Randomized Controlled Trial of Bifrontal Transcranial Direct Current Stimulation on Craving in Alcohol Use Disorder

Background: Transcranial direct current stimulation (tDCS) is a potential neuromodulation option for the management of cravings in patients with alcohol use disorder (AUD). This study aims to assess the efficacy and safety of tDCS in the management of craving for alcohol and to measure the change in subjective well-being in patients with AUD following tDCS intervention. Methods: Patients with AUD aged between 18 and 60 years were randomly assigned to active tDCS intervention and sham tDCS intervention groups, each consisting of 17 patients. Over the course of a week, five tDCS sessions were given, with the anode positioned on the scalp over the right dorsolateral prefrontal cortices (DLPFC) area, the cathode over the left DLPFC area, and a 2 mA current. After every session, a tDCS side effects checklist was used. Follow-up assessments were conducted at week 1, week 4, and week 8 of the recruitment using the alcohol urge questionnaire (AUQ) and the World Health Organization (WHO) (five) Well-Being Index (WHO-5). Results: A significantly greater reduction in AUQ scores was present in the active tDCS intervention group compared to the sham tDCS intervention at week 1 and week 4, but the difference was not significant at the end of 8 weeks. A significant improvement in WHO-5 scores was found in both groups; however, the difference between the groups was not significant at follow-ups. The side effects observed were mild to moderate in intensity, were short-lived, and did not require any active management. Conclusions: The tDCS may be useful in the acute reduction of craving in AUD. It is a safe and well-tolerated intervention modality.