Comparison of the Effectiveness of tACS and tDCS on Craving Reduction and Cognitive Functions

Document Type : Original Article

Authors

1 Master’s Student in Rehabilitation Counseling, Department of Counseling, Faculty of Educational Sciences and Psychology, Tehran, Iran.

2 Assistant Professor, Department of Counseling, Faculty of Educational Sciences and Psychology, Shahid Beheshti University, Tehran, Iran

3 Assistant Professor, Department of Psychology, Faculty of Educational Sciences and Psychology, Shahid Beheshti University, Tehran, Iran

4 Assistant Professor, Department of Psychology, Faculty of Humanities, University of Zanjan, Zanjan, Iran.

Abstract

Abstract: Objective: According to the neurocognitive model of addiction, the initiation and persistence of substance use disorders are associated with cognitive deficits and reduced activity in the prefrontal regions, especially the DLPFC. This study aims to assess the therapeutic efficacy of DLPFC stimulation in methamphetamine addiction and compare the effectiveness of non-invasive techniques, tDCS and tACS, in reducing craving, negative emotional experiences, and improving cognitive functions. Method: The study compared the effectiveness of 10 sessions of transcranial stimulation using alternating current (tACS) and direct current (tDCS) on the DLPFC and its impact on cognitive function improvement and craving reduction in methamphetamine users. Forty-five young participants attending a rehabilitation center were randomly assigned to three groups: tACS, tDCS, and sham. They received 10 sessions of stimulation over 5 weeks. Results: The groups receiving tDCS and tACS showed significant improvements in cognitive functions immediately after the intervention and one month later, compared to the baseline and the sham group. Conclusion: This study demonstrates that repeated DLPFC stimulation can improve cognitive functions and reduce craving in methamphetamine users. Further studies with longer follow-up are needed to confirm these findings.

Keywords

Main Subjects

Alasmari, A., Alhejaili, A., Alharbi, H., Alzahrani, M., & Zughaibi, T. (2024). Challenges and insights: Methamphetamine analysis in post-mortem putrefied human tissues in a hot climate.

Alizadehgoradel J, Nejati V, Sadeghi Movahed F, Imani S, Taherifard M, Mosayebi-Samani M, Vicario CM, Nitsche MA, Salehinejad MA. Repeated stimulation of the dorsolateral-prefrontal cortex improves executive dysfunctions and craving in drug addiction: A randomized, double-blind, parallel-group study. Brain Stimul. 2020 May-Jun;13(3):582-593. doi: 10.1016/j.brs.2019.12.028. Epub 2020 Jan 3. Erratum in: Brain Stimul. 2021 Jan-Feb;14(1):182.

Alizadehgoradel J, Imani S, Nejati V, Vanderhasselt MA, Molaei B, Salehinejad MA, Ahmadi S, Taherifard M. Improved Executive Functions and Reduced Craving in Youths with Methamphetamine Addiction: Evidence from Combined Transcranial Direct Current Stimulation with Mindfulness Treatment. Clin Psychopharmacol Neurosci. 2021 Nov 30;19(4):653-668.

Anderson, E. C., Cantelon, J. A., Holmes, A., Giles, G. E., Brunye, T. T., & Kanarek, R.

APA, 2013. Diagnostic and statistical manual of mental disorders:

Beck, A.T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961).

Beck, A. T., Steer, R. A., & Garbin, M. G. (1988). Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation.

Bikk, A., Chaudhari, J., Navaran, P., Johnson, L Pandit, V., & HI, H. (2024).

Bodeker, R. R. H., & Grace, R. C. (2024). Effects of methamphetamine on probability discounting in rats using concurrent chains.

Cui, Z., Norton, A., & Karamouzian, M. (2023). Characterizing methamphetamine use among people who use opioids:

Droutmana, V., Xue, F., Barkley-Levenson, E., Lam, H. Y., Bechara, A., Smith, B., Lu, Z. L., Xue, G., Miller, L. C., & Read, S. J. (2019). Neurocognitive decision-making processes of casual methamphetamine Users. NeuroImage: Clinical, 21, 101643.

Ekhtiari, H., Kuplicki, R., Aupperle, R. L., & Paulus, M. P. (2021). It is never as good the second time around: Brain areas involved in salience processing habituate during repeated drug cue exposure in treatment engaged abstinent methamphetamine and opioid users.

Ekhtiari, H., Tavakoli, H., Addolorato, G.,Baeken, C., Bonci, A., Bikson, M., & Hanlon, C. A. (2019).Transcranial electrical and magnetic stimulation (tES and TMS) for addiction medicine: A consensus paper on the present state of the science and the road ahead.

Gong, M., Liang, W., He, C., Shen, Y., Zhang, Z., Lou, M., & Xu, Z. (2023). Neuroimaging mechanisms in short-term heroin- and methamphetamine-abstinent users:

Guerin, A. A., Bridson, T., Plapp, H. M., & Bedi, G. (2023). A systematic review and meta-analysis of health, functional, and cognitive outcomes in young people who use methamphetamine.

Haddad, Y. W., Korcari, E., Polsinelli, G. N., & Yuchuan, D. (2021). The effect of cocaine and methamphetamine on saccular aneurysm formation and rupture: A literature review.

He, H., Zhou, S., Peng, C., Ran, W., Tong, S., Hong, L., Cai, F., Jin, W., Jiang, Y., Li, M., Wang, X., Luo, M., Wang, W., & Zhao, K. (2022). Effects of resilience on impulsivity, cognition and depression during protracted withdrawal among Chinese male methamphetamine users.

Hendrickson, K., & Strauss, W. (2020). Characterization and treatment challenges of pulmonary hypertension in methamphetamine users.

Jaehne, E. J., Semaan, H., Grosman, A., Xu, X., Schwarz, Q., & van den Buuse, M. (2023). Enhanced methamphetamine sensitisation in a rat model of the brain-derived neurotrophic factor Val66Met variant: Sex differences and dopamine receptor gene expression.

Jarrett, O., London, E. D., Mahmoudie, T., Suh, J., Ghahremani, D., & Dean, A. C. (2023). Mindfulness and clinical correlates in methamphetamine use disorder.

Kaviyani, F., Khorrami, M., Heydari, H., & Namvar, M. (2023). Understanding the laps and relapse process: In‑depth interviews with individual who use methamphetamine.

Kazemitabar, M., Kheirkhah, M. T., Mokarrami, M., & Garcia, D. (2022). Does auditory attentional bias determine craving for methamphetamine?

Li, D., Wang, D., Tian, Y., Chen, J., Zhu, R., Li, Y., Wang, L., & Zhang, X. Y. (2024). Association between drug craving and aggression in Chinese male methamphetamine‑dependent patients with and without depressive symptoms.

Liu, Y., Wang, L., Yu, C., Liu, Li, H., Zhang, Y., Yu, Y., Bao, J., Wang, T., Qi, Y., & Zhou, Q. (2022). How drug cravings affect metacognitive monitoring in methamphetamine abusers.

Love, S., Nicolls, M., Rowland, B., & Davey, J. (2024). The impact of methamphetamine use and dependence: A systematic review on the cognitive-behavioral implications for road safety.

Ma, C. H., Lin, K. F., Chen, T. T., Yu, U. F., Chien, H. F., & Huang, W. L. (2020). Specific personality traits and associated psychosocial distresses among individuals with heroin or methamphetamine use disorder in Taiwan.

Marvi, N., Haddadnia, J., & Fayyazi Bordbar, M. R. (2024). Modeling functional brain connections in methamphetamine and opioid abusers.

McHugh, K. K., Trinh, C. D., Griffin, M. L., & Weiss, D. (2020). Validation of the Craving Scale in a large sample of adults with substance use disorders. Addictive Behaviors

Northrup, T. F., Green, C., Walker, R., Greer, T. L., & Trivedi, M. H. (2015). On the invariance of the Stimulant Craving Questionnaire (STCQ) across cocaine and methamphetamine users.

Parkin, B. L., Ekhtiari, H., & Walsh, V. F. (2015). Non-invasive human brain stimulation in cognitive neuroscience:

Qi, X., Wang, Y., Lu, Y., Zhao, Q., Chen, Y., Zhou, C., & Yu, Y. (2022). Enhanced brain network flexibility by physical exercise in female methamphetamine users.

Rosen, A. D., Javanbakht, M., Shoptaw, S. J., Seamans, M. J., Lloyd-Smith, J. O., & Gorbach, P. M. (2024). Association of current substance use treatment with future reduced methamphetamine use in an observational cohort of men who have sex with men in Los Angeles.

Serrano, J. I., Iglesias, A., Woods, S. P., & del Castillo, M. D. (2022). A computational cognitive model of the Iowa Gambling Task for finely characterizing decision making in methamphetamine users.

Stacy, P., Frantz, J., Miller, G., Merrill, B., & Gainer, D. (2024). A Narrative Review of the Pathophysiology and Treatment of Methamphetamine‑Associated Psychosis. International Journal of Mental Health and Addiction.

Stalgaitis, C. A., Jordan, J. W., Tate, B., Cruse, B., Bellon, M., Oruga, R., & Hurley, B. (2023). There is hope and help: Reach and reception of a methamphetamine education campaign in Los Angeles County, California.

Substance Abuse and Mental Health Services Administration. (2023). Treatment episode data set admissions (TEDS-A) 2021: Public use file (PUF) codebook. Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration.

Tameh HA, Imani S, Alizadehgoradel J, Noroozi A. Effect of Intensified Transcranial Direct-current Stimulation Targeting Bilateral Dorsolateral Prefrontal Cortex on Craving Reduction in Patients with Opioid (Heroin) Use Disorder. Clin Psychopharmacol Neurosci. 2024 Aug 31;22(3):512-519.

Vilca, S. J., Margetts, A. V., Hoglund, L., Fleites, I., Bystrom, L. L., Pollock, T. A., Bourgain-Guglielmetti, F., Wahlestedt, C., & Tuesta, L. M. (2024)..

Wang, Y., Wang, M., Xie, B., Wen, D., Li, W., Zhou, M., Wang, X., Lu, Y., Cong, B., Ni, Z., & Ma, C. (2023). Effects of molecular hydrogen intervention on the gut microbiome in methamphetamine abusers with mental disorder.

Ward, H. B., Mosquera, M. J., Suzuki, J., & Mariano T.Y. (2020). A systematic review of noninvasive brain stimulation for opioid use disorder. Neuromodulation,

Xing, D. G., Horan, T., Bhuiyan, S., Faisal, A. S. M., Densmore, K., Murnane, K. S., Goeders, N. E., Bailey, S. R., Conrad, S. A., Vanchiere, J. A., Patterson, J. C., Kevil, C. G., & Bhuiyan, M. A. N. (2023). Social-geographic disparities in suicidal ideations among methamphetamine users in the USA.

Xu, W., & Zhao, S. X. (2023). Cases of phenotypic switching from dilated cardiomyopathy to pulmonary arterial hypertension in chronic methamphetamine users..

Xue, M., Li, F., Feng, S., Liu, S., & Gao, L. (2024). A rare incidence of acute ischaemic stroke with reversible middle cerebral artery occlusion in a methamphetamine addict:

Yilmaz, S., Erdogan, Y. E., Tursun, M. Z., Tatliparmak, A. C., & Ak, R. (2024). Unsupervised self-treatment of methamphetamine abuse leading to gastric perforation in the emergency department:

Zerekidze, A., Li, M., Javaheripour, N., Huff, L., Weiss, T., Walter, M., & Wagner, G. (2023). Neural correlates of impaired cognitive control in individuals with methamphetamine dependence:

Zhang, M., Chen, L., Ren, Z., Wang, Z., & Luo, W. (2024). Applications of TMS in individuals with methamphetamine use disorder:

Zhao, Q., Liu, J., Zhou, C., & Liu, T. (2024).

Zhao, X., Wang, L., & Maes, J. H. R. (2021). Training and transfer effects of working memory updating training in male abstinent long-term methamphetamine users. Addictive Behaviors Reports, 14, 100385.

Zhou, Y., Hu, Y., Wang, Q., Yang, Z., Li, J., Ma, Y., & Yang, W. F. Z. (2023). Association between white matter microstructure and cognitive function in patients with methamphetamine use disorder.

References

Alasmari, A., Alhejaili, A., Alharbi, H., Alzahrani, M., & Zughaibi, T. (2024). Challenges and insights: Methamphetamine analysis in post-mortem putrefied human tissues in a hot climate.
Alizadehgoradel J, Nejati V, Sadeghi Movahed F, Imani S, Taherifard M, Mosayebi-Samani M, Vicario CM, Nitsche MA, Salehinejad MA. Repeated stimulation of the dorsolateral-prefrontal cortex improves executive dysfunctions and craving in drug addiction: A randomized, double-blind, parallel-group study. Brain Stimul. 2020 May-Jun;13(3):582-593. doi: 10.1016/j.brs.2019.12.028. Epub 2020 Jan 3. Erratum in: Brain Stimul. 2021 Jan-Feb;14(1):182.
Alizadehgoradel J, Imani S, Nejati V, Vanderhasselt MA, Molaei B, Salehinejad MA, Ahmadi S, Taherifard M. Improved Executive Functions and Reduced Craving in Youths with Methamphetamine Addiction: Evidence from Combined Transcranial Direct Current Stimulation with Mindfulness Treatment. Clin Psychopharmacol Neurosci. 2021 Nov 30;19(4):653-668.
Anderson, E. C., Cantelon, J. A., Holmes, A., Giles, G. E., Brunye, T. T., & Kanarek, R.
APA, 2013. Diagnostic and statistical manual of mental disorders:
Beck, A.T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961).
Beck, A. T., Steer, R. A., & Garbin, M. G. (1988). Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation.
Bikk, A., Chaudhari, J., Navaran, P., Johnson, L Pandit, V., & HI, H. (2024).
Bodeker, R. R. H., & Grace, R. C. (2024). Effects of methamphetamine on probability discounting in rats using concurrent chains.
Cui, Z., Norton, A., & Karamouzian, M. (2023). Characterizing methamphetamine use among people who use opioids:
Droutmana, V., Xue, F., Barkley-Levenson, E., Lam, H. Y., Bechara, A., Smith, B., Lu, Z. L., Xue, G., Miller, L. C., & Read, S. J. (2019). Neurocognitive decision-making processes of casual methamphetamine Users. NeuroImage: Clinical, 21, 101643.
Ekhtiari, H., Kuplicki, R., Aupperle, R. L., & Paulus, M. P. (2021). It is never as good the second time around: Brain areas involved in salience processing habituate during repeated drug cue exposure in treatment engaged abstinent methamphetamine and opioid users.
Ekhtiari, H., Tavakoli, H., Addolorato, G.,Baeken, C., Bonci, A., Bikson, M., & Hanlon, C. A. (2019).Transcranial electrical and magnetic stimulation (tES and TMS) for addiction medicine: A consensus paper on the present state of the science and the road ahead.
Gong, M., Liang, W., He, C., Shen, Y., Zhang, Z., Lou, M., & Xu, Z. (2023). Neuroimaging mechanisms in short-term heroin- and methamphetamine-abstinent users:
Guerin, A. A., Bridson, T., Plapp, H. M., & Bedi, G. (2023). A systematic review and meta-analysis of health, functional, and cognitive outcomes in young people who use methamphetamine.
Haddad, Y. W., Korcari, E., Polsinelli, G. N., & Yuchuan, D. (2021). The effect of cocaine and methamphetamine on saccular aneurysm formation and rupture: A literature review.
He, H., Zhou, S., Peng, C., Ran, W., Tong, S., Hong, L., Cai, F., Jin, W., Jiang, Y., Li, M., Wang, X., Luo, M., Wang, W., & Zhao, K. (2022). Effects of resilience on impulsivity, cognition and depression during protracted withdrawal among Chinese male methamphetamine users.
Hendrickson, K., & Strauss, W. (2020). Characterization and treatment challenges of pulmonary hypertension in methamphetamine users.
Jaehne, E. J., Semaan, H., Grosman, A., Xu, X., Schwarz, Q., & van den Buuse, M. (2023). Enhanced methamphetamine sensitisation in a rat model of the brain-derived neurotrophic factor Val66Met variant: Sex differences and dopamine receptor gene expression.
Jarrett, O., London, E. D., Mahmoudie, T., Suh, J., Ghahremani, D., & Dean, A. C. (2023). Mindfulness and clinical correlates in methamphetamine use disorder.
Kaviyani, F., Khorrami, M., Heydari, H., & Namvar, M. (2023). Understanding the laps and relapse process: In‑depth interviews with individual who use methamphetamine.
Kazemitabar, M., Kheirkhah, M. T., Mokarrami, M., & Garcia, D. (2022). Does auditory attentional bias determine craving for methamphetamine?
Li, D., Wang, D., Tian, Y., Chen, J., Zhu, R., Li, Y., Wang, L., & Zhang, X. Y. (2024). Association between drug craving and aggression in Chinese male methamphetamine‑dependent patients with and without depressive symptoms.
Liu, Y., Wang, L., Yu, C., Liu, Li, H., Zhang, Y., Yu, Y., Bao, J., Wang, T., Qi, Y., & Zhou, Q. (2022). How drug cravings affect metacognitive monitoring in methamphetamine abusers.
Love, S., Nicolls, M., Rowland, B., & Davey, J. (2024). The impact of methamphetamine use and dependence: A systematic review on the cognitive-behavioral implications for road safety.
Ma, C. H., Lin, K. F., Chen, T. T., Yu, U. F., Chien, H. F., & Huang, W. L. (2020). Specific personality traits and associated psychosocial distresses among individuals with heroin or methamphetamine use disorder in Taiwan.
Marvi, N., Haddadnia, J., & Fayyazi Bordbar, M. R. (2024). Modeling functional brain connections in methamphetamine and opioid abusers.
McHugh, K. K., Trinh, C. D., Griffin, M. L., & Weiss, D. (2020). Validation of the Craving Scale in a large sample of adults with substance use disorders. Addictive Behaviors
Northrup, T. F., Green, C., Walker, R., Greer, T. L., & Trivedi, M. H. (2015). On the invariance of the Stimulant Craving Questionnaire (STCQ) across cocaine and methamphetamine users.
Parkin, B. L., Ekhtiari, H., & Walsh, V. F. (2015). Non-invasive human brain stimulation in cognitive neuroscience:
Qi, X., Wang, Y., Lu, Y., Zhao, Q., Chen, Y., Zhou, C., & Yu, Y. (2022). Enhanced brain network flexibility by physical exercise in female methamphetamine users.
Rosen, A. D., Javanbakht, M., Shoptaw, S. J., Seamans, M. J., Lloyd-Smith, J. O., & Gorbach, P. M. (2024). Association of current substance use treatment with future reduced methamphetamine use in an observational cohort of men who have sex with men in Los Angeles.
Serrano, J. I., Iglesias, A., Woods, S. P., & del Castillo, M. D. (2022). A computational cognitive model of the Iowa Gambling Task for finely characterizing decision making in methamphetamine users.
Stacy, P., Frantz, J., Miller, G., Merrill, B., & Gainer, D. (2024). A Narrative Review of the Pathophysiology and Treatment of Methamphetamine‑Associated Psychosis. International Journal of Mental Health and Addiction.
Stalgaitis, C. A., Jordan, J. W., Tate, B., Cruse, B., Bellon, M., Oruga, R., & Hurley, B. (2023). There is hope and help: Reach and reception of a methamphetamine education campaign in Los Angeles County, California.
Substance Abuse and Mental Health Services Administration. (2023). Treatment episode data set admissions (TEDS-A) 2021: Public use file (PUF) codebook. Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration.
Tameh HA, Imani S, Alizadehgoradel J, Noroozi A. Effect of Intensified Transcranial Direct-current Stimulation Targeting Bilateral Dorsolateral Prefrontal Cortex on Craving Reduction in Patients with Opioid (Heroin) Use Disorder. Clin Psychopharmacol Neurosci. 2024 Aug 31;22(3):512-519.
Vilca, S. J., Margetts, A. V., Hoglund, L., Fleites, I., Bystrom, L. L., Pollock, T. A., Bourgain-Guglielmetti, F., Wahlestedt, C., & Tuesta, L. M. (2024)..
Wang, Y., Wang, M., Xie, B., Wen, D., Li, W., Zhou, M., Wang, X., Lu, Y., Cong, B., Ni, Z., & Ma, C. (2023). Effects of molecular hydrogen intervention on the gut microbiome in methamphetamine abusers with mental disorder.
Ward, H. B., Mosquera, M. J., Suzuki, J., & Mariano T.Y. (2020). A systematic review of noninvasive brain stimulation for opioid use disorder. Neuromodulation,
Xing, D. G., Horan, T., Bhuiyan, S., Faisal, A. S. M., Densmore, K., Murnane, K. S., Goeders, N. E., Bailey, S. R., Conrad, S. A., Vanchiere, J. A., Patterson, J. C., Kevil, C. G., & Bhuiyan, M. A. N. (2023). Social-geographic disparities in suicidal ideations among methamphetamine users in the USA.
Xu, W., & Zhao, S. X. (2023). Cases of phenotypic switching from dilated cardiomyopathy to pulmonary arterial hypertension in chronic methamphetamine users..
Xue, M., Li, F., Feng, S., Liu, S., & Gao, L. (2024). A rare incidence of acute ischaemic stroke with reversible middle cerebral artery occlusion in a methamphetamine addict:
Yilmaz, S., Erdogan, Y. E., Tursun, M. Z., Tatliparmak, A. C., & Ak, R. (2024). Unsupervised self-treatment of methamphetamine abuse leading to gastric perforation in the emergency department:
Zerekidze, A., Li, M., Javaheripour, N., Huff, L., Weiss, T., Walter, M., & Wagner, G. (2023). Neural correlates of impaired cognitive control in individuals with methamphetamine dependence:
Zhang, M., Chen, L., Ren, Z., Wang, Z., & Luo, W. (2024). Applications of TMS in individuals with methamphetamine use disorder:
Zhao, Q., Liu, J., Zhou, C., & Liu, T. (2024).
Zhao, X., Wang, L., & Maes, J. H. R. (2021). Training and transfer effects of working memory updating training in male abstinent long-term methamphetamine users. Addictive Behaviors Reports, 14, 100385.
Zhou, Y., Hu, Y., Wang, Q., Yang, Z., Li, J., Ma, Y., & Yang, W. F. Z. (2023). Association between white matter microstructure and cognitive function in patients with methamphetamine use disorder.
Applied Psychology
Volume 19, Issue 3 - Serial Number 75
September 2025
Pages 30-54

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