Prefrontal transcranial direct current stimulation in alcohol use disorder: a pilot randomized sham-controlled trial with exploratory effects on reward craving and depressive symptoms.

TL;DR

Prefrontal tDCS did not outperform sham stimulation on the preregistered primary outcomes of craving severity in a 38-patient AUD pilot trial, but exploratory analyses suggested possible benefits for reward-related craving and depressive symptoms.

Key findings

• Primary outcomes (BSCS and VAS craving measures) showed no significant difference between active tDCS and sham stimulation
• Exploratory analyses indicated potential differential effects on reward-specific craving and depressive symptoms favoring active tDCS at selected timepoints
• Treatment was well tolerated with no major adverse effects reported
• Pilot design and small sample size limit interpretation; findings are preliminary and hypothesis-generating

Why this matters at the bedside

Prefrontal tDCS may warrant further investigation as an adjunctive treatment for AUD, particularly for targeting reward-related craving and comorbid mood symptoms, though rigorous larger trials are needed to establish efficacy.