Abstract Details

Title Home-based Transcranial Direct Current Stimulation (tDCS) Paired With Mindfulness for Cannabis Withdrawal in Women With Multiple Sclerosis: Predictors and Affective Correlates of Response

Topic Multiple Sclerosis

Presentation(s) P3 - Poster Session 3 (5:00 PM-6:00 PM)

Poster/Presentation
Number 20-007

Objective

To identify baseline predictors and affective correlates of withdrawal improvement among women with multiple sclerosis (MS) and cannabis use disorder (CUD) receiving active remotely supervised transcranial direct current stimulation (RS-tDCS), and to assess the durability of response through three months post-treatment.

Background tDCS targeting the dorsolateral prefrontal cortex (DLPFC) has shown promise for reducing craving and withdrawal in CUD by modulating neural circuitry underlying withdrawal-related distress, as described in the Koob and Volkow cycle of addiction. People with MS are at high risk for CUD, which is associated with cognitive and mood disturbances. To address this need, we developed a home-based DLPFC RS-tDCS intervention paired with mindfulness meditation to support reduction of cannabis use. In prior trials, RS-tDCS significantly reduced cannabis withdrawal symptoms.

Design/Methods This secondary analysis included women with MS and CUD assigned to the active RS-tDCS arm (n = 22). Participants completed 4-weeks of stimulation paired with mindfulness meditation audiotracks. The Cannabis Withdrawal Scale (CWS), Kessler Psychological Distress Scale (K10), Positive Affect and Negative Affect Schedule (PANAS), and SymptoMScreen were administered at baseline, post-treatment, and 3-month follow-up. Predictors included age, disease duration, use of cannabis before MS, duration of cannabis use, baseline K10, and baseline CWS. The primary outcome was change in CWS. Correlations examined co-movement of affective change with withdrawal improvement.

Results CWS improved significantly from baseline to post-treatment (from 61.2±31.4 to 38.8±28.7; mean change = 22.4±30.7; p=.001) and these gains were maintained 3-months post-intervention. Longer disease duration predicted greater improvement (r=0.43, p=.05) while age, baseline distress, and cannabis history were insignificant. Changes in affect were small and uncorrelated with CWS improvement, suggesting withdrawal relief occurred independently of mood effects.

Conclusions Among women with MS receiving active treatment, cannabis withdrawal was significantly and durably reduced. Effects appeared independent of mood, suggesting that RS-tDCS may directly modulate neural circuits underlying withdrawal-related distress.

Authors/Disclosures
Shayna Pehel PRESENTER	Ms. Pehel has nothing to disclose.
Carlin A. Beskrone	Mr. Beskrone has nothing to disclose.
Timothy Ko (NYU Langone Health)	Timothy Ko has nothing to disclose.
Leigh E. Charvet, PhD (NYU Langone)	Dr. Charvet has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Johnson & Johnson. Dr. Charvet has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Springer Healthcare. Dr. Charvet has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for YBrain. Dr. Charvet has stock in Johnson&Johnson.
Giuseppina Pilloni, PhD (NYU Grossman School of Medicine)	Dr. Pilloni has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Ceragem.

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