TDCS to Reduce Craving in Cocaine Addiction- Phase 2 Study

Last updated: November 14, 2024
Sponsor: Soterix Medical
Overall Status: Completed

Phase

2

Condition

Stimulant Use Disorder

Treatment

transcranial direct current stimulator (tDCS)

Cognitive Reappraisal

Clinical Study ID

NCT04994821
SMIMS09282020
HS# 18-01324, GCO# 18-1920
  • Ages 18-65
  • All Genders

Study Summary

Transcranial direct current stimulation (tDCS) is a form of non-invasive brain stimulation in which low level electrical currents are applied to the scalp in order to alter brain function. In a prior Phase-I study, the research team demonstrated feasibility of self-administration of a home-tDCS prototype in 14 patients that applied 15 sessions for each patient at an outpatient center.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  • DSM-5 diagnosis of cocaine use disorder

  • Ability to understand the risks/benefits of the study, provide informed consent andperform tasks as per protocol

  • English speaking

  • For females of childbearing capacity, current use of a medically acceptable form ofbirth control

Exclusion

Exclusion Criteria:

  • Current or past history of a major neurological disorder (e.g. mental retardation,Parkinson's disease, Lewy body disease, Huntington's disease, MS, ALS, stroke,delirium tremens) or seizures, including those symptoms associated with periods ofcocaine withdrawal or abstinence

  • History of Axis I disorder, other than substance use disorder, that is associatedwith psychotic symptoms (e.g. schizophrenia) or neurodevelopmental disorder (e.g.,autism)

  • Use of medications (current or in the past 6 months) with known CNS effects or whichmay alter cerebral function, except psychotropics for depression/anxiety/PTSD (e.g.SSRIs)

  • Clinically significant unstable medical illness or infection (e.g. HIV, hepatitis,etc.)

  • Presence of contraindicated metallic implants or devices which may be impacted byelectrical stimulation (e.g. cardiac pacemaker/defibrillator, medication pump,cochlear implant, implanted brain stimulator)

  • Head trauma with loss of consciousness for more than 30 minutes

  • Pregnancy or breast feeding

Study Design

Total Participants: 60
Treatment Group(s): 2
Primary Treatment: transcranial direct current stimulator (tDCS)
Phase: 2
Study Start date:
September 28, 2020
Estimated Completion Date:
September 30, 2022

Study Description

The ultimate goal of this project is to develop a portable neuromodulatory intervention to reduce craving in cocaine addiction. This proposed project is in response to NIH/NIDA's solicitation titled "Development of Portable Neuromodulatory Device for the Treatment of Substance Use Disorders (SUDs)." The present study aims to increase the efficacy of repeated administration of tDCS to reduce drug craving in individuals with cocaine addiction.

Substance use disorders present a treatment challenge for clinicians, as well as a socioeconomic burden on individuals and society at large. Cocaine use disorder occurs when someone experiences clinically significant impairment caused by the recurrent use of cocaine, including health problems, physical withdrawal with discontinuation of use, persistent/escalating use, and failure to meet major personal, occupational, or educational responsibilities. At present, no FDA approved medicines are available to treat cocaine dependence, and behavioral therapy may be used to treat this addiction, though with limited efficacy. Drug craving (strong obsessions about and/or irresistible urges or compulsions to consume a drug) is a central driving force for perpetuation of substance use and subsequent addiction, as well as relapse after abstinence. Currently, no treatments exist that are targeted at reducing drug craving, which is intrusive and distressing to patients. The prefrontal cortex (PFC) plays an important role inhibiting these intrusive cravings. However, decades of data have shown that PFC activity is impaired in addictions. In this study, our goal is to increase PFC activity with non-invasive neuromodulation. Given the role of the PFC in the processing and regulation of craving behavior, this brain region is a key target for brain stimulation.

This study will recruit individuals with a diagnosis of cocaine use disorder (per DSM-5 criteria) who are receiving treatment for their substance use disorder at Samaritan Daytop Village (SDV) and other similar treatment facilities (e.g., Phoenix House, Mount Sinai's network of hospitals and clinics). Patients will be randomly assigned into three groups: active (real-tDCS), real-tDCS and Cognitive Reappraisal (CR), or sham (placebo) tDCS. Participants will receive 20 minutes of stimulation per tDCS day, three days per week for five weeks.

Interviews and neuropsychological testing will be conducted, and self-reported drug craving and addiction severity questionnaires will be used. Follow up cognitive and behavioral assessments will be conducted over a period of 12 months post tDCS stimulation. In addition, participants will be asked to perform EEG, cognitive tasks, and collection of a blood sample to assess genetic/epigenetic patterns

Connect with a study center

  • Icahn School of Medicine at Mount Sinai

    New York, New York 10029
    United States

    Site Not Available

Not the study for you?

Let us help you find the best match. Sign up as a volunteer and receive email notifications when clinical trials are posted in the medical category of interest to you.