tdcs in treatment of craving in sexual addiction

Conditions: Sexual Addiction; Hypersexualism

Summary: in patients with addiction to a substance, an increase in activity in the prefrontal cortex induced by transcranial direct current stimulation -tdcs (non-invasive technique, modulating cortical activity by applying low-intensity electrical currents between two electrodes),may help reduce craving in people addicted to alcohol and tobacco. by analogy with addictive behavior with a substance, the craving observed in certain behavioral addictions would involve the same neural circuits. the main hypothesis is to reduce the sexual craving associated with the viewing of erotic images during active brain stimulation compared to placebo stimulation. functional mri will allow to better understand the neural circuits involved in sexual addiction and in the expected inhibition of sexual arousal by tdcs in sexual addictions during visualization erotic images.

the concept of sexual addiction appeared in american literature about 20 years ago. the term sexual addiction describes an excessive, increasing, and especially uncontrolled frequency of sexual behavior, as a conventional rule, associated with a compelling and irrepressible sexual desire (craving), which persists in spite of the possible negative consequences and personal suffering of the subject. the prevalence of this condition is estimated to be approximately 3-6% in the general population in the united states, it is independent of the socio-cultural environment. the pathophysiology of sexual addictions remains very poorly understood. numerous studies have focused on substance addictions and their pathophysiology. the mesolimbic dopaminergic system plays a major role in addictive behavior. the prefrontal cortex and the basolateral region of the amygdala play an important role in the craving and may cause relapse in subjects. in subjects with sexual addiction, only one controlled study has been conducted on the role of antidepressant treatment in the reduction of craving. the objective of the study is not only to evaluate the efficacy of tdcs neurostimulation in this disorder but also to identify the brain structures involved in this addictive disorder.

Eligibility criteria:
inclusion criteria: * 18-60 year old male * heterosexual * right-handed (manual laterality test) * with a sexual addiction (peacce tool\> 3 and carnes ≥ 13/25) except for controls * having signed a written and informed consent * subject benefiting from social security exclusion criteria: * subject presenting a medical pathology requiring drug treatment, * severe psychiatric pathology (bipolar disorder, hyperactivity or schizophrenia) or another addiction (alcohol, illicit substances or behavioral addiction) * subject consuming psychotropic drugs in progress or during the last month * subject not understanding french * subject under tutorship or curatorship * subjects with neurological disease including epilepsy or a history of head trauma * subjects hospitalized in enforced hospitalization * subject presenting a contraindication to tdcs: subject with an electrical or metal brain implant * subject with a contraindication to mri

Keywords: sexual addiction hypersexualism neurostimulation tdcs fmri