Efectos de la estimulación transcraneal con corriente directa (tDCS) sobre el consumo de tabaco, la motivación y la autoeficacia para dejar de fumar
- Marta Rebull-Monje 1
- Marien Gadea-Domenech 1
- Pilar López-Ruíz 2
- Raúl Espert-Tortajada 2
-
1
Universitat de València
info
- 2 Hospital Clínico Universitario (Valencia)
ISSN: 0213-7615
Ano de publicación: 2024
Volume: 49
Número: 1
Páxinas: 31-57
Tipo: Artigo
Outras publicacións en: Revista española de drogodependencias
Obxectivos de Desenvolvemento Sustentable
Resumo
Recent studies of transcranial direct current stimulation (tDCS), applied to the dorsolateral prefrontal cortex (CPFDL), have shown that they can reduce craving and smoking. However, there is little research that has evaluated the effects of tDCS on motivation and self-efficacy to quit smoking. The objective of this study was to evaluate the effects of tDCS on the pattern of consumption, motivation and perceived self-efficacy to quit smoking in 16 people with Tobacco Use Disorder (TUD). A time series design with intrasubject ABAB replication was used. The treatment consisted of applying 10 repeated sessions of tDCS at 1.5 mA for 20 minutes on the CPFDL (cathode F3 and anode F4), one daily session for two weeks (Monday to Friday). After a one-month rest phase, the intra-subject treatment was replicated under identical conditions. The entire intervention lasted nine weeks and was completed by 10 participants. The results showed a significant reduction in nicotine dependence, the number of cigarettes smoked and the levels of carbon monoxide (CO) in the exhaled air. Furthermore, we observed a significant improvement in motivation and perceived self-efficacy to quit smoking. These findings suggest that the tDCS, applied on the CPFDL, may be an effective technique to use as adjunctive therapy to other pharmacological and / or psychological strategies used in the Addictive Behavior Units, or other drug addiction care centers. However, more studies are needed to investigate the interaction between the effects of nicotine and tDCS to find the optimal treatment strategy
Referencias bibliográficas
- Abrams, D.B. y Biener, L. (1992). Motivational characteristics of smokers in the workplace: A public health challenge. Preventive Medicine, 21, 679-687. https://doi. org/10.1016/0091-7435(92)90075-s
- Anastassiou, C.A., Montgomery, S.M., Barahona, M., Buzsaki, G. y Koch C. (2010). The effect of spatially inhomogeneous extracellular electric fields on neurons. Journal of Neuroscience 30, 1925–1936. https://doi. org/10.1523/JNEUROSCI.3635-09.2010
- Antal, A., Alekseichuk, I., Bikson, M., Brockmöller, J., Brunoni, A.R., Chen, R. y Fregni, F. (2017). Low intensity transcranial electric stimulation: safety, ethical, legal regulatory and application guidelines. Clinical Neurophysiology, 128(9), 1774-1809. https://doi. org/10.1016/j.clinph.2017.06.001
- Ardolino, G., Bossi, B., Barbieri, S. y Priori, A. (2005). Non-synaptic mechanisms underlie the after-effects of cathodal transcutaneous direct current stimulation of the human brain. Journal of Physiology (London) 568:653–63. https://doi.org/10.1113/ jphysiol.2005.088310
- Arnedillo, J.M. y De Osma, F.H.G. (2000). Factores asociados al éxito en programas para dejar de fumar. Adicciones, 12(3), 329-341.
- Baer, J. S. y Lichtenstein, E. (1988). Cognitive assessment. In D. M. Donovan y G. A. Marlatt (Eds.) Assessment of addictive behaviors (pp.189-213). New York: Guilford Press.
- Barrueco M., Hernández M.A. y Torrecilla M. (2009). Manual de prevención y tratamiento del tabaquismo (4a ed). Badalona, España: E.U.R.O.M.E.D.I.C.E., Ediciones Médicas, S.L.
- Batista, E.K., Klauss, J., Fregni, F., Nitsche, M.A. y Nakamura-Palacios, E.M. (2015). A randomized placebo-controlled trial of targeted prefrontal cortex modulation with bilateral tDCS in patients with crackcocaine dependence. International Journal of Neuropsychopharmacoly 18(12). https://doi. org/10.1093/ijnp/pyv066
- Becoña, E. (1994). Tratamiento del tabaquismo. En Graña, J.L.: Conductas adictivas. Teoría, evaluación y tratamiento. Boggio, P.S., Liguori, P, Sultani, N, Rezende, L, Fecteau, S. y Fregni, F. (2009). Cumulative priming effects of cortical stimulation on smoking cue-induced craving. Neuroscience Letters 463, 82–86. https://doi. org/10.1016/j.neulet.2009.07.041
- Bono-Cabré, R. y Arnau-Gras J. (2014). Diseños de caso único en ciencias sociales y de la salud. Madrid: Editorial Síntesis.
- Borland, R., Yong, H. H., O’Connor, R. J., Hyland, A. y Thompson, M. E. (2010). The reliability and predictive validity of the Heaviness of Smoking Index and its two components: findings from the International Tobacco Control Four Country study. Nicotine and Tobacco Reserarch 12: S45–50. https://doi.org/10.1093/ntr/ntq038
- Brody, A.L., Mandelkern, M.A., Jarvik, M.E., Lee, G.S., Smith, E.C. y Huang, J.C. (2004). Differences between smokers and nonsmokers in regional gray matter volumes and densities. Biological Psychiatry, 55(1):77–84. https:// doi.org/10.1016/s0006-3223(03)00610-3
- Chawla, M. y Garrison, K.A. (2018). Neurobiological Considerations for Tobacco Use Disorder. Current Behavioral Neuroscience Reports, 5(4), 238-248. https://doi. org/10.1007/s40473-018-0168-3
- Chib, V.S., Yun, K., Takahashi, H. y Shimojo, S. (2013). Noninvasive remote activation of the ventral midbrain by transcranial direct current stimulation of prefrontal cortex. Translational Psychiatry, 3(6), e268. https:// doi.org/10.1038/tp.2013.44
- Coles, A.S., Kozak, K. y George, T.P. (2018). A review of brain stimulation methods to treat substance use disorders. The American journal on addictions 27(2), 71-91. https:// doi.org/10.1111/ajad.12674
- Espert-Tortajada, R. y López-Ruiz, P. (2018). Neuromodulación: Terapias cerebrales no invasivas coadyuvantes para el tratamiento de las drogadicciones. Francisco Pascual Pastor (Presidencia). XLV Jornadas Nacionales de Socidrogalcohol. Actas del Congreso.
- Espert-Tortajada, R., Rebull-Monje, M y GadeaDoménech, M. (2021). La estimulación transcraneal con corriente directa (tDCS) como tratamiento coadyuvante en el trastorno por consumo de tabaco: Situación actual y perspectivas de futuro. Revista española de drogodependencias, 46 (1): 5-20
- Falcone, M., Bernardo, L., Ashare, R.L., Hamilton, R., Faseyitan, O., Loughead, J. y Lerman, C. (2016) Transcranial Direct Current Brain Stimulation Increases Ability to Resist Smoking. Brain Stimulation Journal 9, 191–196. https://doi.org/10.1016/j.brs.2015.10.004
- Fecteau, S., Agosta, S., Home-Blanchet, A., Fregni, F., Boggio, P., Ciraulo, D., y PascualLeone, A. (2014). Modulation of smoking and decision-making behaviors with transcranial direct current stimulation in tobacco smokers: a preliminary study. Drug and Alcohol Dependence 140, 78–84. https:// doi.org/10.1016/j.drugalcdep.2014.03.036
- Feil, J. y Zangen, A. (2010). Brain stimulation in the study and treatment of addiction. Neuroscience & Biobehavioral Reviews, 34(4), 559-574. https://doi.org/10.1016/j.neubiorev.2009.11.006
- Filmer, H.L., Dux, P.E. y Mattingley, J.B. (2014). Applications of transcranial direct current stimulation for understanding brain function. Trends in neurosciences, 37(12), 742-753. https://doi.org/10.1016/j.tins.2014.08.003
- Fox, M.D., Buckner, R.L., Liu, H.S., Chakravarty, M.M., Lozano, A.M. y Pascual-Leone, A. (2014). Resting-state networks link invasive and noninvasive brain stimulation across diverse psychiatric and neurological diseases. Proceedings of the National Academy of Sciences of the United States of America, 111(41), E4367–75. https://doi.org/10.1073/ pnas.1405003111
- Frank, E., Wilfurth, S., Landgrebe, M., Eichhammer, P., Hajak, G. y Langguth, B. (2010). Anodal skin lesions after treatment with transcranial direct current stimulation. Brain Stimulation 3, 58–59. https://doi. org/10.1016/j.brs.2009.04.002
- Fregni, F., El-Hagrassy, M. M., Pacheco-Barrios, K., Carvalho, S., Leite, J., Simis, M., Brunelin, J., Nakamura-Palacios, E. M., Marangolo, P., Venkatasubramanian, G., San-Juan, D., Caumo, W., Bikson, M., Brunoni, A. R., & Neuromodulation Center Working Group (2021). Evidence-Based Guidelines and Secondary Meta-Analysis for the Use of Transcranial Direct Current Stimulation in Neurological and Psychiatric Disorders. The international journal of neuropsychopharmacology, 24(4), 256–313. https://doi. org/10.1093/ijnp/pyaa051
- Fregni, F., Liguouri, P, Facteau, S., Nitche, M.A., Pascual-Leone, A. y Boggio, P.S. (2008). Cortical stimulation of the prefrontal cortex with transcranial direct current stimulation reduces cue-provoked smoking craving: a randomized, sham-controlled study. Journal of Clinical Psychiatry 69, 32–40. https://doi. org/10.4088/jcp.v69n0105
- Fukuda, H. y Kitani M. (1996). Cigarette smoking is correlated with the periventricular hyperintensity grade of brain magnetic resonance imaging. Stroke 27:645–649. https://doi. org/10.1161/01.str.27.4.645
- Giovino, G.A., Henningfield, J.E., Tomar, S.L., Escobedo, L.G. y Slade, J. (2005). Epidemiology of tobacco use and dependence. Epidemiologic Reviews 17:48–65. https:// doi.org/10.1093/oxfordjournals.epirev. a036185
- Goldstein, R.Z. y Volkow, N.D. (2011). Dysfunction of the prefrontal cortex in addiction: neuroimaging findings and clinical implications. Nature Reviews Neuroscience, 12(11), 652–69. https://doi.org/10.1038/ nrn3119
- Goldstein, R.Z. y Volkow, N.D. (2012). Dysfunction of the prefrontal cortex in addiction: Neuroimaging findings and clinical implications. Nature Reviews Neuroscience 12(11): 652-669. https://doi.org/10.1038/ nrn3119
- Gwaltney, C.J., Shiffman, S., Balabanis, M.H. y Paty, J. A. (2005). Dynamic self-efficacy and outcome expectancies: prediction of smoking lapse and relapse. Journal of Abnormal Psychology 114: 661–75. https://doi. org/10.1037/0021-843X.114.4.661
- Hagimoto, A., Nakamura, M., Morita, T., Masui, S. y Oshima, A. (2009). Smoking cessation patterns and predictors of quitting smoking among the Japanese general population: a 1-year follow-up study. Addiction 105: 164–73. https://doi.org/10.1111/j.1360- 0443.2009.02735.x
- Heatherton, T.F., Kozlowski, L.T., Frecker, R.C. y Fagerström, K.O. (1991). The Fagerström Test for Nicotine Dependence: A revision of the Fagerström Tolerance Questionnaire. British Journal of Addictions, 86, 1119-1127. https://doi. org/10.1111/j.1360-0443.1991.tb01879.x
- Hellman, R., Cummings, K.M., Haughey, B.P., Zielezny, M.A. y O’Shea, R.M. (2001). Predictors of attempting and succeeding at smoking cessation. Health Education Research 6: 77–86. https://doi.org/10.1093/ her/6.1.77
- Jansen, J.M., Daams, J.G., Koeter, M.W., Veltman, D.J., Van Den Brink, W. y Goudriaan, A.E. (2013). Effects of non-invasive neurostimulation on craving: a meta-analysis. Neuroscience & Biobehavioral Reviews, 37(10), 2472-2480. https://doi.org/10.1016/j. neubiorev.2013.07.009
- Kang, N., Kim, R. K., & Kim, H. J. (2019). Effects of transcranial direct current stimulation on symptoms of nicotine dependence: A systematic review and meta-analysis. Addictive behaviors, 96, 133–139. https://doi. org/10.1016/j.addbeh.2019.05.006
- Klauss J., Penido Pinheiro L.C., Silva Merlo B.L., de Almeida Correia Santos G., Fregni F. y Nitsche M.A. (2014). A randomized controlled trial of targeted prefrontal cortex modulation with tDCS in patients with alcohol dependence. International Journal os Neuropsychopharmacology, 17(11):1793–803. https://doi. org/10.1017/S1461145714000984
- Koob, G.F. y Volkow, N.D. (2016). Neurobiology of addiction: a neurocircuitry analysis. The Lancet Psychiatry, 3(8), 760-773. https:// doi.org/10.1016/S2215-0366(16)00104-8
- Lafaucheur, J.P., Antal, A., Ayache, S.S., Benninger, D.H., Brunelin, J., Cogiamanian, F., Cotelli, M., De Ridder, D., Ferrucci, Langguth, B., Marangolo, P., Mylius, V., Nitche, M.A., Padberg, F., Palm, U., Pulet, E., Priori, A., Rossi, S., Schecklmann, M., Vanneste, S., Ziemann, U., Garcia-Larrea, L. y Paulus, W. (2017). Evidence-based guidelines on the therapeutic use of transcranial direct current stimulation (tDCS). Clinical Neurophysiology 128: 56–92. https://doi.org/10.1016/j. clinph.2016.10.087
- Li, L., Borland, R., Yong, H.H., Fong, G.T., BansalTravers, M. y Quah, A. (2010). Predictors of smoking cessation among adult smokers in Malaysia and Thailand: findings from the International Tobacco Control Southeast Asia Survey. Nicotine and Tobbacco Research 12: S34–44. https://doi.org/10.1093/ntr/ ntq030
- Li, L., Feng, G., Jiang, Y., Yong, H.H., Borland, R. y Fong, G.T. (2011). Prospective predictors of quitting behaviours among adult smokers in six cities in China: findings from the International Tobacco Control (ITC) China Survey. Addiction 106: 1335–45. https://doi. org/10.1111/j.1360-0443.2011.03444.x
- Liebetanz, D., Nitsche, M.A., Tergau, F. y Paulus W. (2002). Pharmacological approach to the mechanisms of transcranial DC-stimulationinduced after-effects of human motor cortex excitability. Brain 125:2238–47. https:// doi.org/10.1093/brain/awf238
- Matsumoto, H. y Ugawa, Y. (2016). Adverse events of tDCS and tACS: a review. Clinical Neurophysiology Practice, 2, 19-25. https:// doi.org/10.1016/j.cnp.2016.12.003
- Meng, Z., Liu, C., Yu, C., & Ma, Y. (2014). Transcranial direct current stimulation of the frontal-parietal-temporal area attenuates smoking behavior. Journal of psychiatric research, 54, 19–25. https://doi. org/10.1016/j.jpsychires.2014.03.007
- Mondino, M., Luck, D., Grot, S., Januel, D., Suaud-Chagny, M.F., Poulet, E. y Brunelin, J. (2018). Effects of repeated transcranial direct current stimulation on smoking, craving and brain reactivity to smoking cues. Scientific reports, 8(1), 8724. https://doi. org/10.1038/s41598-018-27057-1
- Nitsche, M.A., Fricke, K., Henschke, U., Schlitterlau, A., Liebetanz, D. y Lang, N. (2003). Pharmacological modulation of cortical excitability shifts induced by transcranial direct current stimulation in humans. The Journal of Physiology 553:293–301. https://doi. org/10.1113/jphysiol.2003.049916
- Palm, U., Keeser, D., Schiller, C., Fintescu, Z., Nitsche, M., Reisinger, E. y Padberg, F. (2008). Skin lesions after treatment with transcranial direct current stimulation (tDCS). Brain Stimulation 1, 386–387. https://doi.org/10.1016/j.brs.2008.04.003
- Parker, R. I. y Vannest, K. J. (2009). An improved effect size for single case research: NonOverlap of All Pairs (NAP). Behavior Therapy, 40, 357–367. https://doi.org/10.1016/j. beth.2008.10.006
- Parvaz, M. A., Rabin, R. A., Adams, F., & Goldstein, R. Z. (2022). Structural and functional brain recovery in individuals with substance use disorders during abstinence: A review of longitudinal neuroimaging studies. Drug and alcohol dependence, 232, 109319. https:// doi.org/10.1016/j.drugalcdep.2022.109319
- Perri, R. L., & Perrotta, D. (2021). Transcranial direct current stimulation of the prefrontal cortex reduces cigarette craving in not motivated to quit smokers: A randomized, sham-controlled study. Addictive behaviors, 120, 106956. https://doi.org/10.1016/j. addbeh.2021.106956
- Piasecki, T.M. (2006). Relapse to smoking. Clinical psychology review, 26(2), 196-215. https://doi.org/10.1016/j.cpr.2005.11.007
- Prochaska, J.O. y Diclemente, C.C. (1983). Stages and processes of self changes in smoking towards and integrative model of change. Journal of Consulting Clinical Psychology 51:390-5. https://doi.org/10.1037//0022- 006x.51.3.390
- Prochaska, J.O. y Prochaska, J.M. (1993). Modelo transteórico de cambio para conductas adictivas. En M. Casas y M. Gossop (Eds.), Tratamientos psicológicos en drogodependencias: recaída y prevención de recaídas (pp. 85- 136). Sitges: Ediciones Neurociencias.
- Raz A, y Michels R. (2007). Contextualizing specificity: specific and nonspecific effects of treatment. Am J Clin Hypnosis 50, 177-82. https://doi.org/10.1080/00029157.2007 .10401614
- Richmond, R.L., Kehoe, L. y Webster, I.W. (1993). Multivariate models for predicting abstention following intervention to stop smoking by general practitioner. Addiction 88:1127-35. https://doi. org/10.1111/j.1360-0443.1993.tb02132.x
- Riedel, P., Kabisch, S., Ragert, P. y von Kriegstein, K. (2012). Contact dermatitis after transcranial direct current stimulation. Brain Stimulation. 5, 432–434. https://doi. org/10.1016/j.brs.2011.09.001
- Rodríguez, N., Opisso, E., Pascual-Leone, A. y Soler, M.D. (2014). Skin lesions induced by transcranial direct current stimulation (tDCS). Brain Stimulation 7, 765–767. https://doi.org/10.1016/j.brs.2014.06.005
- Sanz, J. y García-Vera, M.P. (2015). Técnicas para el análisis de diseños de caso único en la práctica clínica: ejemplos de aplicación en el tratamiento de víctimas de atentados terroristas. Clinica y Salud 26, 167-180.
- Shiozawa, P., da Silva, M.E., Raza, R., Uchida, R.R., Cordeiro, Q., Fregni, F. y Brunoni, A.R. (2013). Safety of repeated transcranial direct current stimulation in impaired skin: a case report. The Journal of ECT 29, 147–148. https://doi.org/10.1097/ YCT.0b013e318279c1a1
- Smith, R.C., Boules, S., Mattiuz, S., Youssef, M., Tobe, R. H., Sershen, H., Lajtha, A., Nolan, K., Amiaz, R. y Davis, J. M. (2015). Effects of transcranial direct current stimulation (tDCS) on cognition, symptoms, and smoking in schizophrenia: a randomized controlled study. Schizophrenia research, 168(1-2), 260-266. https://doi.org/10.1016/j. schres.2015.06.011
- Sreeraj, V. S., Arumugham, S. S., & Venkatasubramanian, G. (2023). Clinical Practice Guidelines for the Use of Transcranial Direct Current Stimulation in Psychiatry Indian journal of psychiatry, 65(2), 289–296. https://doi.org/10.4103/indianjpsychiatry. indianjpsychiatry_496_22
- Szasz, P.L., Szentagotai, A. y Hofmann, S.G. (2012). Effects of emotion regulation strategies on smoking craving, attentional bias, and task persistence. Behaviour Research and Therapy, 50(5), 333–40. https://doi. org/10.1016/j.brat.2012.02.010
- Vangeli, E., Stapleton, J., Smit, E.S., Borland, R. y West, R. (2011). Predictors of attempts to stop smoking and their success in adult general population samples: a systematic review. Addiction, 106(12), 2110-2121. https://doi. org/10.1111/j.1360-0443.2011.03565.x
- Vitor de Souza Brangioni, M. C., Pereira, D. A., Thibaut, A., Fregni, F., Brasil-Neto, J. P., & Boechat-Barros, R. (2018). Effects of Prefrontal Transcranial Direct Current Stimulation and Motivation to Quit in Tobacco Smokers: A Randomized, Sham Controlled, Double-Blind Trial. Frontiers in pharmacology, 9, 14. https://doi.org/10.3389/ fphar.2018.00014
- Wang, J., Wei, Y., Wen, J. y Li, X. (2015). Skin burn after single session of transcranial direct current stimulation (tDCS). Brain Stimulation 8, 165–166. https://doi.org/10.1016/j. brs.2014.10.015
- Wing, V.C., Barr, M.S., Wass, C.E., Lipsman, N., Lozano, A.M., Daskalakis, Z.J. y Geroge, T.P. (2013). Brain stimulation methods to treat tobacco addiction. Brain Stimulation, 6(3), 221–30. https://doi.org/10.1016/j. brs.2012.06.008
- Xu J., Fregni, F., Brody A.L. y Rahman A.S. (2013). Transcranial direct current stimulation reduces negative affect but not cigarette craving in overnight abstinent smokers. Frontiers in Psychiatry 4, 112. https://doi. org/10.3389/fpsyt.2013.00112
- Yang, L.Z., Shi, B., Li, H., Zhang, W., Liu, Y., Wang, H. y Hudak, J. (2017). Electrical stimulation reduces smokers’ craving by modulating the coupling between dorsal lateral prefrontal cortex and parahippocampal gyrus. Social cognitive and affective neuroscience, 12(8), 1296-1302. https://doi. org/10.1093/scan/nsx055
- Zawertailo, L., Zhang, H., Rahmani, N., Rajji, T. K., & Selby, P. (2022). Active versus sham transcranial direct current stimulation (tDCS) as an adjunct to varenicline treatment for smoking cessation: Study protocol for a double-blind single dummy randomized controlled trial. PloS one, 17(12), e0277408. https://doi.org/10.1371/journal.pone.0277408
- Zhang, H., Rajji, T. K., Selby, P., Melamed, O., Attwells, S., & Zawertailo, L. (2023). Augmenting varenicline treatment with transcranial direct current stimulation (tDCS) increases smoking abstinence rates at end of treatment. Brain stimulation, 16(4), 1083–1085. https://doi.org/10.1016/j. brs.2023.07.001
- Zhao, H., Qiao, L., Fan, D., Zhang, S., Turel, O., Li, Y., Li, J., Xue, G., Chen, A., & He, Q. (2017). Modulation of Brain Activity with Noninvasive Transcranial Direct Current Stimulation (tDCS): Clinical Applications and Safety Concerns. Frontiers in psychology, 8, 685. https://doi.org/10.3389/ fpsyg.2017.00685