E.M.N.P.). E.M.N.P. was recipient of researcher capixaba fellowship from Fundação de Amparo à Pesquisa do Espírito Santo (FAPES) and is now recipient of researcher fellopship from Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) (proc. 304374/2014-8).
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Nakamura-Palacios, E.M., Lopes, I.B.C., Souza, R.A. et al. Ventral medial prefrontal cortex (vmPFC) as a target of the dorsolateral prefrontal modulation by transcranial direct current stimulation (tDCS) in drug addiction. J Neural Transm 123, 1179–1194 (2016). https://doi.org/10.1007/s00702-016-1559-9
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DOI: https://doi.org/10.1007/s00702-016-1559-9