Effect of Transcranial Direct Current Stimulation (tDCS) on Tobacco Consumption

Effect of Transcranial Direct Current Stimulation (tDCS) on Tobacco Consumption.

The primary purpose of the protocol is to evaluate the effect of repeated application for 5 consecutive days of a real tDCS compared to the application of a placebo tDCS (sham procedure) on the evolution of tobacco consumption in the short term between Day 1 and Day 5.

The study hypothesis is that a repeated application for 5 consecutive days of a real tDCS on the left dorsolateral prefrontal cortex region will reduce the craving induced causing a decreased of daily tobacco consumption between Day 1 and Day 5 which can persist at the final visit between Day 15 and Day 20.

Smoking is a major public health problem and it is the leading cause of preventable death in the world. Care should include education, psychotherapy and treatments, but despite these therapeutics, the smoking cessation process is often characterized by relapses. The main risk factor for relapse is craving. Neurophysiological studies have provided evidence in the understanding of craving. This craving involves surface structures including the dorsolateral prefrontal cortex, accessible by neurostimulation. Repetitive neurostimulation applies on this structures involved in craving could therefore modulate it. Two non-invasive stimulation techniques exist: repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS). The choice of tDCS is based on its ease of use, excellent tolerance, its better quality of placebo and low cost.

Inclusion Criteria:

• Aged 18 to 60 years old
• Smoking ≥ 5 years
• Smoking ≥ 15 manufactured cigarettes per day or ≥ 10 rolled cigarettes per day
• Fagerström test ≥ 5
• Smokers who have at least an attempt to stop of minimum 7 days
• Written informed consent signed by the patient
• Affiliated to medical insurance

Exclusion Criteria:

• Co-addiction (cannabis, alcohol, other drugs)
• HAD test: D ≥ 8; A + D ≥ 19
• Treatment by nicotine replacement therapy, bupropion or varenicline within 30 days prior inclusion
• Neuropsychiatric disease, considered serious by the investigator
• Psychotropic treatment (antidepressant, anxiolytic, antipsychotic)
• Skin scalp dermatosis
• Pregnancy or breastfeeding. Positive pregnancy test.
• Patient under guardianship, trusteeship or judicial protection
• Patient in inclusion period for another clinical research protocol