Journal: BMC Psychiatry 18(1) (2018)
Authors: K.K Kedzior, I. Gerkensmeier, M. Schuchinsky
Background:
Deep transcranial magnetic stimulation (Deep TMS™) is a non-invasive method of stimulating widespread cortical areas and, presumably, deeper neural networks.
Objective:
The current study assessed the effects of Deep TMS in the treatment of substance use disorders (SUD) using a systematic review.
Methods:
Electronic literature search (PsycInfo, Medline until April 2017) identified k = 9 studies (k = 4 randomized controlled trials, RCTs, with inactive sham and k = 5 open-label studies). Deep TMS was most commonly applied using high frequency/intensity (10–20 Hz/100–120% of the resting motor threshold, MT) protocols for 10–20 daily sessions in cases with alcohol, nicotine or cocaine use disorders. The outcome measures were craving and dependence (according to standardized scales) or consumption (frequency, abstinence or results of biological assays) at the end of the daily treatment phases and at the last follow-up.
Results:
Acute and longer-term (6–12 months) reductions in alcohol craving were observed after 20 sessions (20 Hz, 120% MT) relative to baseline in k = 4 open-label studies with comorbid SUD and major depressive disorder (MDD). In k = 2 RCTs without MDD, alcohol consumption acutely decreased after 10–12 sessions (10–20 Hz, 100–120% MT) relative to baseline or to sham. Alcohol craving was reduced only after higher frequency/intensity Deep TMS (20 Hz, 120% MT) relative to sham in k = 1 RCT. Nicotine consumption was reduced and abstinence was increased after 13 sessions (10 Hz, 120% MT) and at the 6-month follow-up relative to sham in k = 1 RCT. Cocaine craving was reduced after 12 sessions (15 Hz, 100% MT) and at the 2-month follow-up relative to baseline in k = 1 open-label study while consumption was reduced after 12 sessions (10 Hz, 100% MT) relative to baseline but not to sham in k = 1 RCT.
Conclusions:
High-frequency Deep TMS may be effective at treating some SUD both acutely and in the longer-term. Large RCTs with inactive sham are required to determine the efficacy and the optimal stimulation parameters of Deep TMS for the treatment of SUD.
Comparison of the analgesic effects of "superficial" and "deep" repetitive transcranial magnetic sti...Deep magnetic stimulation targeting the medial prefrontal and anterior cingulate cortices for metham...Deep Transcranial Magnetic Stimulation in combination with symptoms provocation: An effective treatm...
