Bilateral Transcranial Magnetic Stimulation of the Prefrontal Cortex Reduces Cocaine Intake: A Pilot Study.
Bilateral Transcranial Magnetic Stimulation of the Prefrontal Cortex Reduces Cocaine Intake: A Pilot Study.
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DOI：
10.3389/fpsyt.2016.00133
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发表时间：
2016
影响因子：
4.7
通讯作者：
Diana M
中科院分区：
文献类型：
--
作者：
Bolloni C;Panella R;Pedetti M;Frascella AG;Gambelunghe C;Piccoli T;Maniaci G;Brancato A;Cannizzaro C;Diana M
慢性可卡因消耗与维持药物摄入的中脑边缘多巴胺传递减少有关。经颅磁刺激（TMS）正获得可靠性，是药物成瘾的有用治疗工具，因为它可以调节皮质边缘活动，从而导致药物渴求的减少。在本研究中，我们调查了双边TMS的前额叶皮层（PFC）在减少可卡因摄入量的治疗效果，在一个样本的寻求治疗的患者与当前可卡因使用障碍（DSM-V）。10名可卡因成瘾者（DSM-V）被随机分配到积极或假刺激方案在双盲实验设计。12个重复的TMS（rTMS）会议，每周3次，持续4周，在100%的运动阈值，超过双边PFC。钴摄入量（ng/mg）进行了评估，在基线（治疗前，T0），1个月后（治疗结束，T1），3（T2），和6（T3）个月后的头发分析。所有受试者每周接受一次心理支持。重复测量的双因素ANOVA未显示时间与给药之间的相互作用的显著影响（F4，32 = 0.35; p = 0.87）。尽管该结果表明两种条件（活性与假手术）的作用随时间无差异（沿着），但当我们以时间为因素进行探索性分析时，观察到活性TMS组（F3，23 = 3.42; p = 0.04）与假手术组（F3，15 = 1.88; p = 0.20）的可卡因消耗量呈下降趋势。事实上，事后比较显示，从发病到3个月后（T0-T2; p = 0.02）和治疗结束（T0-T3; p = 0.01），活动组成瘾者中检测到的可卡因量显著减少。与假手术相比，PFC在10 Hz的双侧rTMS对可卡因摄入量没有显着影响。然而，当我们考虑时间因素时，观察到活动TMS治疗患者的可卡因摄入量长期减少。需要进一步的研究来证实这些令人鼓舞但初步的发现，以巩固rTMS作为治疗可卡因成瘾的有效工具。
Chronic cocaine consumption is associated with a decrease in mesolimbic dopamine transmission that maintains drug intake. transcranial magnetic stimulation (TMS) is gaining reliability, a useful therapeutic tool in drug addiction, since it can modulate cortico-limbic activity resulting in reduction of drug craving. In the present study, we investigated the therapeutic effect of bilateral TMS of prefrontal cortex (PFC) in reducing cocaine intake, in a sample of treatment-seeking patients with current cocaine use disorder (DSM-V). Ten cocaine addicts (DSM-V) were randomly assigned to the active or sham stimulation protocol in a double-blind experimental design. Twelve repetitive TMS (rTMS) sessions were administered three times a week for 4 weeks at 100% of motor threshold, over bilateral PFC. Cocaine intake (ng/mg) was assessed by hair analysis at baseline (before treatment, T0), after 1 month (end of treatment, T1), 3 (T2), and 6 (T3) months later. All subjects received psychological support weekly. The two-way ANOVA for repeated measures did not show a significant effect of the interaction between time and treatment (F4,32 = 0.35; p = 0.87). Despite that result indicated no difference in the effect of the two conditions (active vs. sham) along time, a decreasing trend in cocaine consumption in active TMS group (F3,23 = 3.42; p = 0.04) vs. sham (F3,15 = 1.88; p = 0.20) was observed when we performed exploratory analysis with time as factor. Indeed, Post hoc comparisons showed a significant reduction in the amount of cocaine detected from the onset to 3 months later (T0–T2; p = 0.02) and to the end of treatment (T0–T3; p = 0.01) in addicts from the active group. Bilateral rTMS of PFC at 10 Hz did not show a significant effect on cocaine intake compared to sham. However, a long-term reduction on cocaine intake in active TMS-treated patients was observed when we considered the time as factor. Further studies are required to confirm these encouraging but preliminary findings, in order to consolidate rTMS as a valid tool to treat cocaine addiction.