The use of cognitive training, combined with tDCS, for craving reduction and inhibitory control improvement in cocaine dependence: A case study

Research in the field of pathological addictions has shown how the need and the search for substance are maintained or exacerbated by environmental stimuli linked to the substance (trigger), that determine the state of craving. Many studies consider the craving as a conditioning response, i.e. an active behavior in search of the substance.The resulting obsessive behavior, linked to the search for substance, would be automatic and unavoidable and determined by the subject's impulsiveness and inability to control himself, feeding the cycle of relapses. Several studies have shown how it is possible to reduce the need for craving and increase inhibitory control and self-control through neurostimulation with tDCS directed to the Prefrontal Area and the inferotemporal cortex. Other studies have obtained promising results in this area through specific training, using, for example, the Modified Attentional Bias paradigm.This paper presents an example of a treatment that uses neurostimulation with tDCS together with training based on Modified Attentional Bias on a subject with cocaine addiction. After 20 neurostimulation sessions with tDCS and executive function training, the results show a reduction in craving and impulsivity levels between before and after treatment. Demonstrating the effectiveness of the proposed intervention. These results show how the use of training based on Modified Attentional Bias, combined with neurostimulation, represents an excellent treatment tool for addictions.The potential of the proposed treatment also consists of its possibility of being self-administered and carried out even in the absence of an operator, based on a remotely planned and supervised treatment program.