Neuroplastic changes in resting-state functional connectivity after rTMS intervention for methamphetamine craving

Hang Su; Yilin Liu; Dazhi Yin; Tianzhen Chen; Xiaotong Li; Na Zhong; Haifeng Jiang; Jijun Wang; Jiang Du; Ke Xiao; Ding Xu; Kristina Zeljic; Zheng Wang; Min Zhao

doi:10.1016/j.neuropharm.2020.108177

Neuroplastic changes in resting-state functional connectivity after rTMS intervention for methamphetamine craving

Neuropharmacology. 2020 Sep 15:175:108177. doi: 10.1016/j.neuropharm.2020.108177. Epub 2020 Jun 4.

Authors

Hang Su¹, Yilin Liu², Dazhi Yin³, Tianzhen Chen¹, Xiaotong Li¹, Na Zhong¹, Haifeng Jiang¹, Jijun Wang¹, Jiang Du¹, Ke Xiao⁴, Ding Xu⁴, Kristina Zeljic⁵, Zheng Wang⁶, Min Zhao⁷

Affiliations

¹ Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
² Institute of Neuroscience, CAS Center for Excellence in Brain Science and Intelligence Technology, State Key Laboratory of Neuroscience, CAS Key Laboratory of Primate Neurobiology, Chinese Academy of Sciences, Shanghai, China; University of Chinese Academy of Sciences, Beijing, China.
³ School of Psychology and Cognitive Science, East China Normal University, Shanghai, China.
⁴ Shanghai Drug Rehabilitation Administration Bureau, Shanghai, China.
⁵ Institute of Neuroscience, CAS Center for Excellence in Brain Science and Intelligence Technology, State Key Laboratory of Neuroscience, CAS Key Laboratory of Primate Neurobiology, Chinese Academy of Sciences, Shanghai, China.
⁶ Institute of Neuroscience, CAS Center for Excellence in Brain Science and Intelligence Technology, State Key Laboratory of Neuroscience, CAS Key Laboratory of Primate Neurobiology, Chinese Academy of Sciences, Shanghai, China; University of Chinese Academy of Sciences, Beijing, China; CAS Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, 200031, China. Electronic address: zheng.wang@ion.ac.cn.
⁷ Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; CAS Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, 200031, China; Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China; Institute of Psychological and Behavioral Science, Shanghai Jiao Tong University, Shanghai, China. Electronic address: drminzhao@smhc.org.cn.

PMID: 32505485
DOI: 10.1016/j.neuropharm.2020.108177

Abstract

Amphetamine-type stimulants are the second most commonly abused illicit drug worldwide, with no effective medical treatments currently available. Previous studies have demonstrated that high frequency repetitive transcranial magnetic stimulation (rTMS) over the left dorsolateral prefrontal cortex (DLPFC) reduced cue-induced craving in patients with methamphetamine dependence. However, the neuroplastic mechanism underlying rTMS intervention in methamphetamine users remains to be elucidated. Sixty participants (40 males) with severe methamphetamine use disorder according to DSM-5 were randomized to receive either intermittent theta burst protocols (iTBS) (short bursts of 50 Hz rTMS repeated at a rate in the theta range (5 Hz), 2-sec on, 8-sec off for 5 min; 900 pulses) or sham rTMS over the DLPFC over four weeks (20 daily sessions). Resting state functional connectivity magnetic resonance imaging was acquired before and after rTMS intervention. Participants received drug related cue exposure and rated their craving before and after stimulation. Seed-based functional connectivity analysis was performed to probe rTMS-induced neuroplastic reorganization of brain functional networks. Results showed that twenty daily rTMS sessions decreased craving, increased functional connectivity between left DLPFC and inferior parietal lobule, and decreased functional connectivity between insula and inferior parietal lobule, medial temporal lobe and precuneus. Moreover, the increase of functional connectivity between DLPFC and inferior parietal lobule correlated with craving reduction. This study suggests that neuroplastic changes of frontoparietal functional connectivity contributes to craving reduction, shedding light on the therapeutic effect of rTMS on methamphetamine use disorder. This article is part of the special issue on Stress, Addiction and Plasticity.

Keywords: Craving; Functional connectivity; Methamphetamine; Neuroplasticity; Transcranial magnetic stimulation.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Amphetamine-Related Disorders / physiopathology*
Amphetamine-Related Disorders / psychology*
Brain / physiopathology*
Brain Mapping
Craving / physiology*
Female
Humans
Magnetic Resonance Imaging
Male
Neural Pathways / physiopathology
Neuronal Plasticity / drug effects*
Transcranial Magnetic Stimulation