Effect of Intensified Transcranial Direct-current Stimulation Targeting Bilateral Dorsolateral Prefrontal Cortex on Craving Reduction in Patients with Opioid (Heroin) Use Disorder
Hadis Amini Tameh1, Saeed Imani1, Jaber Alizadehgoradel2, Alireza Noroozi3
1Department of Counseling, Faculty of Educational Sciences and Psychology, Shahid Beheshti University, Tehran, Iran
2Department of Psychology, Faculty of Humanities, University of Zanjan, Zanjan, Iran
3Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences (TUMS), Tehran, Iran
Correspondence to: Saeed Imani
Department of Counseling, Faculty of Educational Sciences and Psychology, Shahid Beheshti University, Tehran 19839-69411, Iran
E-mail: S_imani@sbu.ac.ir
ORCID: https://orcid.org/0000-0002-6990-5858

Jaber Alizadehgoradel
Department of Psychology, Faculty of Humanities, University of Zanjan, Zanjan 45371-38791, Iran
E-mail: j.alizadeh@znu.ac.ir
ORCID: https://orcid.org/0000-0003-4803-0607

*This manuscript was derived from Hadis Amini Tameh’s thesis in Rehabilitation Counseling approved on August 29, 2023, at the Faculty of Psychology and Educational Sciences of Shahid Beheshti University.
Received: January 2, 2024; Revised: February 24, 2024; Accepted: March 4, 2024; Published online: March 26, 2024.
© The Korean College of Neuropsychopharmacology. All rights reserved.

This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Objective: This study aimed to analyze the effect of the intensified transcranial direct-current stimulation (tDCS) targeting bilateral dorsolateral prefrontal cortex (DLPFC) on craving reduction in patients with opioid use disorder.
Methods: This quasi-experimental study was conducted on 30 individuals who participated voluntarily at Baharan Camp of Shahid Mahalati. The participants had already completed the detoxification phase and stayed at the camp to resolve their craving and gain occupational skills to reintegrate into the community. The participants were selected using convenience and purposive sampling methods and were then assigned to an experimental group (n = 15) and a control group (n = 15). The experimental group received ten 20-minute tDCS sessions twice a day for 5 consecutive days. There was a 20-minute break between the two stimulations. The DLPFC was stimulated with a current intensity of 2 mA (anode: F3 and cathode: F4). The control group received a sham stimulation. Both groups completed Franken’s Desires for Drug Questionnaire at baseline and after the stimulation sessions. Additionally, they completed the questionnaires once again three months after the end of the treatment to assess treatment retention.
Results: At the posttest stage, the intensified tDCS had significant effects on momentary opioid craving reduction in all measured factors, e.g., desire and intention, negative reinforcement, and control (p < 0.001). However, the results concerning treatment retention at the 3-month follow-up stage were insignificant for all factors (p < 0.001).
Conclusion: Apparently, tDCS can be used as a tool to reduce craving. However, its application as an independent and sustainable treatment remains debatable.
Keywords: Opioid-related disorders; Transcranial direct-current stimulation; Craving


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