Intermittent theta burst transcranial magnetic stimulation for methamphetamine addiction: A randomized clinical trial

Su, Hang; Chen, Tianzhen; Jiang, Haifeng; Zhong, Na; Du, Jing; Ke, Xiao; Xu, Ding; Song, Weidong; Zhao, Min

doi:10.1016/j.euroneuro.2019.12.114

Cited by 30 publications

(33 citation statements)

References 9 publications

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“…Clinical studies have also shown that cue-induced cravings, electrophysiological changes, and imaging changes are important indicators in predicting relapse in substance-dependent patients [35] , [36] , [37] . The present study found that Group A significantly decreased cue-induced craving after a two-week treatment, which is consistent with our previous study [27] . Interestingly, Group B has a better but non-significant craving decrease effect compared with Group A.…”

Section: Discussionsupporting

confidence: 94%

“…Sample size were calculated according to superiority test formula (

, k is the number of groups,

and S j are the mean value and standard deviation of each group respectively) for multiple groups [28] , with α = 0.05, β = 0.1, k = 4. Based on our previous study [27] , A conservative estimation for the craving change of DLPFC iTBS, vmPFC cTBS, and sham group at two-week are 25(SD=15), 25(SD=15), and 5(SD=15) respectively. Combining the two treatment methods may have better efficacy, so the estimated value of the combination of DLPFC iTBS and vmPFC cTBS was set as 35(SD=15).…”

Section: Methodsmentioning

confidence: 99%

“…A total of 10 sessions over two weeks (one session/day and five days/ week) were administered to all patients. The TBS parameters in this study were based on the previous safe standard TBS parameters used in our lab [27] , with 3-pulse 50-Hz bursts given every 200 ms. The resting motor threshold (RMT) was identified by using the standardized PEST procedure [29] and have also been reported in our previous study [30] .…”

Section: Methodsmentioning

confidence: 99%

“…By exploring the curative effect of these two regions, it may help us to develop optimized , precise, and individualized rTMS therapy for SUD. In addition to craving, we also sought to determine its impact on cognitive functions and emotion symptoms which were often reported in previous studies [ 26 , 27 ].…”

Section: Introductionmentioning

confidence: 99%

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The exploration of optimized protocol for repetitive transcranial magnetic stimulation in the treatment of methamphetamine use disorder: A randomized sham-controlled study

Chen

et al. 2020

EBioMedicine

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Background The prefrontal-striatal circuit is a core circuit related to substance dependence. Previous studies have found that repetitive transcranial magnetic stimulation (rTMS) targeting the dorsolateral prefrontal cortex (DLPFC) (key region of executive network) had limited responses, while inhibiting hyperactivation of ventromedial prefrontal cortex (vmPFC) (key region of limbic network) may be another strategy. However, there is currently no comparison between these two treatment locations. Methods Seventy-four methamphetamine-dependent patients were randomly assigned to one of treatment groups with two-week treatment: (1) Group A: intermittent theta-burst stimulation (iTBS) targeting the left DLPFC; (2) Group B: continuous theta-burst stimulation (cTBS) targeting the left vmPFC; (3) Group C: a combination of treatment protocol of Group A and Group B; (4) Group D: sham theta-burst stimulation. The primary endpoint was the change of cue-induced craving. The trial was registered at ClinicalTrials.gov (NCT03736317). Findings The three real TBS groups had more craving decrease effect than the sham group ( p <0.01). The changes of craving were positively correlated with the improvement of anxiety and withdrawal symptom. With the highest respondence rate, group C also had shorter respondence time than Group A ( p = 0.03). Group C was effective in improve depression symptoms ( p = 0.04) and withdrawal symptom ( p = 0.02) compared with Group D. Besides, Group C was significant in improve sleep quality ( p = 0.04) compared with Group A. Baseline depression scores and spatial working memory were positively predicting the intervention response. Interpretation The rTMS paradigms involving vmPFC with cTBS are optimized protocols and well-tolerated for methamphetamine-dependent individuals, and they may have better efficacies compared with DLPFC iTBS. Emotion and cognitive function are rTMS treatment response predictors for methamphetamine-dependent patients. Funding This work was supported by the National Key R&D Program of China (2017YFC1310400), National Natural Science Foundation of China (81,771,436, 81,801,319, 81,601,164), Shanghai Municipal Health and Family Planning Commission (2017ZZ02021), Municipal Human Resources Development Program for Outstanding Young Talents in Medical and Health Sciences in Shanghai (2017YQ013), Qihang Project of Shanghai Mental Health Center (2019-QH-05), Shanghai Sailing Program (19YF1442100), Shanghai Key Laboratory of Psychotic Disorders (13DZ2260500), Program of Shanghai Academic Research Leader (17XD1403300), Shanghai Municipal Science and Technology Major Project (2018SHZDZX05), and Shanghai Clinical Research Center for Mental Health (19MC1911100).

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Section: Discussionsupporting

confidence: 94%

“…Sample size were calculated according to superiority test formula (

, k is the number of groups,

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The exploration of optimized protocol for repetitive transcranial magnetic stimulation in the treatment of methamphetamine use disorder: A randomized sham-controlled study

Chen

et al. 2020

EBioMedicine

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“…Six studies assessed either repetitive transcranial magnetic stimulation (rTMS) ( n = 4) or transcranial direct current stimulation (tDCS) ( n = 2) of the dorsolateral prefrontal cortex (DLPFC) to evaluate changes in cue-induced craving [ 40 , 48 , 49 , 50 , 51 , 52 ]. Li et al (2013) found low-frequency rTMS of 1 Hz to transiently increase cue-induced craving [ 48 ] while Su et al (2017) found high frequency rTMS of 10 Hz to reduce cue-induced craving in methamphetamine users [ 40 ].…”

Section: Resultsmentioning

confidence: 99%

A Scoping Review on Cue Reactivity in Methamphetamine Use Disorder

Seow

Ong

Hombali

et al. 2020

IJERPH

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The experience of craving via exposure to drug-related cues often leads to relapse in drug users. This study consolidated existing empirical evidences of cue reactivity to methamphetamine to provide an overview of current literature and to inform the directions for future research. The best practice methodological framework for conducting scoping review by Arkey and O’Malley was adopted. Studies that have used a cue paradigm or reported on cue reactivity in persons with a history of methamphetamine use were included. Databases such as Medline, EMBASE, PsycINFO and CINAHL were searched using key terms, in addition to citation check and hand search. The search resulted in a total of 32 original research articles published between 2006 to 2020. Three main themes with regard to cue reactivity were identified and synthesized: (1) effects of cue exposure, (2) individual factors associated with cue reactivity, and (3) strategies that modulate craving or reactivity to cues. Exposure to methamphetamine-associated cues elicits significant craving and other autonomic reactivity. Evidence suggests that drug cue reactivity is strongly associated with indices of drug use and other individual-specific factors. Future studies should focus on high quality studies to support evidence-based interventions for reducing cue reactivity and to examine cue reactivity as an outcome measure.

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