A double-blind sham-controlled phase 1 clinical trial of tDCS of the dorsolateral prefrontal cortex in cocaine inpatients: craving, sleepiness, and contemplation to change
Bibliographic record
Abstract
Abstract Impaired inhibitory control accompanied by enhanced salience attributed to drug-related cues, both dorsolateral prefrontal cortex (dlPFC) functions, are hallmarks of drug addiction, contributing to worse symptomatology including craving. dlPFC modulation with transcranial direct current stimulation (tDCS) showed craving reduction in inpatients with cocaine use disorder (CUD). Our study aimed at assessing feasibility of a longer tDCS protocol in CUD (15 vs. the common five/10 sessions), and replicability of previous results. In a randomized double-blind sham-controlled protocol, 17 inpatients were assigned to either a real-tDCS (right anodal/left cathodal) or a sham-tDCS condition, for 15 sessions. Primary outcome measures were self-reported craving, anxiety, depression, and quality of life. Secondary measures included sleepiness, readiness to change drug use, and affect. We also assessed cognitive function including impulsivity. An 82% retention rate demonstrated feasibility. Partially supporting previous results, there was a trend for self-reported craving to decrease in the real-tDCS group more than the sham group, an effect that would reach significance with 15 subjects per group. Quality of life and impulsivity improved over time of treatment in both groups. Significant group × time interactions showed improvements after treatment only in the real-tDCS group for daytime sleepiness and readiness to change drug use. One-month follow-up suggested transient effects of tDCS on sleepiness and craving. This study suggests that more subjects are needed to show a unique effect of real-tDCS on craving and to examine the duration of effect. Increased vigilance and motivation to change in the real-tDCS group suggest fortification of dlPFC-supported executive functions.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".