A feasibility and tolerability study of home-use tDCS in patients with substance use disorders (SUD)

Background: Transcranial Direct Current Stimulation (tDCS) is a non-invasive neuromodulation technique employing low-intensity direct electrical currents across scalp electrodes. Its potential therapeutic application for substance use disorders (SUD) has gained attention, particularly in targeting the dorsolateral prefrontal cortex (dlPFC) due to its involvement in inhibitory control and reward mechanisms. The utilization of at-home tDCS offers an accessible and cost-effective treatment modality for SUD treatment. This study aims to assess patient adherence and evaluate overall tolerability and acceptability. Secondary goals include exploring potential adverse events, including impacts on executive functions, mood symptomatology, and other clinical data.
Methods: This randomized longitudinal study aims to evaluate the feasibility and acceptability of employing an at-home tDCS headset, specifically the PlatoWork 2.0, for addiction patients. Recruitment was conducted at the Addiction outpatient and Day Hospital Unit at the Department of Psychiatry, Hospital Clínic in Barcelona. 60 participants with alcohol (n=20), tobacco (n=20), and psychostimulant (n=20) use disorders were enrolled. Patients engaged in half-hour sessions for ten consecutive days at home and were randomly assigned to either a fixed (n=30) or self-paced (n=30) schedule of tDCS stimulation. 
Results: Preliminary findings indicate consistent treatment adherence overall, with patients in the fixed regime group showing a propensity toward self-paced schedules in stimulation times. No adverse effects of stimulation have been observed in cognitive functions, mood symptomatology, and other clinical data. However, a few patients with pre-existing or current skin conditions, or those using skin creams, experienced the emergence of small wounds, leading to an immediate cessation of treatment. In summary, treatment was generally safe in the majority of cases.
Conclusion: The positive outcomes in terms of adherence and safety observed in this study show the potential of at-home tDCS as a possible adjuvant treatment for SUD. Therefore, future investigations should consider evaluating the effectiveness of this intervention as a complementary therapeutic approach alongside psychopharmacological therapy for SUD patients.