Deep Transcranial Magnetic Stimulation in Patients With Opioid Use Disorder: A Double-Blind, Placebo-Controlled Randomized Trial

IF 2.6 3区医学 Q3 BIOCHEMISTRY & MOLECULAR BIOLOGY

Addiction Biology Pub Date : 2025-06-19 DOI:10.1111/adb.70057

Soner Guldas, Selim Tumkaya, Bengu Yucens

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引用次数: 0

Abstract

Opioid use disorder (OUD) is a chronic, relapsing brain disorder. The efficacy of brain stimulation methods in the treatment of OUD has been increasingly investigated. However, the efficacy of deep transcranial magnetic stimulation, namely, wide-volume TMS, in the treatment of OUD has not been investigated. The aim of this randomized, double-blind, sham-controlled add-on study was to evaluate the efficacy of wide-volume TMS using a double-cone coil in participants with OUD. A total of 55 OUD patients were recruited and randomized to receive either active or sham TMS. Active wide-volume TMS treatment was applied to the left dorsolateral prefrontal cortex (DLPFC) in the active TMS group using a double-cone coil, twice daily for 2 weeks, at a frequency of 10 Hz. Sham TMS was also applied to the same region in the placebo group using a placebo coil. Opioid Craving Visual Analogue Scale (OC-VAS), Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HARS) and Barratt Impulsiveness Scale-11 (BIS-11) were measured before treatment, at the end of treatment, and 2 months after treatment. A total of 21 patients from the active TMS group and 19 patients from the sham TMS group completed the study. Although the active TMS group exhibited more reduction in craving and a less pronounced increase in buprenorphine-naloxone dose during the treatment period compared to the sham group, these differences did not reach statistical significance. This study suggests that while wide-volume TMS using a double-cone coil applied to the left DLPFC was well tolerated, it did not produce statistically significant improvements in craving, depression, anxiety, or impulsivity when compared to the sham treatment. However, the observed trends warrant further investigation with larger sample sizes and refined protocols.

Trial Registration: This trial was registered at ClinicalTrials.gov (NCT06081985)

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深经颅磁刺激治疗阿片类药物使用障碍：一项双盲、安慰剂对照的随机试验

阿片类药物使用障碍（OUD）是一种慢性、复发性脑疾病。脑刺激方法治疗OUD的疗效已得到越来越多的研究。然而，深经颅磁刺激（即大容量TMS）治疗OUD的疗效尚未得到研究。这项随机、双盲、假对照的附加研究的目的是评估使用双锥体线圈的大容量经颅磁刺激对OUD患者的疗效。共招募了55名OUD患者，并随机接受主动或假性经颅磁刺激。采用双锥体线圈对主动TMS组左背外侧前额叶皮质（DLPFC）进行主动大容量TMS治疗，每天两次，持续2周，频率为10 Hz。假性经颅磁刺激也应用于安慰剂组的同一区域，使用安慰剂线圈。分别于治疗前、治疗结束时和治疗后2个月测量阿片渴望视觉模拟量表（ocs - vas）、汉密尔顿抑郁评定量表（HDRS）、汉密尔顿焦虑评定量表（HARS）和Barratt冲动性量表-11 （BIS-11）。激活TMS组共21例患者和假TMS组共19例患者完成了研究。虽然与假手术组相比，经颅磁刺激活性组在治疗期间表现出更多的渴望减少和不太明显的丁丙诺啡-纳洛酮剂量增加，但这些差异没有达到统计学意义。这项研究表明，虽然使用双锥体线圈对左DLPFC进行大容量经颅磁刺激的耐受性良好，但与假治疗相比，它在渴望、抑郁、焦虑或冲动方面没有统计学上显著的改善。然而，观察到的趋势值得进一步调查更大的样本量和完善的方案。试验注册：本试验已在ClinicalTrials.gov注册（NCT06081985）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Addiction Biology 生物-生化与分子生物学

CiteScore

8.10

自引率

2.90%

发文量

118

审稿时长

6-12 weeks

期刊介绍： Addiction Biology is focused on neuroscience contributions and it aims to advance our understanding of the action of drugs of abuse and addictive processes. Papers are accepted in both animal experimentation or clinical research. The content is geared towards behavioral, molecular, genetic, biochemical, neuro-biological and pharmacology aspects of these fields. Addiction Biology includes peer-reviewed original research reports and reviews. Addiction Biology is published on behalf of the Society for the Study of Addiction to Alcohol and other Drugs (SSA). Members of the Society for the Study of Addiction receive the Journal as part of their annual membership subscription.