At-home neural stimulation lowers cannabis withdrawal in MS women
Symptoms also tended to ease with tDCS, mindfulness training
Supervised, noninvasive at-home neural stimulation helped women with multiple sclerosis (MS) and cannabis use disorder (CUD) decrease their cannabis intake and reduce withdrawal, a study suggests.
Overall symptoms of MS also tended to ease with four weeks of transcranial direct current stimulation (tDCS) plus mindfulness training.
“This pilot [randomized control trial] shows that a fully remote, home-based tDCS intervention is a feasible, safe, and promising approach for reducing cannabis use and withdrawal symptoms in women with MS and CUD,” the study’s researchers wrote in “Telehealth tDCS to Reduce Cannabis Use: A Pilot RCT in Multiple Sclerosis as a Framework for Generalized Use,” which was published in Drug and Alcohol Dependence.
A progressive neurodegenerative disorder, MS can lead to a variety of symptoms including pain, cognitive impairment, and muscle spasms. Some people use recreational or medicinal cannabis to manage their symptoms, but findings from scientific trials remain split on the potential benefits and drawbacks of this approach.
Nabiximols, a cannabis-based oral spray, has been found to effectively ease spasms related to MS and may also help with pain. Cannabis may exacerbate cognitive symptoms of MS, however, particularly with chronic use. Some frequent users may develop CUD, wherein they become reliant on it and have withdrawal symptoms if they discontinue it.
For this reason, people with MS and CUD may want to reduce their reliance on it without triggering withdrawal. “Targeting the neural circuitry underlying addiction represents a novel and promising approach to addressing substance use disorders,” wrote the researchers, who used tDCS, a technique that uses low intensity electrical current to noninvasively modulate neural activity, to test their hypothesis.
Less cannabis withdrawal and use, and reduced symptoms
In the clinical study (NCT05005013), the researchers stimulated the dorsolateral prefrontal cortex (DLPFC), an area of the brain involved in cognition and emotional regulation. Many researchers believe the DLPFC perpetuates distress and other negative emotions that drive cycles of addition.
The participants included 47 women with relapsing-remitting MS and confirmed CUD, who were an average age of 43 and lived in 25 U.S. states. One of the criteria for being included was a desire to reduce cannabis use. All the women received an at-home tDCS device preprogrammed to deliver either active stimulation for 20 minutes or sham stimulation, a control condition where the device was off for 18 minutes.
Research technicians used video chats to supervise daily sessions five days a week for four weeks, for a total of 20 sessions. During each session, both groups’ participants listened to a 10-minute mindfulness meditation followed by music. Mindfulness meditation is a practice where a person focuses their attention on the present moment, calmly observing their thoughts, feelings, and sensations.
The’ primary goal was to determine if this type of virtual study design with tDCS was feasible. With 83% of women completing the intervention, they concluded that the at-home setup was successful, including for those who had jobs or school to go to.
Cannabis withdrawal symptoms decreased significantly by the end of the four weeks for the women who received active stimulation. In particular, symptoms of craving, depressed mood, and restlessness were significantly lower in the active stimulation group and were maintained for up to three months.
Cannabis use frequency also significantly decreased in the active group. At the beginning of the intervention, both groups had an average use of 5.3 days per week. After four weeks, the treatment group showed a statistically significant decrease to 3.9 days per week, while the control group had a nonsignificant reduction to 4.8 days per week. Monthly use also went down over time, but only those in the active tDCS group showed a significant decrease.
Participants in the active group also saw a significant decrease in MS symptoms, as measured with the SymptoMScreen questionnaire, and increases in cognitive performance metrics. The effect on MS symptoms wasn’t sustained by the end of the three-month follow-up. “Future studies should explore whether longer-term interventions or maintenance protocols could help sustain these gains,” the researchers wrote.
The study had some limitations, including that all the participants were female and had the same MS subtype. “While we believe this intervention has potential for wider applicability, there may be unique characteristics of this specific population that contributed to its feasibility and effectiveness,” wrote the scientists, who said enrollment and completion rates can “[lay] the groundwork for future studies aimed at establishing clinical utility” of at-home tDCS.
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