Pubblicazioni

Cognitive and emotional predictors of real versus sham repetitive transcranial magnetic stimulation treatment response in methamphetamine use disorder

C, Tianzhen; S, Hang; J, Haifeng; L, Xiaotong; Z, Na; D, Jiang; M, Yiran; D, Chunmei; Z, Congbin; X, Ke; X, Ding; S, Weidong; Z, Min

Abstract:

Background and aims: Repetitive transcranial magnetic stimulation (rTMS) of the left dorsolateral prefrontal cortex (DLPFC) can effectively reduce cravings in methamphetamine use disorder (MUD). However, a considerable group still fails to respond. Cognitive and emotional disturbance, as well as impulsive features, are widespread in patients with MUD and might mediate the treatment response of rTMS. The purpose of this study is to figure out whether these variables can help predicting patients' responses to rTMS treatment. Methods: Ninety-seven patients with severe MUD and thirty-one gender- and age-matched healthy subjects were included. Patients were randomized to receive 20 sessions of real or sham rTMS. Intermittent theta burst protocols (iTBS) or sham iTBS were applied every weekday over the DLPFC for 20 daily sessions. Both groups received regular treatment. Craving induced by drug-related cue was measured before and after stimulation. Cognition was evaluated by using the CogState Battery. Baseline characteristics were collected through the Addiction Severity Index, Patient Health Questionnaire-9, General Anxiety Disorder Scale-7, and Barrett Impulsivity Scale-11. Results: Results showed that patients with MUD have worse spatial working memory, problem-solving ability, as well as depression and anxiety symptoms compared with healthy controls. Cognition and emotion differed between responders (craving decrease ≥60%) and non-responders in real rTMS group but not in the sham group. Better cognitive and emotional functions means that patients have higher possibility for better response to real rTMS treatment. Conclusions: This study suggests that cognitive, emotional and impulsive features could be used to predict the prospective treatment responses of rTMS in patients with MUD. Keywords: Cognitive function; Emotion; Impulsivity; Methamphetamine; Responder; Transcranial magnetic stimulation.

Patologie/Applicazioni:

• Dipendenze
• Terapia del dolore
• Stimolazione Magnetica Transcranica (TMS)

Anno:

2020

Tipo di pubblicazione:

Articolo

Parola chiave:

TMS; dipendenze; Metanfetamina; Sham; funzione cognitiva; emozioni

Testata scientifica:

Journal of Psichiatric Research

Nota:

In questo articolo viene descritto uno studio effettuato utilizzando la rTMS applicata alla corteccia dorsolaterale sinistra su pazienti con dipendenza da metanfetamina. I disturbi cognitivi ed emotivi, così come le caratteristiche impulsive, sono diffusi nei pazienti con MUD e potrebbero mediare la risposta al trattamento della rTMS. I risultati hanno mostrato che i pazienti con MUD hanno una memoria di lavoro spaziale peggiore, capacità di risoluzione dei problemi, nonché sintomi di depressione e ansia rispetto ai controlli sani. Questo studio suggerisce che le caratteristiche cognitive, emotive e impulsive potrebbero essere utilizzate per prevedere le potenziali risposte al trattamento di rTMS nei pazienti con MUD.

DOI:

10.1016/j.jpsychires.2020.05.007