Effect Of alpha Transcranial alternating current stimulation (tACS) over Left Dorso lateral pre frontal cortex (DLPFC) on cue related Craving in Patients with Cannabis Dependence Syndrome: An ERP-Based Sham-Controlled Study

This randomized, sham-controlled study investigates the effect of alpha transcranial alternating current stimulation (tACS) over the left dorsolateral prefrontal cortex (DLPFC) on cue-induced craving in patients with cannabis dependence syndrome. Thirty male patients (aged 18–50 years) diagnosed using ICD-11 criteria, without comorbid psychiatric disorders (except nicotine/caffeine), major medical illness, or color blindness, were randomized into active (n=15) and sham (n=15) groups. Active tACS involved 10 Hz stimulation at 2 mA using the Starstim 32 device (F3-F4 montage), applied for 20 minutes, twice daily over 2 weeks, while the sham group received identical setup with minimal stimulation. The primary outcomes were changes in craving measured by the Marijuana Craving Questionnaire and neural responses assessed using mismatch negativity (MMN) components of Event-Related Potentials (ERP). Secondary assessments included the Hamilton Anxiety Rating Scale, Brief Psychiatric Rating Scale, and Addiction Severity Index, with additional analysis of correlations with socio-demographic factors. The study aims to evaluate whether alpha tACS can modulate craving-related neural activity and reduce subjective craving, offering potential as a non-invasive neuromodulatory treatment for cannabis dependence.