Add-on High Frequency Deep Transcranial Magnetic Stimulation (dTMS) to Bilateral Prefrontal Cortex Reduces Cocaine Craving in Patients with Cocaine Use Disorder

TITLE
Add-on High Frequency Deep Transcranial Magnetic Stimulation (dTMS) to Bilateral Prefrontal Cortex Reduces Cocaine Craving in Patients with Cocaine Use Disorder

AUTHORS
Rapinesi C; Del Casale A; Di Pietro S; Ferri VR; Piacentino D; Sani G; Raccah RN; Zangen A; Ferracuti S; Vento AE; Angeletti G; Brugnoli R; D Kotzalidis G; Girardi P. Institution Rapinesi, Chiara. NESMOS (Neurosciences, Mental Health, and Sensory Organs) Department, Sapienza University of Rome, School of Medicine and Psychology, Sant’Andrea Hospital, Rome, Italy. Del Casale, Antonio. NESMOS (Neurosciences, Mental Health, and Sensory Organs) Department, Sapienza University of Rome, School of Medicine and Psychology, Sant’Andrea Hospital, Rome, Italy; Department of Psychiatric Rehabilitation, P. Alberto Mileno Onlus Foundation, Vasto, Italy. Di Pietro, Simone. NESMOS (Neurosciences, Mental Health, and Sensory Organs) Department, Sapienza University of Rome, School of Medicine and Psychology, Sant’Andrea Hospital, Rome, Italy. Ferri, Vittoria Rachele. NESMOS (Neurosciences, Mental Health, and Sensory Organs) Department, Sapienza University of Rome, School of Medicine and Psychology, Sant’Andrea Hospital, Rome, Italy. Piacentino, Daria. NESMOS (Neurosciences, Mental Health, and Sensory Organs) Department, Sapienza University of Rome, School of Medicine and Psychology, Sant’Andrea Hospital, Rome, Italy. Sani, Gabriele. NESMOS (Neurosciences, Mental Health, and Sensory Organs) Department, Sapienza University of Rome, School of Medicine and Psychology, Sant’Andrea Hospital, Rome, Italy. Raccah, Ruggero Nessim. ATID Ltd Advanced Technology Innovation Distribution, Rome, Italy. Zangen, Abraham. Department of Life Sciences, Ben Gurion University of the Negev, Be’er Sheva, Israel. Ferracuti, Stefano. Department of Neurology and Psychiatry, Sapienza University of Rome, Italy. Vento, Alessandro Emiliano. Asl Roma 2, Osservatorio sulle Dipendenze e sui Disturbi Psichici Sotto Soglia, Rome, Italy. Angeletti, Gloria. NESMOS (Neurosciences, Mental Health, and Sensory Organs) Department, Sapienza University of Rome, School of Medicine and Psychology, Sant’Andrea Hospital, Rome, Italy. Brugnoli, Roberto. NESMOS (Neurosciences, Mental Health, and Sensory Organs) Department, Sapienza University of Rome, School of Medicine and Psychology, Sant’Andrea Hospital, Rome, Italy. D Kotzalidis, Georgios. NESMOS (Neurosciences, Mental Health, and Sensory Organs) Department, Sapienza University of Rome, School of Medicine and Psychology, Sant’Andrea Hospital, Rome, Italy. Girardi, Paolo. NESMOS (Neurosciences, Mental Health, and Sensory Organs) Department, Sapienza University of Rome, School of Medicine and Psychology, Sant’Andrea Hospital, Rome, Italy.

ELECTRONIC ADDRESSES
antonio.delcasale@uniroma1.it

SOURCE
Neuroscience Letters. 629:43-7, 2016 Aug 26.

INTRODUCTION
Cocaine dependence is a substantial public health problem. The aim of this study is to evaluate the effect of high frequency deep transcranial magnetic stimulation (dTMS) on craving in patients with cocaine use disorder (CUD).

METHODS
Seven men (mean age, 48.71 years; standard deviation [SD], 9.45; range 32-60 years) with CUD and no concurrent axis 1 or 2 disorder save nicotine abuse, underwent three sessions of alternate day 20Hz dTMS in 20 trains delivered to the dorsolateral prefrontal cortex (DLPFC) preferentially to the left hemisphere, for 12 sessions spread over one month, added to unchanged prior drug treatment. We used a visual analogue scale (VAS) to measure cocaine craving the week before, each week during, and one month after dTMS treatment.

RESULTS
DLPFC stimulation significantly reduced craving over time: within-subjects main effect of time of treatment (ANOVA, F[3,18]=46.154; p<0.001; eta(2)=0.88). The reduction of craving from baseline was significant at two weeks (p<0.001), and four weeks (p<0.001) of treatment, and at the week eight, four weeks after treatment interruption (p=0.003), although the increase of craving was significant from week four and eight (p=0.014).

CONCLUSION
dTMS over left DLPFC reduced craving in CUD patients in a small sample that is to be considered preliminary. However, maintenance sessions would be needed to maintain the achieved results. Our findings highlight the potential of noninvasive neuromodulation as a therapeutic tool for cocaine addiction.

Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.