Repetitive transcranial magnetic stimulation combined with cognitive behavioral therapy treatment in alcohol-dependent patients: A randomized, double-blind sham-controlled multicenter clinical trial
BackgroundAlcohol dependence (AD) is a complex addictive disorder with a high relapse rate. Previous studies have shown that both repetitive transcranial magnetic stimulation (rTMS) and cognitive behavioral therapy (CBT) may be effective for AD, and we aim to explore more effective treatment options...
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Frontiers Media S.A.
2022-10-01
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| Series: | Frontiers in Psychiatry |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyt.2022.935491/full |
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| author | Xiaorui Hu Tian Zhang Hongkun Ma Xuhui Zhou Hongxuan Wang Xiaohong Wang Chang Cheng Yanfei Li Ranran Duan Bo Zhang Huaizhi Wang Jia Lu Chuanyi Kang Na Zhao Yingjie Zhang Lu Tian Jun Liu Jingjing Shi Zhe Wang Xinxin Zhou Shuang Zhu Qingxia Liu Xuemin Li Honghui Wang Mingxuan Nie Mei Yang Jianzhong Yang Yong Chi Xiaofeng Zhu Jian Hu Yanjie Jia Ying Peng Lei Liu |
| author_facet | Xiaorui Hu Tian Zhang Hongkun Ma Xuhui Zhou Hongxuan Wang Xiaohong Wang Chang Cheng Yanfei Li Ranran Duan Bo Zhang Huaizhi Wang Jia Lu Chuanyi Kang Na Zhao Yingjie Zhang Lu Tian Jun Liu Jingjing Shi Zhe Wang Xinxin Zhou Shuang Zhu Qingxia Liu Xuemin Li Honghui Wang Mingxuan Nie Mei Yang Jianzhong Yang Yong Chi Xiaofeng Zhu Jian Hu Yanjie Jia Ying Peng Lei Liu |
| author_sort | Xiaorui Hu |
| collection | DOAJ |
| description | BackgroundAlcohol dependence (AD) is a complex addictive disorder with a high relapse rate. Previous studies have shown that both repetitive transcranial magnetic stimulation (rTMS) and cognitive behavioral therapy (CBT) may be effective for AD, and we aim to explore more effective treatment options to reduce relapse rates for AD.Materials and methodsA total of 263 AD patients were recruited. They were divided into six groups according to the location and the type of rTMS: left dorsolateral prefrontal cortex (DLPFC), right DLPFC, sham stimulation, and whether they received CBT treatment: with a fixed schedule (C1) and without a fixed plan (C0). There were included in sham rTMS + C0 group (n = 50), sham rTMS + C1 group (n = 37), right rTMS + C0 group (n = 45), right rTMS + C1 group (n = 42), left rTMS + C0 group (n = 49), left rTMS + C1 group (n = 40). We used obsessive compulsive drinking scale (OCDS), visual analogue scale (VAS), alcohol dependence scale (ADS), montreal cognitive assessment (MoCA), generalized anxiety disorder-7 (GAD-7), patient health questionnaire-9 items (PHQ-9), and Pittsburgh sleep quality index (PSQI) to assess alcohol cravings, alcohol dependence, cognition, anxiety, depression, and sleep quality. They were followed up and evaluated for relapse.ResultsThe sham rTMS + C0 group relapse rate was significantly higher than the right rTMS + C1 group (P = 0.006), the left rTMS + C0 group (P = 0.031), the left rTMS + C1 group (P = 0.043). The right rTMS + C0 group showed significantly higher relapse rate compared to the right rTMS + C1 group (P = 0.046). There was no significant difference in relapse rates between other groups. The repeated-measures ANOVA showed an interaction effect between group and time was significant in the rate of patient health questionnaire-9 items (PHQ-9) scale reduction (P = 0.020). Logistic analysis indicated that smoking and alcohol consumption were independent determinants of relapse (P < 0.05). At 24 weeks of follow-up, Kaplan–Meier survival analysis reveal that there is statistically significant relapse rate between six groups (P = 0.025), left rTMS + C1 group has the best treatment effect for alcohol dependent patients. Cox regression analysis confirmed that current smoking, total cholesterol, and total bilirubin (TBIL) level were risk factors of relapse (P < 0.05).ConclusionThis study is the first to suggest that the combination of rTMS and CBT may be a potentially effective treatment for reducing relapse. |
| first_indexed | 2024-04-11T10:23:02Z |
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| institution | Directory Open Access Journal |
| issn | 1664-0640 |
| language | English |
| last_indexed | 2024-04-11T10:23:02Z |
| publishDate | 2022-10-01 |
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| series | Frontiers in Psychiatry |
| spelling | doaj.art-c4fc871ff9494969bcf52b91a6a2c4042022-12-22T04:29:41ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402022-10-011310.3389/fpsyt.2022.935491935491Repetitive transcranial magnetic stimulation combined with cognitive behavioral therapy treatment in alcohol-dependent patients: A randomized, double-blind sham-controlled multicenter clinical trialXiaorui Hu0Tian Zhang1Hongkun Ma2Xuhui Zhou3Hongxuan Wang4Xiaohong Wang5Chang Cheng6Yanfei Li7Ranran Duan8Bo Zhang9Huaizhi Wang10Jia Lu11Chuanyi Kang12Na Zhao13Yingjie Zhang14Lu Tian15Jun Liu16Jingjing Shi17Zhe Wang18Xinxin Zhou19Shuang Zhu20Qingxia Liu21Xuemin Li22Honghui Wang23Mingxuan Nie24Mei Yang25Jianzhong Yang26Yong Chi27Xiaofeng Zhu28Jian Hu29Yanjie Jia30Ying Peng31Lei Liu32Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, ChinaThe First Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaDepartment of Epidemiology and Health Statistics, Mudanjiang Medical University, Mudanjiang, ChinaHunan Provincial Brain Hospital, Changsha, ChinaSun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, ChinaDepartment of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, ChinaDepartment of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, ChinaThe First Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaThe First Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaDepartment of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, ChinaDepartment of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, ChinaDepartment of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, ChinaDepartment of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, ChinaDepartment of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, ChinaBeijing Anding Hospital, Capital Medical University, Beijing, ChinaBeijing Anding Hospital, Capital Medical University, Beijing, ChinaThe First Psychiatric Hospital of Harbin, Harbin, ChinaDepartment of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, ChinaThe First Psychiatric Hospital of Harbin, Harbin, ChinaThe First Psychiatric Hospital of Harbin, Harbin, ChinaDepartment of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, ChinaDepartment of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, ChinaDepartment of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, ChinaDepartment of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, ChinaDepartment of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, ChinaShenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen, ChinaThe Second Affiliated Hospital of Kunming Medical University, Kunming, ChinaBeijing Anding Hospital, Capital Medical University, Beijing, China0Department of Physiology and Neurobiology, Mudanjiang Medical University, Mudanjiang, ChinaDepartment of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, ChinaThe First Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaSun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, ChinaDepartment of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, ChinaBackgroundAlcohol dependence (AD) is a complex addictive disorder with a high relapse rate. Previous studies have shown that both repetitive transcranial magnetic stimulation (rTMS) and cognitive behavioral therapy (CBT) may be effective for AD, and we aim to explore more effective treatment options to reduce relapse rates for AD.Materials and methodsA total of 263 AD patients were recruited. They were divided into six groups according to the location and the type of rTMS: left dorsolateral prefrontal cortex (DLPFC), right DLPFC, sham stimulation, and whether they received CBT treatment: with a fixed schedule (C1) and without a fixed plan (C0). There were included in sham rTMS + C0 group (n = 50), sham rTMS + C1 group (n = 37), right rTMS + C0 group (n = 45), right rTMS + C1 group (n = 42), left rTMS + C0 group (n = 49), left rTMS + C1 group (n = 40). We used obsessive compulsive drinking scale (OCDS), visual analogue scale (VAS), alcohol dependence scale (ADS), montreal cognitive assessment (MoCA), generalized anxiety disorder-7 (GAD-7), patient health questionnaire-9 items (PHQ-9), and Pittsburgh sleep quality index (PSQI) to assess alcohol cravings, alcohol dependence, cognition, anxiety, depression, and sleep quality. They were followed up and evaluated for relapse.ResultsThe sham rTMS + C0 group relapse rate was significantly higher than the right rTMS + C1 group (P = 0.006), the left rTMS + C0 group (P = 0.031), the left rTMS + C1 group (P = 0.043). The right rTMS + C0 group showed significantly higher relapse rate compared to the right rTMS + C1 group (P = 0.046). There was no significant difference in relapse rates between other groups. The repeated-measures ANOVA showed an interaction effect between group and time was significant in the rate of patient health questionnaire-9 items (PHQ-9) scale reduction (P = 0.020). Logistic analysis indicated that smoking and alcohol consumption were independent determinants of relapse (P < 0.05). At 24 weeks of follow-up, Kaplan–Meier survival analysis reveal that there is statistically significant relapse rate between six groups (P = 0.025), left rTMS + C1 group has the best treatment effect for alcohol dependent patients. Cox regression analysis confirmed that current smoking, total cholesterol, and total bilirubin (TBIL) level were risk factors of relapse (P < 0.05).ConclusionThis study is the first to suggest that the combination of rTMS and CBT may be a potentially effective treatment for reducing relapse.https://www.frontiersin.org/articles/10.3389/fpsyt.2022.935491/fullalcohol dependencerepetitive transcranial magnetic stimulationcognitive behavioral therapyrelapsecombination therapy |
| spellingShingle | Xiaorui Hu Tian Zhang Hongkun Ma Xuhui Zhou Hongxuan Wang Xiaohong Wang Chang Cheng Yanfei Li Ranran Duan Bo Zhang Huaizhi Wang Jia Lu Chuanyi Kang Na Zhao Yingjie Zhang Lu Tian Jun Liu Jingjing Shi Zhe Wang Xinxin Zhou Shuang Zhu Qingxia Liu Xuemin Li Honghui Wang Mingxuan Nie Mei Yang Jianzhong Yang Yong Chi Xiaofeng Zhu Jian Hu Yanjie Jia Ying Peng Lei Liu Repetitive transcranial magnetic stimulation combined with cognitive behavioral therapy treatment in alcohol-dependent patients: A randomized, double-blind sham-controlled multicenter clinical trial Frontiers in Psychiatry alcohol dependence repetitive transcranial magnetic stimulation cognitive behavioral therapy relapse combination therapy |
| title | Repetitive transcranial magnetic stimulation combined with cognitive behavioral therapy treatment in alcohol-dependent patients: A randomized, double-blind sham-controlled multicenter clinical trial |
| title_full | Repetitive transcranial magnetic stimulation combined with cognitive behavioral therapy treatment in alcohol-dependent patients: A randomized, double-blind sham-controlled multicenter clinical trial |
| title_fullStr | Repetitive transcranial magnetic stimulation combined with cognitive behavioral therapy treatment in alcohol-dependent patients: A randomized, double-blind sham-controlled multicenter clinical trial |
| title_full_unstemmed | Repetitive transcranial magnetic stimulation combined with cognitive behavioral therapy treatment in alcohol-dependent patients: A randomized, double-blind sham-controlled multicenter clinical trial |
| title_short | Repetitive transcranial magnetic stimulation combined with cognitive behavioral therapy treatment in alcohol-dependent patients: A randomized, double-blind sham-controlled multicenter clinical trial |
| title_sort | repetitive transcranial magnetic stimulation combined with cognitive behavioral therapy treatment in alcohol dependent patients a randomized double blind sham controlled multicenter clinical trial |
| topic | alcohol dependence repetitive transcranial magnetic stimulation cognitive behavioral therapy relapse combination therapy |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2022.935491/full |
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