A Preliminary Investigation of Pre-Frontal repetitive Transcranial Magnetic Stimulation (rTMS) for the Treatment of Cannabis Use Disorder

前额重复经颅磁刺激（rTMS）治疗大麻使用障碍的初步研究

• 批准号: 9295291
• 负责人: Gregory Sahlem
• 金额: $ 20万
• 依托单位: MEDICAL UNIVERSITY OF SOUTH CAROLINA
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-07-01 至 2021-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9295291
• 关键词: Abstinence; Acute; Address; Adult; Adverse effects; Aftercare; Alcohols; American; Attention; Behavior Therapy; Brain; Cannabis; Clinical; Clinical Trials; Cocaine; Creatinine; Cross-Over Studies; Cues; Data; Development; Disease; Disease remission; Double-Blind Method; FDA approved; Functional Magnetic Resonance Imaging; Functional disorder; Goals; High Prevalence; Individual; Intervention; Investigation; K-Series Research Career Programs; Laboratories; Left; Literature; Major Depressive Disorder; Measures; Mental Depression; Mentorship; Moods; Nicotine; Participant; Patient Self-Report; Patients; Pharmaceutical Preparations; Population; Prefrontal Cortex; Prevalence; Provider; Publishing; Randomized; Research; Rewards; Signal Transduction; Site; Smoker; Structure; Substance Use Disorder; Techniques; Testing; Time; Tobacco use; Training; Translating; United States; Urine; Work; addiction; alcohol use disorder; base; blood oxygenation level dependent response; career; cocaine use; craving; cue reactivity; depressed patient; effective therapy; innovation; marijuana use; marijuana use disorder; motivational enhancement therapy; novel; repetitive transcranial magnetic stimulation; sham-controlled study; standard of care; tobacco abstinence; tool

Project Summary / Abstract: Cannabis use disorder (CUD) is a common condition with few validated treatments and, to date, no FDA- approved medications. Subsequently, providers have few options to offer treatment seekers. An expanding literature base suggests that a single treatment of excitatory repetitive Transcranial Magnetic stimulation (rTMS) applied to the dorsolateral pre-frontal cortex (DLPFC) may temporarily reduce drug cue induced craving across substance use disorders. Two recent clinical trials suggest that delivering a course of multiple rTMS treatments holds promise as a potential treatment for tobacco and cocaine use disorders. Consistent with the findings in addictions, in Major Depressive Disorder a single treatment of rTMS has little if any mood effect; however repeated treatments result in clinically meaningful improvement and remission from depression in a substantial number of depressed patients. The candidate and mentorship team recently completed a laboratory-based trial demonstrating that a single treatment of rTMS is safe, tolerable, and feasible in non-treatment seeking cannabis use disordered participants. Additionally, rTMS reduced cannabis cue-induced craving. Given these promising preliminary findings, it is possible that a full course of rTMS would have a larger effect on craving and an effect on cannabis use. In this application for a career development award, the candidate proposes to determine if a course of rTMS treatments applied to the DLPFC can result in reduced cannabis cue-induced craving (Aim1) and cue reactivity in reward structures during an fMRI paradigm (Aim2) in treatment seeking cannabis use disordered individuals. Additionally, he will determine if a course of rTMS reduces cannabis use (Exploratory Aim). Development of a novel, effective treatment for CUD would have the potential of helping the estimated one million cannabis using Americans that seek treatment each year. Of note, rTMS is a treatment with few side effects, and it may focally target CUD's pathophysiology.

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