Add-on repetitive transcranial magnetic stimulation in patients with opioid use disorder undergoing methadone maintenance therapy

Tsai, Tsung Yu; Wang, Tzu Yun; Liu, Yu Chia; Lee, Po Wei; Chang, Wei Hung; Lu, Tsung Hua; Tseng, Huai Hsuan; Lee, Sheng Yu; Chang, Yun Hsuan; Yang, Yihong; Chen, Po See; Chen, Kao Chin; Yang, Yen Kuang; Lu, Ru Band

doi:10.1080/00952990.2020.1849247

Cited by 16 publications

(9 citation statements)

References 76 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Four trials evaluated adding rTMS (one low‐frequency, two high‐frequency, and one cTBS) to nicotine replacement therapy (NRT) patches for the treatment of tobacco use disorder 22 or to either buprenorphine‐naloxone, 23 methadone, 24 or naltrexone 25 in the treatment of OUD. The earliest study was in 2015 by Trojak et al, who combined 10 sessions of 1 Hz rTMS over 2 weeks targeting the right DLPFC (MRI‐guided) with 21 mg NRT patch in treating smoking cessation.…”

Section: Resultsmentioning

confidence: 99%

“…At 12‐week study follow‐up, no significant difference was seen in reported craving or heroin use, nor in urine morphine test results. They note that active treatment did result in significant improvements in mood (Hamilton Depression Rating Scale) and concentration (Barratt Impulsiveness Scale) 24 . Ankit et al followed this study 1 year later, enrolling 40 patients (20 active stimulation, 20 sham) with OUD who initially underwent opioid detoxification with clonidine and then were started on naltrexone 50 mg daily.…”

Section: Resultsmentioning

confidence: 99%

“…Four trials evaluated adding rTMS (one low-frequency, two highfrequency, and one cTBS) to nicotine replacement therapy (NRT) patches for the treatment of tobacco use disorder 22 or to either buprenorphine-naloxone, 23 methadone, 24 or naltrexone 25…”

Section: Stimulation Type: Rtmsmentioning

confidence: 99%

“…It is possible that lower quality sham arms may have suppressed a possible placebo response, thereby inflating the reported effect of active treatment. The DLPFC was the primary stimulation target, with 3 studies targeting the right side, 22,27,28 3 studies targeting the left, 23,24,29 and 1 study with a cross-over design that stimulated either side with 72 h in-between. 26 Ankit et al stimulated the right OFC as the lone alternative location.…”

Section: Limitationsmentioning

confidence: 99%

See 3 more Smart Citations

Systematic review and meta‐analysis: Combining transcranial magnetic stimulation or direct current stimulation with pharmacotherapy for treatment of substance use disorders

Bormann,

Oesterle,

Arndt

et al. 2024

American J Addict

View full text Add to dashboard Cite

Background and ObjectivesTranscranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) have evidence for their potential in the treatment of substance use disorders (SUD). Medication for addiction treatment (MAT) is underutilized and not always effective. We identified randomized controlled trials (RCTs) and case studies that evaluated the effectiveness of TMS or tDCS used concurrently with MAT in SUD treatment.MethodsA systematic review of published literature following Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines was conducted on 6/1/2023 by a medical librarian. Craving‐related scales were extracted for an effect size calculation. The Physiotherapy Evidence Database (PEDro) scale assessed study quality.ResultsEight studies (7 RCT, 1 case) including 253 individuals were published from 2015 to 2022, 5 of which had available data for meta‐analysis. TMS or tDCS combined with MAT significantly reduced craving‐related measures relative to sham stimulation (Hedges' g = −0.42, confidence interval: −0.73 to −0.11, p < .01). Opioid use disorder, methadone, and the dorsolateral prefrontal cortex were the most commonly studied SUD, MAT, and target region.Discussion and ConclusionsOur results show a significant effect; however, is limited by a small number of studies with heterogeneous methodology across intervention methods and SUDs. Additional trials are needed to fully assess the clinical impact and mechanisms of combined brain stimulation and pharmacotherapy. We discuss a possible mechanism for synergism from these treatment combinations.Scientific SignificanceAdds the first systematic review of combination treatment with TMS or tDCS and MAT in SUD patients to the literature and estimates its overall effect size.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Stimulation Type: Rtmsmentioning

confidence: 99%

Section: Limitationsmentioning

confidence: 99%

See 2 more Smart Citations

Systematic review and meta‐analysis: Combining transcranial magnetic stimulation or direct current stimulation with pharmacotherapy for treatment of substance use disorders

Bormann,

Oesterle,

Arndt

et al. 2024

American J Addict

View full text Add to dashboard Cite

show abstract

“…By contrast, Tsai and colleagues found that rTMS over the DLPFC in addition to MMT did not improve heroin use behaviours or cravings in a cohort of 20 participants in Taiwan, although there was evidence that it did reduce depressive symptoms. 42 Using tDCS, Wang and colleagues 43 attempted to reduce opioid cravings based on prior evidence of its previous effectiveness in reducing nicotine cravings. [44][45][46] Twenty males with OUD who were abstinent for at least 1.5 years were randomly assigned to tDCS treatment group or sham tDCS.…”

Section: Opportunities For Actionmentioning

confidence: 99%

Neuromodulation and Opioid Use Disorder: Ethical Opportunities for Canada

Boyle

Illes

2023

Can. J. Neurol. Sci.

View full text Add to dashboard Cite

ABSTRACT:Despite increased efforts of government and non-government organisations to intervene via harm reduction and education initiatives, the opioid crisis has continued to worsen and has been exacerbated by the COVID-19 pandemic. In British Columbia, Canada, opioid overdose deaths in 2021 are the highest ever recorded. Neuromodulation procedures such as deep brain stimulation and repetitive transcranial magnetic stimulation have gained traction as treatments for opioid use disorder in various countries such as Germany, the Netherlands, the United States and China. However, these treatment options have been met with apprehension from both clinicians and patients, likely owing to fear, stigma and reluctance to label addiction as a brain disorder. Further complicating this landscape are socio-demographic factors, as marginalised communities are disproportionately burdened by addiction, while having poor access to care and a history of distrust in the health system. This multifactorial challenge involving many sociocultural factors requires culturally sensitive, interdisciplinary approaches to ensure direct-to-brain innovations are implemented ethically and equitably. This review summarises the state of the science for using neuromodulation to treat opioid use disorder, as well as the available ethical discourse surrounding the expansion of clinical trials and eventual widespread clinical implementation. Additional ethics discussions highlight opportunities for the engineering and clinical evolution of neuromodulation for opioid use disorder trials.

show abstract

Brain Stimulation Methods for Substance Use Disorders

Padda

2023

Technology-Assisted Interventions for Substance Use Disorders

View full text Add to dashboard Cite

Add-on repetitive transcranial magnetic stimulation in patients with opioid use disorder undergoing methadone maintenance therapy

Cited by 16 publications

References 76 publications

Systematic review and meta‐analysis: Combining transcranial magnetic stimulation or direct current stimulation with pharmacotherapy for treatment of substance use disorders

Systematic review and meta‐analysis: Combining transcranial magnetic stimulation or direct current stimulation with pharmacotherapy for treatment of substance use disorders

Neuromodulation and Opioid Use Disorder: Ethical Opportunities for Canada

Brain Stimulation Methods for Substance Use Disorders

Contact Info

Product

Resources

About