Cognitive and emotional predictors of real versus sham repetitive transcranial magnetic stimulation treatment response in methamphetamine use disorder

Tianzhen Chen; Hang Su; Haifeng Jiang; Xiaotong Li; Na Zhong; Jiang Du; Yiran Meng; Chunmei Duan; Congbin Zhang; Ke Xiao; Ding Xu; Weidong Song; Min Zhao

doi:10.1016/j.jpsychires.2020.05.007

Cognitive and emotional predictors of real versus sham repetitive transcranial magnetic stimulation treatment response in methamphetamine use disorder

J Psychiatr Res. 2020 Jul:126:73-80. doi: 10.1016/j.jpsychires.2020.05.007. Epub 2020 May 12.

Authors

Tianzhen Chen¹, Hang Su¹, Haifeng Jiang¹, Xiaotong Li¹, Na Zhong¹, Jiang Du¹, Yiran Meng², Chunmei Duan², Congbin Zhang², Ke Xiao³, Ding Xu³, Weidong Song³, Min Zhao⁴

Affiliations

¹ Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
² Yunnan Institute on Drug Dependence, Yunnan, China.
³ Shanghai Drug Rehabilitation Administration Bureau, Shanghai, China.
⁴ Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China; Institute of Psychological and Behavioral Science, Shanghai Jiao Tong University, Shanghai, China; CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Sciences, Shanghai, China. Electronic address: drminzhao@smhc.org.cn.

PMID: 32422456
DOI: 10.1016/j.jpsychires.2020.05.007

Abstract

Background and aims: Repetitive transcranial magnetic stimulation (rTMS) of the left dorsolateral prefrontal cortex (DLPFC) can effectively reduce cravings in methamphetamine use disorder (MUD). However, a considerable group still fails to respond. Cognitive and emotional disturbance, as well as impulsive features, are widespread in patients with MUD and might mediate the treatment response of rTMS. The purpose of this study is to figure out whether these variables can help predicting patients' responses to rTMS treatment.

Methods: Ninety-seven patients with severe MUD and thirty-one gender- and age-matched healthy subjects were included. Patients were randomized to receive 20 sessions of real or sham rTMS. Intermittent theta burst protocols (iTBS) or sham iTBS were applied every weekday over the DLPFC for 20 daily sessions. Both groups received regular treatment. Craving induced by drug-related cue was measured before and after stimulation. Cognition was evaluated by using the CogState Battery. Baseline characteristics were collected through the Addiction Severity Index, Patient Health Questionnaire-9, General Anxiety Disorder Scale-7, and Barrett Impulsivity Scale-11.

Results: Results showed that patients with MUD have worse spatial working memory, problem-solving ability, as well as depression and anxiety symptoms compared with healthy controls. Cognition and emotion differed between responders (craving decrease ≥60%) and non-responders in real rTMS group but not in the sham group. Better cognitive and emotional functions means that patients have higher possibility for better response to real rTMS treatment.

Conclusions: This study suggests that cognitive, emotional and impulsive features could be used to predict the prospective treatment responses of rTMS in patients with MUD.

Keywords: Cognitive function; Emotion; Impulsivity; Methamphetamine; Responder; Transcranial magnetic stimulation.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Cognition
Emotions
Humans
Methamphetamine*
Prefrontal Cortex
Prospective Studies
Transcranial Magnetic Stimulation*
Treatment Outcome

Substances

Methamphetamine