Add-on high frequency deep transcranial magnetic stimulation (dTMS) to bilateral prefrontal cortex reduces cocaine craving in patients with cocaine use disorder

Chiara Rapinesi, Antonio Del Casale, Simone Di Pietro, Vittoria Rachele Ferri, Daria Piacentino, Gabriele Sani, Ruggero Nessim Raccah, Abraham Zangen, Stefano Ferracuti, Alessandro Emiliano Vento, Gloria Angeletti, Roberto Brugnoli, Georgios D. Kotzalidis, Paolo Girardi

Research output: Contribution to journalArticlepeer-review

59 Scopus citations

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 20 Hz 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; η2 = 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.

Original languageEnglish
Pages (from-to)43-47
Number of pages5
JournalNeuroscience Letters
Volume629
DOIs
StatePublished - 26 Aug 2016

Keywords

  • Cocaine use disorder
  • Craving
  • Deep Transcranial Magnetic Stimulation (dTMS)
  • Dorsolateral Prefrontal Cortex (DLPFC)

ASJC Scopus subject areas

  • General Neuroscience

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