Alessandra Del Felice1, Elisa Bellamoli2, Emanuela Formaggio3, Paolo Manganotti4, Stefano Masiero5, Giuseppe Cuoghi6, Claudia Rimondo7, Bruno Genetti8, Milena Sperotto8, Flavia Corso9, Giampaolo Brunetto9, Francesco Bricolo9, Maurizio Gomma9, Giovanni Serpelloni9. 1. Department of Neuroscience-DSN, University of Padova, Via Giustiniani 2, Padua, Italy. Electronic address: alessandra.delfelice@unipd.it. 2. Department of Neurological and Movement Sciences, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy. 3. Department of Neurophysiology, Foundation IRCCS San Camillo Hospital, 30126 Venice, Italy. 4. Neurology Clinic, University Hospital, Strada di Fiume, 447, 34149 Trieste, Italy. 5. Department of Neuroscience-DSN, University of Padova, Via Giustiniani 2, Padua, Italy. 6. Institute of Constructivist Psychology, Via Martiri della Libertà 13, 35137 Padua, Italy. 7. National Coordination Centre for NIDA Collaborations, Via Germania 20, 37136 Verona, Italy. 8. Explora-Centro di Ricerca e Analisi Statistica, Via Cà Pisani 7, Padua, Vigodarzere, Italy. 9. Addiction Department, ULSS 20, Via Germania 20, 37136 Verona, Italy.
Abstract
BACKGROUND: Addiction is associated with dorso-lateral prefrontal cortex (DLPFC) dysfunction and altered brain-oscillations. High frequency repetitive transcranial magnetic stimulation (HFrTMS) over DLPFC reportedly reduces drug craving. Its effects on neuropsychological, behavioural and neurophysiological are unclear. METHODS: We assessed psychological, behavioural and neurophysiological effects of 4 sessions of 10-min adjunctive HFrTMS over the left DLPFC during two weeks during a residential programme for alcohol detoxification. Participants were randomized to active HFrTMS (10 Hz, 100% motor threshold) or sham. Immediately before the first and after the last session, 32-channels EEG was recorded and alcohol craving Visual Analogue Scale, Symptom Check List-90-R, Numeric Stroop task and Go/No-go task administered. Tests were repeated at 1-month follow-up. RESULTS:17 subjects (mean age 44.7 years, 4 F) were assessed. Active rTMS subjects performed better at Stroop test at end of treatment (p=0.036) and follow up (p=0.004) and at Go-NoGo at end of treatment (p=0.05) and follow up (p=0.015). Depressive symptoms decreased at end of active treatment (p=0.036). Active-TMS showed an overall decrease of fast EEG frequencies after treatment compared to sham (p=0.026). No significant modifications over time or group emerged for craving and number of drinks at follow up. CONCLUSION: 4 HFrTMS sessions over two weeks on the left DLPFC can improve inhibitory control task and selective attention and reduce depressive symptoms. An overall reduction of faster EEG frequencies was observed. Nonetheless, this schedule is ineffective in reducing craving and alcohol intake.
RCT Entities:
BACKGROUND: Addiction is associated with dorso-lateral prefrontal cortex (DLPFC) dysfunction and altered brain-oscillations. High frequency repetitive transcranial magnetic stimulation (HFrTMS) over DLPFC reportedly reduces drug craving. Its effects on neuropsychological, behavioural and neurophysiological are unclear. METHODS: We assessed psychological, behavioural and neurophysiological effects of 4 sessions of 10-min adjunctive HFrTMS over the left DLPFC during two weeks during a residential programme for alcohol detoxification. Participants were randomized to active HFrTMS (10 Hz, 100% motor threshold) or sham. Immediately before the first and after the last session, 32-channels EEG was recorded and alcohol craving Visual Analogue Scale, Symptom Check List-90-R, Numeric Stroop task and Go/No-go task administered. Tests were repeated at 1-month follow-up. RESULTS: 17 subjects (mean age 44.7 years, 4 F) were assessed. Active rTMS subjects performed better at Stroop test at end of treatment (p=0.036) and follow up (p=0.004) and at Go-NoGo at end of treatment (p=0.05) and follow up (p=0.015). Depressive symptoms decreased at end of active treatment (p=0.036). Active-TMS showed an overall decrease of fast EEG frequencies after treatment compared to sham (p=0.026). No significant modifications over time or group emerged for craving and number of drinks at follow up. CONCLUSION: 4 HFrTMS sessions over two weeks on the left DLPFC can improve inhibitory control task and selective attention and reduce depressive symptoms. An overall reduction of faster EEG frequencies was observed. Nonetheless, this schedule is ineffective in reducing craving and alcohol intake.
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