Telehealth tDCS to reduce cannabis use: A pilot RCT in multiple sclerosis as a framework for generalized use

Area of Science:

• Neuroscience
• Psychiatry
• Telehealth

Background:

• Cannabis use disorder (CUD) is prevalent and lacks FDA-approved treatments.
• Women with multiple sclerosis (MS) represent a vulnerable population with high CUD rates.
• Novel therapeutic approaches are needed for CUD, particularly in specific medical subpopulations.

Purpose of the Study:

• To evaluate the feasibility and preliminary efficacy of a one-month telehealth intervention for CUD in women with MS.
• The intervention combined remotely supervised transcranial direct current stimulation (RS-tDCS) with mindfulness meditation.
• To assess the impact on cannabis use, withdrawal symptoms, and MS-related symptoms.

Main Methods:

• A randomized controlled trial (RCT) involving 47 women with MS and CUD.
• Participants received 20 sessions of home-based RS-tDCS targeting the left dorsolateral prefrontal cortex (DLPFC) over four weeks.
• Intervention was paired with guided mindfulness meditation; feasibility assessed by retention and adherence.

Main Results:

• High retention rate (83%) indicates feasibility of the telehealth approach.
• Active RS-tDCS group showed significant reductions in weekly cannabis use and withdrawal symptoms.
• A trend toward reduced MS-related symptoms and significant cognitive performance improvement was observed in the active group.

Conclusions:

• Telehealth RS-tDCS combined with mindfulness meditation is a feasible and promising treatment for CUD in women with MS.
• This approach shows potential for larger-scale clinical trials and future clinical application.
• Highlights the need for accessible CUD treatments in vulnerable medical subpopulations.