Motivation to ingest alcohol is among the most important factors that contributes to the development and maintenance of alcohol use disorders. The neural substrates underlying these approach motivations include ventral and dorsal striatum, anterior cingulate cortex, dorsolateral prefrontal cortex, and insula. Current treatments including both pharmacological and psychosocial interventions, appear to work in part by reducing engagement of neural circuits involved in incentive motivation such as the ventral striatum. Further, a new potential treatment that uses cognitive retraining of implicit approach motivations likely exerts its effects by reducing incentive motivation for alcohol and thus the desire to consume alcohol. Few attempts have been made to explicitly enhance cortical regions involved behavioral control, another manner by which it may be possible to reduce motivational drives to use alcohol. Transcranial direct current stimulation (tDCS) is one method of brain stimulation that is known to increase cortical excitability, and its application can result in redued craving, enhanced behavioral control, and enhanced learning, suggesting that tDCS may be useful for augmenting current treatment approaches. Building on cognitive retraining efforts, we propose to 1) investigate the neural mechanisms associated with approach and avoid motivations towards alcohol in high risk drinkers, and 2) investigate the degree to which application of tDCS can enhance learning during cognitive retraining protocols and subsequently reduce approach related motivations and drinking. To that end, we will first determine the neural correlates of avoidance responses to alcohol related stimuli in high risk drinkers as compared to social drinkers. Following this initial study, we will conduct a double-blind investigation of the effects of full strength or sham tDCS on individuals engaged in an avoid alcohol or sham cognitive retraining program on implicit alcohol approach and avoid motivations and drinking. By examining the effects of tDCS on cognitive retraining of alcohol related motivations, we hope to provide initial evidence of the utility of brain stimulation techniques in treatment for alcohol dependence.
Reducing the motivation to drink alcohol is one of the most challenging aspects of treatment for alcohol dependence. Brain stimulation techniques such as transcranial direct current stimulation may hold incredible promise for augmenting attempts to reduce drinking. This research aims to test the effectiveness of concurrent brain stimulation and cognitive retraining on reducing motivation to drink in high-risk drinkers.
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