Repeated prefrontal tDCS improves cognitive emotion regulation and readiness for treatment in substance use disorder

BackgroundPrevious studies have shown that individuals with substance use disorder (iSUD) often show diminished motivation toward seeking and adhering to treatment resulting in a higher relapse rate. One important cognitive correlate of substance use behavior and treatment seeking in iSUD is their ability to adaptatively regulate emotion regulation. This randomized, placebo-controlled study assessed the impact of up- and downregulation of the left and right dorsolateral prefrontal cortex (dlPFC) via transcranial direct current electrical stimulation (tDCS) on cognitive emotion regulation as well as treatment motivation in iSUD. MethodsThirty male iSUDs were randomly assigned to the experimental (n=15) or placebo (n=15) groups. The experimental group underwent 15 sessions of anodal left and cathodal right dlPFC stimulation (2 mA, 20 minutes), while the placebo group received sham stimulation over the same period. Assessments of readiness, eagerness, motivation for treatment, and cognitive emotion regulation were conducted pre-and post-intervention. ResultsResults showed that simultaneous upregulation and downregulation of the left and right dlPFC significantly boosted motivation for change and treatment in individuals with iSUD. This intervention improved participants' recognition of issues related to their substance use and reduced ambivalence about it. Additionally, it enhanced adaptive cognitive emotion regulation strategies in iSUD. ConclusionsModulation of the prefrontal-subcortical network via dlPFC tDCS can help iSUD to improve adaptive emotion regulation strategies thereby boosting motivation for treatment seeking. Cognitive control interventions, via noninvasive brain stimulation, are a promising approach for cognitively and motivationally preparing iSUD for treatment-seeking and reducing substance use behavior.