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 pre-stimulation 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. CONCLUSIONS Improvement of cognitive control functions is closely associated with reduced craving. Repeated DLPFC stimulation in order to improve executive control could be a promising approach for therapeutic interventions in drug addiction. However, the observed findings require further confirmation by studies that measure relapse/consumption of the respective substances over longer follow-up measurements.

中文翻译：

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反复刺激背外侧前额叶皮层可改善执行功能障碍和对毒瘾的渴望：一项随机、双盲、平行组研究

背景根据成瘾的神经认知模型，药物成瘾的发展和维持与认知控制缺陷以及前额叶区域，尤其是背外侧前额叶皮层（DLPFC）的活动减少有关。这项研究调查了改善执行功能 (EF) 如何影响甲基苯丙胺使用障碍，与渴望​​相比，对甲基苯丙胺使用障碍的探索较少，但可能是 DLPFC 刺激对药物成瘾的治疗效果的核心方面。方法 我们评估了 10 次重复的经颅直流电刺激 (tDCS) 对 DLPFC 对甲基苯丙胺使用障碍的执行功能障碍的疗效，及其与渴望改变的关联。在一项随机、双盲平行组研究中，最初招募的 50 名接受戒断治疗的甲基苯丙胺使用障碍患者中有 39 名被随机分配到“主动”和“假”刺激组。他们在 5 周内接受了 10 次活动（2 mA，20 分钟）或假 tDCS。主要 EF 任务（例如，工作记忆、抑制控制、认知灵活性和冒险行为）和渴望的表现在干预之前、之后和之后 1 个月进行了测量。参与者报告在整个实验过程中戒断药物消费，并在研究过程中通过定期尿液检测进行验证，直至后续测量。结果与刺激前基线和接受假 tDCS 的个体相比，接受主动 DLPFC tDCS 的组在干预后立即和 1 个月后在所有 EF 中显示出显着改善的任务表现。类似地，在主动刺激组（而非假刺激组）干预后立即和 1 个月后观察到渴望显着减少。还发现认知控制改善和渴望减少之间存在显着相关性。结论 认知控制功能的改善与渴望的减少密切相关。重复 DLPFC 刺激以改善执行控制可能是药物成瘾治疗干预的一种有前途的方法。然而，