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TITLE
Both Active and Sham Low-Frequency rTMS Single Sessions Over the Right DLPFC Decrease Cue-Induced Cravings Among Pathological Gamblers Seeking Treatment
AUTHORS
Sauvaget A; Bulteau S; Guilleux A; Leboucher J; Pichot A; Valriviere P; Vanelle JM; Sebille-Rivain V; Grall-Bronnec M.
SOURCE
Journal of Behavioral Addictions. 7(1):126-136, 2018 Mar 01.
ABSTRACT
Craving is a core symptom of addictive disorders, such as pathological gambling for example. Over the last decade, several studies have assessed the efficacy of repetitive transcranial magnetic stimulation (rTMS) in the addiction field, which triggers the dorsolateral prefrontal cortex (DLPFC) to decrease craving. The STIMJEU study investigated whether a single session of low-frequency (LF, i.e., 1 Hz) rTMS applied to the right DLPFC reduced cue-induced gambling craving in a sample of treatment-seeking pathological gamblers.
METHODS
Thirty patients received both active and sham rTMS in random order and were blinded to the condition in a within-subject crossover design. Outcome measures included self-reported gambling craving (Visual Analog Scale and Gambling Craving Scale) and physiological measures (heart rate and blood pressure).
RESULTS
The rTMS sessions were associated with a significant decrease in the gambling urge, regardless of whether the session was active or sham. When controlling cue-induced craving levels, no effects were observed on craving for active rTMS. Overall, rTMS was well-tolerated, and the credibility of the sham procedure was assessed and appeared to be appropriate.
CONCLUSIONS
We failed to demonstrate the specific efficacy of one session of LF rTMS to decrease cue-induced craving in pathological gamblers. A strong placebo-effect and rTMS parameters may partly explain these results. Yet, we are convinced that rTMS remains a promising therapeutic method. Further studies are required to examine its potential effect.
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