Background and rationale. Severe alcohol use disorder (SAUD) is a major public health concern, given its massive individual, interpersonal, and societal consequences. The available prevention and treatment programs have proven limited effectiveness, as relapse rates are still high in this clinical population. Developing effective interventions reducing the appearance and persistence of SAUD thus constitutes an experimental and clinical priority. Among the new therapeutic approaches, there is a growing interest for noninvasive neuromodulation techniques, and particularly for transcranial direct current stimulation (tDCS) as an adjunctive treatment in neuropsychiatric disorders, including SAUD. Methods. We propose a systematic review, based on preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines, evaluating the available evidence on the effectiveness of tDCS to improve clinical interventions in SAUD. Results. We provide an integrative overview of studies applying tDCS in clinical populations with SAUD, together with a standardized methodological quality assessment. We show that the currently available data remain inconsistent. Some data suggested that tDCS can (1) reduce craving, relapse or alcohol-cue reactivity and (2) improve cognitive control and inhibition. However, other studies did not observe any beneficial effect of tDCS in SAUD. Conclusions. Capitalizing on the identified strengths and shortcomings of available results, we present evidence-based clinical guidelines to integrate tDCS in current clinical settings and to combine it with neurocognitive training.

背景和理由。严重酒精使用障碍 (SAUD) 是一个主要的公共卫生问题，因为它会产生巨大的个人、人际关系和社会后果。现有的预防和治疗方案已证明效果有限，因为该临床人群的复发率仍然很高。因此，开发有效的干预措施以减少 SAUD 的出现和持续存在构成了实验和临床优先事项。在新的治疗方法中，人们对无创神经调节技术的兴趣越来越大，特别是经颅直流电刺激 (tDCS) 作为包括 SAUD 在内的神经精神疾病的辅助治疗。方法. 我们根据系统评价和荟萃分析 (PRISMA) 指南的首选报告项目提出系统评价，评估关于 tDCS 改善 SAUD 临床干预有效性的现有证据。结果。我们提供了在 SAUD 临床人群中应用 tD​​CS 的研究的综合概述，以及标准化的方法学质量评估。我们表明当前可用的数据仍然不一致。一些数据表明，tDCS 可以 (1) 减少渴望、复发或酒精提示反应，以及 (2) 改善认知控制和抑制。然而，其他研究并未观察到 tDCS 在 SAUD 中的任何有益作用。结论. 利用已确定的现有结果的优点和缺点，我们提出了基于证据的临床指南，以将 tDCS 整合到当前的临床环境中，并将其与神经认知训练相结合。