Transcranial direct current stimulation to modulate fMRI drug cue reactivity in methamphetamine users: A randomized clinical trial

Hamed Ekhtiari, Ghazaleh Soleimani, Rayus Kuplicki, Hung Wen Yeh, Yoon Hee Cha, Martin Paulus

Research output: Contribution to journalArticlepeer-review


Transcranial direct current stimulation (tDCS) has been studied as a therapeutic option to alter maladaptive brain functions associated with chronic substance use. We present a randomized, triple-blind, sham-controlled, clinical trial to determine the neural substrates of tDCS effects on drug craving. Sixty participants with methamphetamine use disorder were assigned to two groups: active tDCS (5 x 7 cm2, 2 mA, 20 min, anode/cathode over the F4/Fp1) and sham stimulation. Neuroimaging data of a methamphetamine cue reactivity task were collected immediately before and after stimulation. There was a significant reduction in self-reported craving after stimulation without any significant effect of time-by-group interaction. Our whole-brain analysis demonstrated that there was a global decrease in brain reactivity to cues following sham but not active tDCS. There were significant time-by-group interactions in five main clusters in middle and inferior frontal gyri, anterior insula, inferior parietal lobule, and precuneus with higher activations after active stimulation. There was a significant effect of stimulation type in the relationship between electrical current at the individual level and changes in task-modulated activation. Brain regions with the highest electric current in the prefrontal cortex showed a significant time-by-group interaction in task-modulated connectivity in the frontoparietal network. In this trial, there was no significant effect of the one session of active-F4/Fp1 tDCS on drug craving self-report compared to sham stimulation. However, activation and connectivity differences induced by active compared to sham stimulation suggested some potential mechanisms of tDCS to modulate neural response to drug cues.

Original languageEnglish (US)
Pages (from-to)5340-5357
Number of pages18
JournalHuman Brain Mapping
Issue number17
StatePublished - Dec 1 2022

Bibliographical note

Funding Information:
This study is supported by internal funds at Laureate Institute for Brain Research to Hamed Ekhtiari provided by Warren Family Foundation. There was no role for the funding agency in the design, execution, analysis, or reporting of this study.

Funding Information:
Hamed Ekhtiari received supports from Warren K Family foundation for this work and also supported by a NARSAD young investigator grant (27305) from Brain and Behavior Research Foundation.

Publisher Copyright:
© 2022 The Authors. Human Brain Mapping published by Wiley Periodicals LLC.


  • craving
  • drug cue
  • fMRI
  • functional connectivity
  • methamphetamine
  • psychophysiological interaction
  • transcranial direct current stimulation

PubMed: MeSH publication types

  • Randomized Controlled Trial
  • Journal Article
  • Research Support, Non-U.S. Gov't


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