rTMS Reduces Psychopathological Burden and Cocaine Consumption in Treatment-Seeking Subjects With Cocaine Use Disorder: An Open Label, Feasibility Study
Introduction: Cocaine use disorder (CUD) currently represents a notable public health concern, linked with significant disability, high chances of chronicity, and lack of effective pharmacological or psychological treatments. Repetitive transcranial magnetic stimulation (rTMS) is supposed to be a po...
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| Format: | Article |
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Frontiers Media S.A.
2019-09-01
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| Series: | Frontiers in Psychiatry |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fpsyt.2019.00621/full |
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| author | Mauro Pettorruso Mauro Pettorruso Giovanni Martinotti Giovanni Martinotti Rita Santacroce Rita Santacroce Chiara Montemitro Fabrizio Fanella Massimo di Giannantonio the rTMS stimulation group Luisa De Risio Ilaria Petrucci Gaia Tourjansky Patrizia Capicotto Francesca Neri Gianluca Ruggiero Barbara Cassiani Silvia Fraticelli Valentina Moroni |
| author_facet | Mauro Pettorruso Mauro Pettorruso Giovanni Martinotti Giovanni Martinotti Rita Santacroce Rita Santacroce Chiara Montemitro Fabrizio Fanella Massimo di Giannantonio the rTMS stimulation group Luisa De Risio Ilaria Petrucci Gaia Tourjansky Patrizia Capicotto Francesca Neri Gianluca Ruggiero Barbara Cassiani Silvia Fraticelli Valentina Moroni |
| author_sort | Mauro Pettorruso |
| collection | DOAJ |
| description | Introduction: Cocaine use disorder (CUD) currently represents a notable public health concern, linked with significant disability, high chances of chronicity, and lack of effective pharmacological or psychological treatments. Repetitive transcranial magnetic stimulation (rTMS) is supposed to be a potential therapeutic option for addictive disorders. Aim of this study was to evaluate the feasibility of rTMS on (1) cocaine craving and consumption and (2) other comorbid psychiatric symptoms.Methods: Twenty treatment seeking CUD subjects underwent 2 weeks of intensive rTMS treatment (15Hz; 5 days/week, twice a day for a total of 20 stimulation sessions) of the left dorsolateral prefrontal cortex, followed by 2 weeks of maintenance treatment (15Hz, 1 day/week, twice a day). Sixteen patients completed the study. Patients were evaluated at baseline (T0), after 2 weeks of treatment (T1), and at the end of the study (T2; 4 weeks), with the following scales: Cocaine Selective Severity Assessment (CSSA), Zung Self-Rating Anxiety Scale, Beck Depression Inventory (BDI), Symptom Checklist-90 (SCL-90), and the Insomnia Severity Index.Results: After four weeks of rTMS treatment, 9 out of 16 subjects (56.25%) had a negative urinalysis test, with a significant conversion rate with respect to baseline (Z = −3.00; p = 0.003). Craving scores significantly improved only at T2 (p = 0.020). The overall psychopathological burden, as measured by the SCL-90 Global Severity Index (GSI), significantly decreased during the study period (Z = −2.689; p = 0.007), with a relevant improvement with regards to depressive symptoms, anhedonia, and anxiety. Subjects exhibiting lower baseline scores on the SCL-90 were more likely to be in the positive outcome group at the end of the study (Z = −3.334; p = 0.001).Discussion: Findings from this study are consistent with previous contributions on rTMS use in subjects with cocaine use disorder. We evidenced a specific action on some psychopathological areas and a consequent indirect effect in terms of relapse prevention and craving reduction. A double-blind, sham-controlled, neuro-navigated rTMS study design is needed, in order to confirm the potential benefits of this technique, opening new scenarios in substance use disorders treatment. |
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| issn | 1664-0640 |
| language | English |
| last_indexed | 2024-12-12T22:27:17Z |
| publishDate | 2019-09-01 |
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| series | Frontiers in Psychiatry |
| spelling | doaj.art-ed82d3bacca44fb9b6ba0e0c6e3e628f2022-12-22T00:09:43ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402019-09-011010.3389/fpsyt.2019.00621434622rTMS Reduces Psychopathological Burden and Cocaine Consumption in Treatment-Seeking Subjects With Cocaine Use Disorder: An Open Label, Feasibility StudyMauro Pettorruso0Mauro Pettorruso1Giovanni Martinotti2Giovanni Martinotti3Rita Santacroce4Rita Santacroce5Chiara Montemitro6Fabrizio Fanella7Massimo di Giannantonio8the rTMS stimulation groupLuisa De RisioIlaria PetrucciGaia TourjanskyPatrizia CapicottoFrancesca NeriGianluca RuggieroBarbara CassianiSilvia FraticelliValentina MoroniDepartment of Neuroscience, Imaging and Clinical Sciences, G.d’Annunzio University, Chieti, ItalyLa Promessa o.n.l.u.s., Rome, ItalyDepartment of Neuroscience, Imaging and Clinical Sciences, G.d’Annunzio University, Chieti, ItalyDepartment of Pharmacy, Pharmacology and Postgraduate Medicine, University of Hertfordshire, Hatfield, United KingdomDepartment of Neuroscience, Imaging and Clinical Sciences, G.d’Annunzio University, Chieti, ItalyDepartment of Pharmacy, Pharmacology and Postgraduate Medicine, University of Hertfordshire, Hatfield, United KingdomDepartment of Neuroscience, Imaging and Clinical Sciences, G.d’Annunzio University, Chieti, ItalyLa Promessa o.n.l.u.s., Rome, ItalyDepartment of Neuroscience, Imaging and Clinical Sciences, G.d’Annunzio University, Chieti, ItalyIntroduction: Cocaine use disorder (CUD) currently represents a notable public health concern, linked with significant disability, high chances of chronicity, and lack of effective pharmacological or psychological treatments. Repetitive transcranial magnetic stimulation (rTMS) is supposed to be a potential therapeutic option for addictive disorders. Aim of this study was to evaluate the feasibility of rTMS on (1) cocaine craving and consumption and (2) other comorbid psychiatric symptoms.Methods: Twenty treatment seeking CUD subjects underwent 2 weeks of intensive rTMS treatment (15Hz; 5 days/week, twice a day for a total of 20 stimulation sessions) of the left dorsolateral prefrontal cortex, followed by 2 weeks of maintenance treatment (15Hz, 1 day/week, twice a day). Sixteen patients completed the study. Patients were evaluated at baseline (T0), after 2 weeks of treatment (T1), and at the end of the study (T2; 4 weeks), with the following scales: Cocaine Selective Severity Assessment (CSSA), Zung Self-Rating Anxiety Scale, Beck Depression Inventory (BDI), Symptom Checklist-90 (SCL-90), and the Insomnia Severity Index.Results: After four weeks of rTMS treatment, 9 out of 16 subjects (56.25%) had a negative urinalysis test, with a significant conversion rate with respect to baseline (Z = −3.00; p = 0.003). Craving scores significantly improved only at T2 (p = 0.020). The overall psychopathological burden, as measured by the SCL-90 Global Severity Index (GSI), significantly decreased during the study period (Z = −2.689; p = 0.007), with a relevant improvement with regards to depressive symptoms, anhedonia, and anxiety. Subjects exhibiting lower baseline scores on the SCL-90 were more likely to be in the positive outcome group at the end of the study (Z = −3.334; p = 0.001).Discussion: Findings from this study are consistent with previous contributions on rTMS use in subjects with cocaine use disorder. We evidenced a specific action on some psychopathological areas and a consequent indirect effect in terms of relapse prevention and craving reduction. A double-blind, sham-controlled, neuro-navigated rTMS study design is needed, in order to confirm the potential benefits of this technique, opening new scenarios in substance use disorders treatment.https://www.frontiersin.org/article/10.3389/fpsyt.2019.00621/fulltranscranial magnetic stimulationcocaine use disorderaddictionanhedoniaanxietydepression |
| spellingShingle | Mauro Pettorruso Mauro Pettorruso Giovanni Martinotti Giovanni Martinotti Rita Santacroce Rita Santacroce Chiara Montemitro Fabrizio Fanella Massimo di Giannantonio the rTMS stimulation group Luisa De Risio Ilaria Petrucci Gaia Tourjansky Patrizia Capicotto Francesca Neri Gianluca Ruggiero Barbara Cassiani Silvia Fraticelli Valentina Moroni rTMS Reduces Psychopathological Burden and Cocaine Consumption in Treatment-Seeking Subjects With Cocaine Use Disorder: An Open Label, Feasibility Study Frontiers in Psychiatry transcranial magnetic stimulation cocaine use disorder addiction anhedonia anxiety depression |
| title | rTMS Reduces Psychopathological Burden and Cocaine Consumption in Treatment-Seeking Subjects With Cocaine Use Disorder: An Open Label, Feasibility Study |
| title_full | rTMS Reduces Psychopathological Burden and Cocaine Consumption in Treatment-Seeking Subjects With Cocaine Use Disorder: An Open Label, Feasibility Study |
| title_fullStr | rTMS Reduces Psychopathological Burden and Cocaine Consumption in Treatment-Seeking Subjects With Cocaine Use Disorder: An Open Label, Feasibility Study |
| title_full_unstemmed | rTMS Reduces Psychopathological Burden and Cocaine Consumption in Treatment-Seeking Subjects With Cocaine Use Disorder: An Open Label, Feasibility Study |
| title_short | rTMS Reduces Psychopathological Burden and Cocaine Consumption in Treatment-Seeking Subjects With Cocaine Use Disorder: An Open Label, Feasibility Study |
| title_sort | rtms reduces psychopathological burden and cocaine consumption in treatment seeking subjects with cocaine use disorder an open label feasibility study |
| topic | transcranial magnetic stimulation cocaine use disorder addiction anhedonia anxiety depression |
| url | https://www.frontiersin.org/article/10.3389/fpsyt.2019.00621/full |
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