Safety and efficacy of intensified electrical stimulation targeting dorsolateral prefrontal cortex for the treatment of gambling disorder associated with online sports betting: a case report

The number of individuals with gambling disorders (GD) associated with online sports betting (OSB) is on the rise, despite the absence of effective treatment. Recently, the effectiveness of noninvasive brain stimulation (NIBS) techniques, such as transcranial direct current stimulation (tDCS) targeting the dorsolateral prefrontal cortex (DLPFC), has been demonstrated in treating various addictive disorders. Consequently, tDCS may be a promising treatment option. In the present case report, we evaluate the efficacy of a new intensified tDCS protocol (ten sessions, 2 mA for 20 min, two sessions daily, with 20 min intervals between daily sessions, one week in total) applied to the DLPFC (anode over the left and cathode over the right) in a patient with GD and OSB. Research variables were measured before, during, and after the intervention. The results indicate that the tDCS intervention improved gambling symptoms, impulsivity, depression, and anxiety states. The highest percentage of changes from before to after the intervention is associated with symptoms of gambling and depression. Our findings indicate that an intensified tDCS stimulation protocol of the left anodal/right cathodal DLPFC may effectively improve gambling behavior. Additional research on large patient populations is required to improve the generalizability of the current protocol.