Background: Opioid use disorder (OUD) is a chronic disorder with a considerable amount of morbidity and mortality. Despite remarkable improvement achieved by maintenance programs, an array of treatment goals were still unmet. Mounting evidence suggests that transcranial Direct Current Stimulation (tDCS) improves decision making and cognitive functions in addictive disorders. tDCS paired with a decision making task was depicted to diminish impulsivity as well. Objectives: The present study aimed to assess the effect of tDCS combined with cognitive training (CT) in OUD for the first time. Methods: In this triple-blind randomized sham- . . .controlled pilot study, 38 individuals with OUD from the Buprenorphine-Naloxone Maintenance Therapy program were administered 20-minutes of 2mA active/sham tDCS over the dorsolateral prefrontal cortex with concomitant cognitive training. A selected test battery evaluating decision making under risk and ambiguity as well as executive functions, verbal fluency and working memory was utilized before and after the intervention. Results: Greater improvements were observed in decision making under ambiguity (p=0.016), set shifting ability and alternating fluency while no improvements were observed in decision making under risk in the active group, compared to sham. Conclusions: Deficits of decision making and executive functions have a pivotal role in the perpetuation and the relapse of the OUD. Alleviation of these impairments brought tDCS/ CT forth as an expedient neuroscientifically-grounded treatment option that merits further exploration in OUD, Trial registration: NCT05568251
Objectives: Posterior cortex epilepsies (PCE) are characterized by seizures originating from the occipital, parietal, or occipital border of the temporal lobe. It is very important to analyze the patient series and bring them to the literature in the evaluation of the clinical features of this rare seizure type. In our study, the patients with PCE were retrospectively examined and the cognitive functions of the patients were evaluated and the results were compared with those of temporal lobe epilepsy (TLE). Methods: Patients who fulfilled the inclusion criteria among epilepsy patients treated in Cerrahpasa Faculty of Medicine, Depar . . .tment of Neurology were retrospectively screened and included in this study. As a result of the described findings, cases where localization could be made to the posterior or temporal lobe were included in the study and two separate study groups were formed: Group-1
Posterior cortex patients, Group-2
Temporal cortex patients. A control group without any neurological or psychiatric disease was also formed. Detailed neurocognitive tests were applied to all 3 patient groups. Results: There was no significant difference between the demographic data of the control and patient groups. In all the parameters studied, the test results of Group-1 were found to be lower than the control group. The variables that best differentiated the control group from Group-1 and 2 were determined as 'Rey-Osterrieth complex figure test (ROCF),' 'Trail Making Test (TMT) Form A,' 'The Judgment of Line Orientation (JLO) test and California Verbal Learning Test (CVLT) delayed recall' scores. Conclusion: Our findings suggest that both posterior epilepsies and TLE are associated with impairments in visual configuration, verbal skills, and executive functions. From these results, deterioration in visual configuration is an expected result in PCE, whereas deterioration in verbal skills and executive functions is considered an unexpected result in PCE cases since it is typically controlled by the fronto-temporal regions. It was suggested that it would be useful to follow up the patients with a comprehensive cognitive assessment
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