The effectiveness of transcranial photobiomodulation therapy (tPBM) and transauricular vagus nerve stimulation (taVNS) on reducing alcohol craving.

Alcohol craving plays a central role in sustaining alcohol use and contributing to relapse. Noninvasive neuromodulation techniques such as transcranial photobiomodulation (tPBM) and transauricular vagus nerve stimulation (taVNS) may target craving-related neural circuits through complementary cortical and subcortical mechanisms. However, their relative and combined effects on craving and related symptoms remain unclear. To compare the effects of tPBM, taVNS, and combined tPBM + taVNS on alcohol craving, alcohol use, and psychological outcomes in individuals with subclinical alcohol use. Sixty participants were randomized to one of three intervention groups: tPBM, taVNS, or combined tPBM + taVNS. Participants self-administered the assigned stimulation five times per week for five weeks using portable home devices (15 min/session, total 25 sessions). Change in craving was the primary outcome. Both tPBM and combined tPBM + taVNS produced significant reductions in craving (PACS: p < 0.001) and alcohol use (AUDIT: p ≤ 0.011) compared with taVNS alone. ANCOVA revealed a significant group effect on craving (F(2,54) = 5.24, p = 0.008). Logistic regression showed higher odds of craving response with tPBM (OR = 8.09) and of drinking-behavior improvement with combined stimulation (OR = 16.73). tPBM and combined tPBM + taVNS effectively reduced craving, alcohol use in individuals with subclinical alcohol use.