| Nicotine dependence is among the leading causes of mortality worldwide with almost 6million deaths each year according to the World Health Organization,and has caused major economic losses to the country and society.Despite the availability of treatments for nicotine dependence(bupropion,varenicline)including nicotine replacement therapy(NRT)(skin patch,nasal spray)and cognitivebehavioral therapy(CBT),only 6%of the more than 1 billion smokers who want to quit each year are successful in doing so for more than a month.Recently The potential of neurostimulation techniques(such as transcranial direct current stimulation(tDCS)and transcranial magnetic stimulation(TMS))to treat nicotine addiction has received some preliminary empirical support,but the meta-analysis results show that the treatment effect is only a moderate effect,so it is urgently needed to develop a more effective alternative to treat nicotine addiction.A large number of studies have shown that transcranial direct current stimulation(tDCS)can help reduce smoking-related behaviors,such as reported cravings and the number of cigarettes.The psychological mechanism may be that transcranial direct current stimulation improves the inhibition control ability and cognitive ability of smokers.Cognitive behavioral therapy is a commonly used method of psychotherapy,which can improve the bad cognition of drug abusers,reduce their negative behaviors and negative emotions,and enhance their motivation to quit smoking.In this study,transcranial direct current stimulation(tDCS)and cognitive intervention were combined to explore the effects on cigarette cravings and smoking quantity of the smoking subjects.In experiment one,The Nicotine Dependence Questionnaire(FTND)was used to screen 20smoking male subjects.The average nicotine dependence test score(FTND)was 4.53,the average age was 20.89 years old and the average daily smoker was 14.79.The small smoke sensor pi CO+Smokerlyzer of Bedfont was used to determine whether the cigarette withdrawal time of the subjects reached the standard.Researchers used 2(tDCS stimulation type:active,sham)×2(cognitive intervention:smoking is not good,animal experiment is not good)repeated experimental design within the subject in experiment one.Transcranial direct current stimulation performed anode stimulation on the right DLPFC and cathode stimulation on the left DLPFC with a stimulation current of 2 mA.For active stimulation,subjects received a constant current of 2 mA within 25 minutes;for sham stimulation,the stimulation current turn on to 2mA only in the first 30seconds and the last 30 seconds of 25 minutes,with one week interval between two stimulation to eliminate the effect of the last stimulation.Cognitive intervention material is a 3-minute audio clip designed to mimic key components of cognitive behavioral therapy,including psychological education and cognitive reorganization.The smoking craving questionnaire(QSU-Brief)and the VAS scale were used to measure changes in craving levels of short-term withdrawal smokers.The smoking incubation period and the number of cigarettes smoked within 30 minutes after the end of the stimulation intervention were recorded.The results of repeated measurement analysis of variance found that:(1)For the changes in cravings and smoking incubation period,the main effects of stimulus type and cognitive intervention are significant.Compared with sham stimulation,cravings are reduced more under active stimulation,and smoking latency is longer;compared with control interventions,cravings are reduced more under cognitive intervention,and smoking latency is longer.The interaction between stimulus type and cognitive intervention is not significant.(2)For the number of smoking,repeated measures analysis of variance found that the main effects of stimulus type and cognitive intervention were significant,and the interaction between stimulus type and cognitive intervention was significant F(1,18)=5.660,p=0.029,?~2=0.239.(3)Simple effects analysis found that under true stimulation conditions,the total amount of smoking in the cognitive intervention group was significantly lower than that in the control group,while under sham stimulus,there was no significant difference in the total amount of smoking between the cognitive intervention group and the control group.In experiment two,the nicotine dependence questionnaire(FTND)was used to screen 48smoking male subjects.The average nicotine dependence test score(FTND)was 4.64,the average age was 20.90 years old and the average daily smoker was 16.33.Experiment two used a mixed experimental design of 2(tDCS stimulation type:active,sham)×2(cognitive intervention:smoking harmful health videos,neutral videos)×5(number of stimulation interventions),tDCS stimulation type and cognitive intervention were variables between groups,and the number of stimulation interventions were internal variables.Transcranial direct current stimulation performed anode stimulation on the right DLPFC and cathode stimulation on the left DLPFC with a stimulation current of 2 mA.For active stimulation,subjects received a constant current of 2 mA within 20 minutes;for sham stimulation,the stimulation current turn on to 2mA only in the first 30seconds and the last 30 seconds of 20 minutes.Cognitive intervention material is a 5-minute video designed to mimic key components of cognitive behavioral therapy,including psychological education and cognitive reorganization.Subjects were subjected to transcranial direct current stimulation combined with cognitive intervention for 5 consecutive days(once a day),and watched the video twice during each transcranial direct current stimulation(The video is played at the 5th minute and the 15th minute after the start of the stimulation,with an interval of 5 minutes).The video sound is transmitted through the headphones.Cravings,motivation to quit smoking,positive and negative emotions were measured before and after each stimulation intervention.The smoking diary was used to record the daily smoking volume of the subjects two days before the start of the formal stimulation intervention and one week after the end of the stimulation intervention(a total of 14 days).The results of experiment two are as follows:(1)Repeated analysis of variance was performed on the smoking craving questionnaire score(pretest),and the main effects of the number of stimuli were found to be significant F(4,44)=10.31,p<0.001,?2=0.52.As the number of stimuli increased,the craving Gradually decreases.The main effects of stimulus type and cognitive intervention were not significant.Significant interaction was found between the number of stimuli and cognitive intervention F(4,44)=3.61,p=0.014,?2=0.275,Under the condition of cognitive intervention,the short version of the craving questionnaire score(pretest)gradually decreases with the increase of the number of stimuli;Other interactions were not significant.(2)Correlation analysis was performed on the subjects'desire for VAS(pretest-posttest)and changes in motivation(pretest-posttest).The results showed that each change in cigarette cravings and change in motivation to quit smoking were significantly negatively correlated.(3)Repeated analysis of variance was performed on the number of cigarettes smoked one day before the stimulus intervention(D2),one day after the stimulus intervention(D8),and one week(D14)after the stimulus intervention.The results showed that the main effect of stimulus type was not significant F(1,44)=2.12,p>0.05,the main effect of cognitive intervention was not significant F(1,44)=0.59,p>0.05,the main effect of time was significant F(2,44)=35.13,p<0.001,?~2=0.637,The interaction type of stimulus,cognitive intervention and time was significantly marginal,F(4,44)=2.96,p=0.063,?~2=0.129.A simple effect analysis found that under true stimulation+cognitive intervention conditions,the amount of smoking after stimulation(D2)and one week(D14)after stimulation was significantly lower than that before stimulation(D2)(p<0.001);Under the condition of sham stimulation+cognitive intervention,the smoking amount after the stimulation(D8)was significantly lower than that before the stimulation(D2)(p<0.001),and the amount of smoking one week(D14)after the stimulation was significantly higher than that after the stimulation(D8)(p<0.01).The effect of smoking cessation intervention under the condition of true stimulation+cognitive intervention is persistent.However,under false stimulus+cognitive intervention conditions,smoking can be reduced during treatment,but smoking will rebound after treatment.From these results,we draw the following conclusions:(1)Both transcranial direct current stimulation and cognitive intervention can reduce craving and increase smoking latency;(2)Compared with transcranial direct current stimulation and cognitive intervention alone,transcranial direct current Stimulation combined with cognitive intervention has a cumulative effect on reducing cigarette cravings and smoking volume;(3)The smoking cessation effect of multiple transcranial direct current stimulation combined with cognitive intervention has long-lasting effects,and the amount of smoking will not rebound for at least one week after the stimulation intervention;(4)Cognitive intervention has a cumulative effect on reducing cravings,as the number of interventions increases,cravings gradually decrease;(5)The possible reason that cognitive intervention can reduce craving is that cognitive intervention can change the motivation to quit smoking,and the level of motivation to quit smoking is significantly increased,leading to a decrease in craving and a decrease in the number of smoking. |
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