An Exploratory Investigation Utilizing Repetitive Transcranial Magnetic Stimulation (rTMS) as a Tool to Decrease Pain and Improve Functioning in Veterans with Opioid Use Disorder
一项利用重复经颅磁刺激 (rTMS) 作为减少阿片类药物使用障碍退伍军人疼痛和改善功能的工具的探索性研究
基本信息
- 批准号:10337022
- 负责人:
- 金额:--
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2019
- 资助国家:美国
- 起止时间:2019-06-01 至 2021-12-31
- 项目状态:已结题
- 来源:
- 关键词:AbstinenceAcuteAffectiveAlcoholsAnxietyBlindedBuprenorphineClinicalClinical TrialsCocaineCross-Over TrialsCuesDataDiseaseDouble-Blind MethodFDA approvedFutureGeneral PopulationGoalsHealthcare SystemsIndividualInterventionInvestigationLaboratoriesLiteratureMajor Depressive DisorderMeasurementMechanicsMedical centerMental DepressionMiddle EastMorbidity - disease rateMorphineNicotineOpiate AddictionOpioidOpioid replacement therapyOutcomePainPain ThresholdParticipantPatientsPerceptionPilot ProjectsPopulationPost-Traumatic Stress DisordersPrefrontal CortexPreparationRandomizedRecoveryRelapseReportingSelf AdministrationSensorySleepSmokerSubstance Use DisorderTechniquesTranslatingTreatment outcomeVeteransVisitWorkacceptability and feasibilityalcohol use disorderbariatric surgerybasechronic painchronic pain patientchronic painful conditionclinically relevantcocaine usecohortcommunity reintegrationcomorbiditycravingeffective therapyfollow-upfunctional outcomesimprovedimproved functioningmilitary veteranmortalityneuroregulationnicotine usenoninvasive brain stimulationnovelopioid abuseopioid overdoseopioid useopioid use disorderpain reductionpain sensitivityprogramsrepetitive transcranial magnetic stimulationsubstance usetobacco abstinencetooltreatment effect
项目摘要
Opioid use disorders (OUDs) are common among Veterans. Despite the availability of opioid replacement
therapies, many individuals continue to abuse opioids and relapse rates remain high. Veterans are nearly twice
as likely to die from accidental opioid overdose than the general population. Approximately 60% of Veterans
returning from the Middle East and more than 50% of older Veterans in the VA health care system have chronic
pain. Further, post-traumatic stress disorder, a common comorbidity in the Veteran population, has been shown
to negatively impact early engagement and retention of individuals in OUD treatment. As is the case with other
substance use disorders, opioid craving is commonly described by abstinent patients whether or not they are
stabilized on buprenorphine (Northrup et al., 2015; Tsui et al., 2014). Subsequently, a treatment that reduces
pain and craving, while also improving early engagement and retention in treatment, would improve recovery
from opioid addiction.
Repetitive Transcranial Magnetic Stimulation (rTMS) is capable of non-invasively altering cortical function. rTMS
is an FDA-approved treatment for major depressive disorder. Preliminary evidence suggests that rTMS can also
reduce pain in chronic pain conditions and craving in substance use disorders. Single sessions of rTMS produce
small temporary effects, while multiple sessions of rTMS result in larger, more durable effects. Our group recently
completed a blinded, sham-controlled crossover trial in non-treatment seeking OUD participants. A single
session of rTMS reduced cue-induced craving and increased thermal pain thresholds. Given that multiple
sessions of rTMS produce larger and more durable treatment effects than single sessions of rTMS, it follows that
multiple treatment sessions applied to OUD patients may result in a clinically relevant reduction in pain and cue-
induced craving, which could improve clinical and functional outcomes.
In this SPiRE pilot proposal, we will perform a randomized, double-blind, sham-controlled trial delivering an
accelerated course of rTMS to a cohort of OUD Veterans with chronic pain receiving treatment through the Ralph
H. Johnson VA Medical Center Substance Treatment and Recovery program. The goal of this proposal is to
evaluate the feasibility and acceptability of delivering rTMS to the dorsolateral pre-frontal cortex in Veterans with
OUD and chronic pain. We will also preliminarily explore the feasibility of evaluating potential outcome
measurements in preparation for a larger trial, including abstinence, treatment retention, community reintegration
and functional outcomes, pain, and opioid craving. Positive results from this pilot project will inform a future
MERIT application and have the potential to significantly improve treatment outcomes in this difficult to treat
Veteran population.
阿片类药物使用障碍(OUDs)在退伍军人中很常见。尽管阿片类药物可以替代
项目成果
期刊论文数量(0)
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AIMEE L MCRAE-CLARK其他文献
AIMEE L MCRAE-CLARK的其他文献
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{{ truncateString('AIMEE L MCRAE-CLARK', 18)}}的其他基金
Varenicline for Comorbid Tobacco and Cannnabis Use in Veterans
伐尼克兰治疗退伍军人同时使用烟草和大麻的情况
- 批准号:
10369080 - 财政年份:2022
- 资助金额:
-- - 项目类别:
Gender and Sex Hormone Influences on Cannabis Use Disorder Remission
性别和性激素对大麻使用障碍缓解的影响
- 批准号:
10307840 - 财政年份:2021
- 资助金额:
-- - 项目类别:
Gender and Sex Hormone Influences on Cannabis Use Disorder Remission
性别和性激素对大麻使用障碍缓解的影响
- 批准号:
10615214 - 财政年份:2021
- 资助金额:
-- - 项目类别:
Gender and Sex Hormone Influences on Cannabis Use Disorder Remission
性别和性激素对大麻使用障碍缓解的影响
- 批准号:
10435554 - 财政年份:2021
- 资助金额:
-- - 项目类别:
Gender and Sex Hormone Influences on Cannabis Use Disorder Remission
性别和性激素对大麻使用障碍缓解的影响
- 批准号:
10832236 - 财政年份:2021
- 资助金额:
-- - 项目类别:
An Exploratory Investigation Utilizing Repetitive Transcranial Magnetic Stimulation (rTMS) as a Tool to Decrease Pain and Improve Functioning in Veterans with Opioid Use Disorder
一项利用重复经颅磁刺激 (rTMS) 作为减少阿片类药物使用障碍退伍军人疼痛和改善功能的工具的探索性研究
- 批准号:
9918168 - 财政年份:2019
- 资助金额:
-- - 项目类别:
MID-CAREER AWARD IN PATIENT-ORIENTED DRUG ABUSE RESEARCH
以患者为导向的药物滥用研究中的职业生涯中期奖
- 批准号:
10440401 - 财政年份:2014
- 资助金额:
-- - 项目类别:
MID-CAREER AWARD IN PATIENT-ORIENTED DRUG ABUSE RESEARCH
以患者为导向的药物滥用研究中的职业生涯中期奖
- 批准号:
10190876 - 财政年份:2014
- 资助金额:
-- - 项目类别:
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