Improvement of Impulsivity and Decision Making by Transcranial Direct Current Stimulation of the Dorsolateral Prefrontal Cortex in a Patient with Gambling Disorder

Abstract

Gambling disorder (GD) is a form of behavioral addiction. In recent years, it has been suggested that the application of transcranial Direct Current Stimulation (tDCS) to the dorsolateral prefrontal cortex (DLPFC), which plays a key role in top-down inhibitory control and impulsivity, may represent a new therapeutic approach for treating addictions. Here we investigated the effectiveness of a novel low dose tDCS protocol (i.e. six sessions of right anodal/left cathodal tDCS for 20 min, with a current intensity of 1 mA) applied to DLPFC in a patient with GD. To evaluate the effect of the proposed intervention, cognitive, psychological and behavioural evaluations were performed at different time points, pre and post intervention. The results showed improvement of impulsivity, decision making, and cognitive functioning after tDCS intervention. Findings of the present study suggest that low doses of right anodal/left cathodal tDCS to DLPFC may effectively improve gambling behaviour. They also suggest to carefully evaluate the effects of this tDCS polarity on the patient’s emotional state. The current protocol warrants further investigation in large groups of patients, as it may provide relevant insights into the design of effective, low dose treatments of gambling disorder.

Transcranial-Direct-Current-Stimulation Accelerates Motor Recovery After Cortical Infarction in Mice: The Interplay of Structural Cellular Responses and Functional Recovery

“…Stroke is a leading cause of death and disability in our society, primarily as specific therapeutic rehabilitation strategies remain limited. 1-4 The potential of novel non-invasive brain stimulation methods, for example, transcranial direct current stimulation (tDCS), to promote recovery in human patients has been investigated for decades and is widely considered promising after stroke and other conditions, 5-14 although large randomized clinical trials are lacking. Furthermore, the neurobiological mechanisms underlying non-invasive brain stimulation remain poorly understood, and standardized protocols have not been established.…”

The Counterproductive Effect of Right Anodal/Left Cathodal Transcranial Direct Current Stimulation Over the Dorsolateral Prefrontal Cortex on Impulsivity in Methamphetamine Addicts

“…Previous studies have found that individuals with impaired DLPFC generally performed worse on executive measures relative to healthy individuals and individuals with damage in other brain regions ( 34 ). Moreover, some studies have found that stimulating the DLPFC of individuals through tDCS decreased the impulsivity of healthy ( 19 ), ADHD individuals ( 35 ), and gambling addicts ( 18 ), and suggested that using an appropriate tDCS protocol to stimulate DLPFC may effectively improve individuals’ impulse control or behavioral inhibition ability. Based on these findings, the current study selected the DLPFC as a tDCS target and expected this protocol to significantly decrease behavioral impulsivity in methamphetamine addicts.…”

“…For example, a warm-up usually improves performance in healthy people, but the same warm-up may deplete sick person and his/her subsequent performance. This may be one potential reason why a similar protocol decreased impulsivity in healthy individuals ( 40 ) and individuals with other psychological disorders ( 18 ) but led to counterproductive results in methamphetamine addicts.…”

“…The DLPFC plays a primary role in the execution and inhibition of behavior, and its impairment decreased the ability to inhibit behavior ( 16 ). Notably, recent evidence suggested that using transcranial direct current stimulation (tDCS) to stimulate the DLPFC decreases behavioral impulsivity in individuals with attention deficit hyperactivity disorder ( 17 ), Gambling Disorder ( 18 ), and healthy individuals ( 19 ). However, it is unclear whether tDCS may effectively decrease behavioral impulsivity in methamphetamine addicts.…”

“…Previous studies have found a variety of tDCS protocols effective in decreasing craving in methamphetamine addicts ( 23 – 25 ), such as bilateral tDCS over the DLPFC (right anodal/left cathodal). This protocol has been shown to be effective in decreasing the symptoms of addiction, impulsivity in some substance addictions (e.g., tobacco and cocaine), or psychiatric disorders ( 18 , 26 , 27 ). In addition, multi-session of tDCS intervention has been found more effective than one session ( 28 ).…”