Background: According to the neurocognitive model of addiction, the development and maintenance of drug addiction is associated with cognitive control deficits, as well as decreased activity of prefrontal regions, especially the dorsolateral prefrontal cortex (DLPFC). This study investigated how improving executive functions (EFs) impacts methamphetamine-use disorder, which has been less explored compared to craving, but might be a central aspect for the therapeutic efficacy of DLPFC stimulation in drug addiction. Methods: We assessed the efficacy of 10 repeated sessions of transcranial direct current stimulation (tDCS) over the DLPFC on executive dysfunctions in methamphetamine-use disorder, and its association with craving alterations. 39 of 50 initially recruited individuals with methamphetamine-use disorder who were in the abstinent-course treatment were randomly assigned to "active" and "sham" stimulation groups in a randomized, double-blind parallel-group study. They received active (2 mA, 20 min) or sham tDCS for 10 sessions over 5 weeks. Performance on major EF tasks (e.g., working memory, inhibitory control, cognitive flexibility, and risk-taking behaviour) and craving were measured before, immediately after, and 1 month following the intervention. Participants reported abstinence from drug consumption throughout the experiment, verified by regular urine tests during the course of the study up to the follow-up measurement. Results: The group which received active DLPFC tDCS showed significantly improved task performance across all EFs immediately after and 1 month following the intervention, when compared to both prestimulation baseline and individuals who received sham tDCS. Similarly, a significant reduction in craving was observed immediately after and 1 month following the intervention in the active, but not sham stimulation group. A significant correlation between cognitive control improvement and craving reduction was found as well.
Background: Social Anxiety Disorder (SAD) is the most common anxiety disorder while remains largely untreated. Disturbed amygdala-frontal network functions are central to the pathophysiology of SAD, marked by hypoactivity of the lateral prefrontal cortex (PFC), and hypersensitivity of the medial PFC and the amygdala. The objective of this study was to determine whether modulation of the dorsolateral and medial PFC activity with a novel intensified stimulation protocol reduces SAD core symptoms, improves treatment-related variables, and reduces attention bias to threatening stimuli. Methods: In this randomized, sham-controlled, double-blind trial, we assessed the efficacy of an intensified stimulation protocol (20 min, twice-daily sessions with 20 min intervals, 5 consecutive days) in two intensities (1 vs 2 mA) compared to sham stimulations. 45 patients with SAD were randomized in three tDCS arms (1-mA, 2-mA, sham). SAD symptoms, treatment-related variables (worries, depressive state, emotion regulation, quality of life), and attention bias to threatening stimuli (dot-probe paradigm) were assessed before and right after the intervention. SAD symptoms were also assessed at 2-month follow-up. Results: Both 1-mA and 2-mA protocols significantly reduced fear/avoidance symptoms, worries and improved, emotion regulation and quality of life after the intervention compared to the sham group. Improving effect of the 2-mA protocol on avoidance symptoms, worries and depressive state was significantly larger than the 1-mA group. Only the 2-mA protocol reduced attention bias to threat-related stimuli, the avoidance symptom at follow-up, and depressive states, as compared to the sham group. Conclusions: Modulation of lateral-medial PFC activity with intensified stimulation can improve cognitive control, motivation and emotion networks in SAD and might thereby result in therapeutic effects. These effects can be larger with 2-mA vs 1-mA intensities, though a linear relationship between intensity and efficacy should not be concluded. Our results need replication in larger trials.
Objective: Transcranial direct current stimulation (tDCS) and mindfulness practices have been proposed as a potential approach to improve executive functions (EFs) and reduce craving in persons with substance use disorders. Based on the neural mechanisms of action of each of these interventions, the combination of both non-pharmacological interventions might have additive effects. In the current study, the effects of tDCS combined with mindfulness-based substance abuse treatment (MBSAT) to improve EFs and reduce craving were investigated in early abstinent methamphetamine abuse. Methods: Eighty (youths aged between 18 and 21) early-abstinent methamphetamine users were randomly assigned to the research groups (tDCS group [n = 20], mindfulness group [n = 20], combined mindfulness-tDCS group [n = 20], and sham group [n = 20]). Active tDCS (1.5 mA,20 min, 12 sessions) or sham tDCS was appliedover the left dorsolateral prefrontal cortex and the MBSAT protocol was used over twelve 50-min sessions. Results: Both in the post-test phase (immediately after the intervention) and follow-up phase (one month after the intervention), performance in most EFs tasks significantly improved in the combination group which received real tDCS + MBSAT, as compared to baseline values and sham stimulation group. Similarly, a significant reduction in craving was observed after intervention inall treatment groups, but not the sham stimulation group. Interestingly, the increase in EFs and the reduction in craving post versus pre tDCS + MBSAT intervention were correlated. Conclusion: Findings from the current study provide initial support for the clinical effectiveness of combination tDCS + MBSAT, possibly influencing cognitive/affective processes.
SummaryAim: The aim of the study was to investigate the effect of supportive-expressive therapy on the hope and quality of life in patients with multiple sclerosis (MS). Sample and method:This was an experimental study with pre/post-test design and a control group. 32 patients selected from members of the MS Society of Tehran were selected as the sample by target sampling, and then placed into two groups of 16 (experimental and control group) through random assignment. The supportive-expressive therapy was applied to the experimental group in 12 sessions of 75 minutes each. The instruments used were Snyder et al.'s Hope Inventory and World Health Organization's Quality of Life-Brief. Results:The results showed that there was a significant difference between hope and quality of life in the experimental and control groups (p<0.01).Discussion: Supportive-expressive therapy is effective in increasing hope and quality of life in patients with MS. Conclusion:The results showed that supportive-expressive therapy, with its emphasis on providing support and helping patients face and deal with their disease-related stress, can help increases hope and quality of life in patients with MS.supportive-expressive therapy, hope, quality of life, multiple sclerosis
SummaryAim. The aim of the present study was to compare positive and negative urgency as well as sleep quality among patients with borderline personality disorder (BPD) and antisocial personality disorder (ASPD).Sample and method. This was a causal-comparative study. The sample included 50 patients diagnosed with ASPD and 50 patients diagnosed with BPD, as well as 50 healthy controls. All subjects were selected based on availability. The instruments used were Lynam et al.'s Impulse Control Scale and Pittsburgh's Sleep Quality Index.Results. The results show that the mean of negative urgency is significantly higher in BPD patients than in ASPD patients, whereas the mean of positive urgency is significantly higher in ASPD patients than in BPD patients. Dimensions of sleep quality in both BPD and ASPD patients are significantly higher than for healthy controls (p<0.01).Discussion. a significant difference exists among the BPD and ASPD patients and healthy controls in the positive and negative urgency and sleep quality. Conclusion.We found that BPD and ASPD patients manifest reckless behaviours both due to more negative urgency when experiencing negative emotional situations and due to positive urgency when experiencing positive emotional situations. Both patient groups show lower sleep quality, which has diagnostic and therapeutic implications.antisocial personality disorder/borderline personality disorder/positive urgency/negative urgency/sleep quality
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