Chiara Rapinesi1, Antonio Del Casale2, Simone Di Pietro1, Vittoria Rachele Ferri1, Daria Piacentino1, Gabriele Sani1, Ruggero Nessim Raccah3, Abraham Zangen4, Stefano Ferracuti5, Alessandro Emiliano Vento6, Gloria Angeletti1, Roberto Brugnoli1, Georgios D Kotzalidis1, Paolo Girardi1. 1. NESMOS (Neurosciences, Mental Health, and Sensory Organs) Department, Sapienza University of Rome, School of Medicine and Psychology, Sant'Andrea Hospital, Rome, Italy. 2. NESMOS (Neurosciences, Mental Health, and Sensory Organs) Department, Sapienza University of Rome, School of Medicine and Psychology, Sant'Andrea Hospital, Rome, Italy; Department of Psychiatric Rehabilitation, P. Alberto Mileno Onlus Foundation, Vasto, Italy. Electronic address: antonio.delcasale@uniroma1.it. 3. ATID Ltd Advanced Technology Innovation Distribution, Rome, Italy. 4. Department of Life Sciences, Ben Gurion University of the Negev, Be'er Sheva, Israel. 5. Department of Neurology and Psychiatry, Sapienza University of Rome, Italy. 6. Asl Roma 2, Osservatorio sulle Dipendenze e sui Disturbi Psichici Sotto Soglia, Rome, Italy.
Abstract
INTRODUCTION: Cocaine dependence is a substantial public health problem. The aim of this study is to evaluate the effect of high frequency deep transcranial magnetic stimulation (dTMS) on craving in patients with cocaine use disorder (CUD). METHODS: Seven men (mean age, 48.71 years; standard deviation [SD], 9.45; range 32-60 years) with CUD and no concurrent axis 1 or 2 disorder save nicotine abuse, underwent three sessions of alternate day 20Hz dTMS in 20 trains delivered to the dorsolateral prefrontal cortex (DLPFC) preferentially to the left hemisphere, for 12 sessions spread over one month, added to unchanged prior drug treatment. We used a visual analogue scale (VAS) to measure cocaine craving the week before, each week during, and one month after dTMS treatment. RESULTS: DLPFC stimulation significantly reduced craving over time: within-subjects main effect of time of treatment (ANOVA, F[3,18]=46.154; p<0.001; η(2)=0.88). The reduction of craving from baseline was significant at two weeks (p<0.001), and four weeks (p<0.001) of treatment, and at the week eight, four weeks after treatment interruption (p=0.003), although the increase of craving was significant from week four and eight (p=0.014). CONCLUSION: dTMS over left DLPFC reduced craving in CUD patients in a small sample that is to be considered preliminary. However, maintenance sessions would be needed to maintain the achieved results. Our findings highlight the potential of noninvasive neuromodulation as a therapeutic tool for cocaine addiction.
INTRODUCTION:Cocaine dependence is a substantial public health problem. The aim of this study is to evaluate the effect of high frequency deep transcranial magnetic stimulation (dTMS) on craving in patients with cocaine use disorder (CUD). METHODS: Seven men (mean age, 48.71 years; standard deviation [SD], 9.45; range 32-60 years) with CUD and no concurrent axis 1 or 2 disorder save nicotine abuse, underwent three sessions of alternate day 20Hz dTMS in 20 trains delivered to the dorsolateral prefrontal cortex (DLPFC) preferentially to the left hemisphere, for 12 sessions spread over one month, added to unchanged prior drug treatment. We used a visual analogue scale (VAS) to measure cocaine craving the week before, each week during, and one month after dTMS treatment. RESULTS: DLPFC stimulation significantly reduced craving over time: within-subjects main effect of time of treatment (ANOVA, F[3,18]=46.154; p<0.001; η(2)=0.88). The reduction of craving from baseline was significant at two weeks (p<0.001), and four weeks (p<0.001) of treatment, and at the week eight, four weeks after treatment interruption (p=0.003), although the increase of craving was significant from week four and eight (p=0.014). CONCLUSION:dTMS over left DLPFC reduced craving in CUDpatients in a small sample that is to be considered preliminary. However, maintenance sessions would be needed to maintain the achieved results. Our findings highlight the potential of noninvasive neuromodulation as a therapeutic tool for cocaine addiction.
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Authors: Diana Martinez; Nina Urban; Alex Grassetti; Dinissa Chang; Mei-Chen Hu; Abraham Zangen; Frances R Levin; Richard Foltin; Edward V Nunes Journal: Front Psychiatry Date: 2018-03-16 Impact factor: 4.157