Brain stimulation may help people with multiple sclerosis cut back on excessive cannabis use

A noninvasive device that delivers weak electrical currents to the brain may help those with multiple sclerosis cut back on excessive cannabis use, a new NYU Langone Health study of women with the condition shows.

More than half of people with multiple sclerosis use cannabis products to ease sleep problems, chronic pain, and muscle spasms, among other common symptoms. Experts say up to 20 percent may develop cannabis use disorder, a condition marked by disruptive, hard to control, and often heavy use.

In the pilot study, the research team investigated the effects of the at-home transcranial direct current stimulation (tDCS) device, combined with guided mindfulness meditation, in 47 women diagnosed with both multiple sclerosis and cannabis use disorder. Over four weeks, participants completed daily tDCS sessions, with average cannabis use falling from about five days per week to two days per week after treatment.

The device passes an electrical current through two electrodes placed on the scalp, targeting the prefrontal cortex—the part of the brain involved in decision-making and emotional regulation. This stimulation is thought to enhance neuroplasticity, which is the brain's ability to adapt and form new connections. By boosting this process during mindfulness exercises, the researchers say, patients may find it easier to relax, manage cravings, and gradually reduce their need for cannabis.

Our initial study suggests that at-home transcranial direct current stimulation may offer a safe, portable option that people with cannabis use disorder can use daily to support their recovery."

Giuseppina Pilloni, PhD, study lead author, assistant professor, Department of Neurology at NYU Grossman School of Medicine

Dr. Pilloni notes that there are currently no approved treatments for long-term and heavy cannabis use. The disorder has been linked to problems with memory, attention, and mood, and it can reduce overall quality of life.

Previous research showed the potential of tDCS to treat a variety of psychiatric and neurological disorders, most notably depression.

The new investigation, published online May 8 in the journal Drug and Alcohol Dependence, is the first to demonstrate clinical results for tDCS in patients diagnosed with both multiple sclerosis and cannabis use disorder, Dr. Pilloni says.

As part of the study, participants received 20 sessions of tDCS—5 sessions per week, each lasting 20 minutes.

Each session was paired with guided online mindfulness meditation, and all treatments were administered remotely via telehealth, allowing participants to interact with the researchers in real time. The study compared outcomes among participants who received active stimulation and those who received a placebo that mimicked the feeling of an electrical current without delivering stimulation.

The findings showed a reduction in withdrawal symptoms, including anxiety, sleep disturbances, decreased appetite, and irritability.

"Cannabis use disorder is often overlooked and undertreated," said study senior author Leigh E. Charvet, PhD, a professor in the Department of Neurology at NYU Grossman School of Medicine. "This study highlights that transcranial direct current stimulation may be a scalable, accessible intervention that could fill a critical gap in care."

Dr. Charvet adds that because of the promising findings, the research team has launched a nationwide pilot study to investigate the therapy for cannabis use disorder in people without multiple sclerosis. The team also plans to expand the current study to a larger group of men and women with multiple sclerosis and to examine how reducing cannabis use may not only improve daily functioning but also reduce symptoms of the neurological disease.

Funding for the study was provided by National Institutes of Health grant R21DA055427.

Dr. Pilloni and Dr. Charvet have received speaking fees from Soterix Medical. The terms and conditions of these relationships are being managed in accordance with the policies and procedures of NYU Langone Health.

In addition to Dr. Pilloni and Dr. Charvet, NYU Langone researchers involved in the study are Shayna Pehel, BS; Timothy Ko, BS; Carrie L. Sammarco, NP; and Robert W. Charlson, MD.