The effects of repetitive transcranial magnetic stimulation on cue-induced craving in male patients with heroin use disorder

Xiaoli Liu; Xiwen Zhao; Ting Liu; Qingming Liu; Li Tang; Hui Zhang; Wenbo Luo; Zafiris J Daskalakis; Ti-Fei Yuan

doi:10.1016/j.ebiom.2020.102809

The effects of repetitive transcranial magnetic stimulation on cue-induced craving in male patients with heroin use disorder

EBioMedicine. 2020 Jun:56:102809. doi: 10.1016/j.ebiom.2020.102809. Epub 2020 Jun 5.

Authors

Xiaoli Liu¹, Xiwen Zhao², Ting Liu³, Qingming Liu³, Li Tang⁴, Hui Zhang⁵, Wenbo Luo⁶, Zafiris J Daskalakis⁷, Ti-Fei Yuan⁸

Affiliations

¹ Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; School of Psychology, Nanjing Normal University, Nanjing, Jiangsu, China; Co-innovation Center of Neuroregeneration, Nantong University, Nantong, Jiangsu, China; Ningbo Key Laboratory of Sleep Medicine, Ningbo Kangning Hospital, Ningbo, Zhejiang, China.
² Yale Center for Analytical Sciences, School of Public Health, Yale University, New Haven, CT, U.S.A.
³ Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; School of Psychology, Nanjing Normal University, Nanjing, Jiangsu, China.
⁴ Department of Biostatistics, St. Jude Children's Research Hospital, U.S.A.
⁵ Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, U.S.A.
⁶ Research Center of Brain and Cognitive Neuroscience, Liaoning Normal University, Dalian, China; Key Laboratory of Brain and Cognitive Neurosience, Liaoning Province, China. Electronic address: luowb@lnnu.edu.cn.
⁷ Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ont., Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
⁸ Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Co-innovation Center of Neuroregeneration, Nantong University, Nantong, Jiangsu, China. Electronic address: ytf0707@126.com.

Abstract

Background: Craving is a central feature of addiction. Early evidence suggests that repetitive transcranial magnetic stimulation is effective in reducing cue induced craving for patients with opioid use disorder (OUD). However, trials in large populations of patients with OUDs are lacking.

Methods: We randomly assigned 118 male heroin patients into three groups (i.e., 10 Hz rTMS, 1 Hz rTMS and a wait-list control group) from two addiction rehabilitation centers. rTMS was applied to the left dorsolateral prefrontal cortex (DLPFC) for 20 daily consecutive sessions.

Findings: Results showed that 10 Hz rTMS and 1 Hz rTMS were both effective in reducing cue-induced craving scores in heroin users when compared to the wait list group. The treatment effects lasted for up to 60 days after rTMS treatment cessation.

Interpretation: Our results suggest that rTMS applied to the DLPFC is effective in reducing craving severity in heroin use disorder patients. Our results also suggest that such treatment effects can last for up to 60 days after treatment cessation.

Keywords: Addiction; Craving; Heroin; Opioid; Transcranial magnetic stimulation.

Publication types

Multicenter Study
Randomized Controlled Trial

MeSH terms

Adult
Craving
Heroin Dependence / therapy*
Humans
Inpatients
Male
Substance Abuse Treatment Centers
Transcranial Magnetic Stimulation / methods*
Treatment Outcome