Abstract
Background: Repetitive transcranial magnetic stimulation (rTMS) has therapeutic effects on craving in methamphetamine (METH) use disorder (MUD). The chronic abuse of METH causes impairments in executive function, and improving executive function reduces relapse and improves treatment outcomes for drug use disorder. The purpose of this study was to determine whether executive function helped predict patients' responses to rTMS treatment.Methods: This study employed intermittent theta burst stimulation (iTBS) rTMS modalities and observed their therapeutic effects on executive function and craving in MUD patients. MUD patients from an isolated Drug Rehabilitation Institute in China were chosen and randomly allocated to the iTBS group and sham-stimulation group. All participants underwent the Behavior Rating Inventory of Executive Function - Adult Version Scale (BRIEF-A) and Visual Analog Scales (VAS) measurements. Sixty-five healthy adults matched to the general condition of MUD patients were also recruited as healthy controls.Findings: Patients with MUD had significantly worse executive function. iTBS groups had better treatment effects on the MUD group than the sham-stimulation group. Further Spearman rank correlation and stepwise multivariate regression analysis revealed that reduction rates of the total score of the BRIEF-A and subscale scores of the inhibition factor and working memory factor in the iTBS group positively correlated with improvements in craving. ROC curve analysis showed that working memory (AUC = 87.4%; 95% CI = 0.220, 0.631) and GEC (AUC = 0.761%; 95% CI = 0.209, 0.659) had predictive power to iTBS therapeutic efficacy. The cutoff values are 13.393 and 59.804, respectively.Conclusions: The iTBS rTMS had a better therapeutic effect on the executive function of patients with MUD, and the improved executive function had the potential to become a predictor for the efficacy of iTBS modality for MUD treatment.Clinical Trial Registration: ClinicalTrials.gov, identifier: ChiCTR2100046954.
Highlights
Methamphetamine (METH) is an extremely dependent psychoactive substance with a high relapse rate for addiction, and the search for an effective treatment against it has been a challenge in the field of addiction medicine [1]
Nine patients in the intermittent theta burst stimulation (iTBS) group who were transferred to other Drug Rehabilitation Centers for criminal reasons before study completion were not included in the dataset
There were no differences between the METH use disorder (MUD) (n = 66) and healthy control (HC) groups (n = 65) in terms of years of education, age, and marital status (p > 0.05)
Summary
Methamphetamine (METH) is an extremely dependent psychoactive substance with a high relapse rate for addiction, and the search for an effective treatment against it has been a challenge in the field of addiction medicine [1]. Repetitive transcranial magnetic stimulation (rTMS) is a widely used physiotherapy technique for brain stimulation; several previous studies have found it to be effective against substance use disorder (SUD) [2,3,4,5]. ITBS has been gradually used in the field of SUD It was previously studied in patients with cocaine addiction where the amount of cocaine and frequency of its use were reduced after 30 sessions of iTBS treatment [10]. In treating METH use disorder (MUD), iTBS stimulation was recently reported to reduce craving and improve cognition in MUD patients [7, 11, 12]. Repetitive transcranial magnetic stimulation (rTMS) has therapeutic effects on craving in methamphetamine (METH) use disorder (MUD). The purpose of this study was to determine whether executive function helped predict patients’ responses to rTMS treatment
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