Accelerated HD-tACS for craving and cognition in synthetic cannabinoid use disorder: a case report

Transcranial alternating current stimulation (tACS), a noninvasive neuromodulation technique, has been demonstrated to improve cognitive function. Recent advances in neuromodulation protocols have introduced an accelerated intervention paradigm, which has shown promising therapeutic outcomes across various noninvasive brain stimulation modalities. Despite these encouraging developments in cognitive enhancement, there remains a significant gap in the literature regarding the potential therapeutic applications of accelerated tACS protocols in substance use disorders. We present the case of a 22-year-old man diagnosed with synthetic cannabinoid use disorder (SCUD), who underwent accelerated high-definition tACS (HD-tACS) over two days. Changes in attention bias, craving, and impulsivity were assessed by electroencephalography (EEG), standardized scale, and behavioral test. The results revealed that the patient experienced reductions in pathological attention bias, drug craving, and impulsive and risk-taking behaviors following the accelerated HD-tACS intervention, with reductions in drug craving and behavior control sustained for five weeks post-treatment. This is the first case to confirm the feasibility, safety, and efficacy of accelerated HD-tACS in treating SCUD, with therapeutic effects sustained for up to five weeks, highlighting the need for further systematic investigations in substance use disorders.