- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03470480
rTMS for Craving in Methamphetamine Use Disorder
September 16, 2021 updated by: Brandon Cornejo MD, PhD, Oregon Health and Science University
The Use of Repetitive Transmagnetic Stimulation to Target Craving in Methamphetamine Use Disorder
The primary aim of this project is to use a randomized single-blind sham-controlled study to investigate if high frequency repetitive transmagnetic stimulation (HF-rTMS) can modulate cue-induced craving in adult methamphetamine (METH) users.
The investigators hypothesize that HF-rTMS directed at left dorsolateral prefrontal cortex (DLPFC) will result in a reduction in craving for METH compared to sham-controlled rTMS in adults with methamphetamine use disorder (MUD) as evidenced by validated measures of METH craving.
Neurobiologically, the investigators anticipate rTMS mediated stimulation of the DLPFC could result in inhibition of cue-induced craving through potential disruption of involved circuitry.
The current project proposes that participants who are recently abstinent from METH will be randomized into four experimental groups to provide two rTMS conditions (real versus sham) and two picture cues conditions (METH versus neutral).
The experiment will have an induction phase where each subject will receive 10 daily treatments within 2 weeks.
Just before each rTMS/sham session participants will be shown visual cues (METH or neutral).
Participants will then undergo a maintenance phase for an additional month with assessments to evaluate craving and relapse.
Urine samples for urine drug screening (UDS) will be collected at screening day and on days 1, 5 and 10.
Just before each rTMS/sham session participants will be shown visual cues (METH and neutral).
VAS craving scores will be assessed before and after picture presentation and after the rTMS/sham session.
Before the first and 10th treatment session, participants were evaluated by the the Stimulant Craving Questionnaire (STCQ) and the Severity of Dependence Scale (SDS) questionnaires.
Participants will then undergo a maintenance phase for an additional month.
During the first week of maintenance, three rTMS/sham sessions will be administered.
During each of the following 3 weeks, one rTMS/sham session will be given per week.
As with the induction phase, urine samples will be collected for screening and STCQ and the SDS questionnaires will be completed at each maintenance session.
To evaluate the long-term effects of the rTMS treatment, the investigators plan on contacting participants 6 months after treatment termination for all subjects who completed the 10 treatment sessions.
During that phone conversation, craving and relapse will again be assessed.
Study Overview
Status
Recruiting
Conditions
Study Type
Interventional
Enrollment (Anticipated)
50
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: Brandon J Cornejo, MD, PhD
- Phone Number: 503-721-7964
- Email: brandon.cornejo@va.gov
Study Contact Backup
- Name: Holly McCready
- Phone Number: 503-721-7964
Study Locations
-
-
Oregon
-
Portland, Oregon, United States, 97239
- Recruiting
- Veterans Affairs Portland Health Care System
-
Contact:
- Holly McCready
- Phone Number: 503-721-7964
-
Contact:
- Brandon J Cornejo, MD, PhD
- Phone Number: 503-721-7964
-
Principal Investigator:
- Brandon J Cornejo, MD, PhD
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
16 years to 63 years (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Subjects must use at least 0.5 g per day at least 5 days per week and have a minimum 12-month history of METH abuse.
- Subjects must meet DSM V diagnosis for methamphetamine use disorder.
- Subjects must have a minimum 4-week period of detoxification and a desire to stop using methamphetamine.
Exclusion Criteria:
- Present or past history of neurological disorder
- The present history of a DSM IV Axis I or DSM V primary psychiatric disease (apart from MUD and depressive symptoms defined as a Hamilton Depression Scale Score < 7 ("normal"))
- Scores on the Hamilton Depression Scale > 8, possibly indicating clinical depression
- No current abuse of drugs other than methamphetamine (except nicotine). Urine-screening tests for psychoactive drugs will be performed to corroborate the lack of drug use.
- Individuals meeting criteria for cannabis use disorder or alcohol use disorder
- Medical illness that can affect brain function
- Past or present history of cardiovascular disease or high blood pressure
- Any history of epilepsy or a known history of seizure disorder
- A history of metal in the head or chest area (except dental fillings or braces)
- Current consumption of psychiatric medication
- Any other medical, neurological or neurosurgical condition that would preclude the administration of repetitive transmagnetic stimulation
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Treatment rTMS + meth pictures
Participants in this group will receive real repetitive transcranial magnetic stimulation treatments.
Before each rTMS session they will be exposed to a series of methamphetamine-related pictures to evaluate response to methamphetamine visual cues while receiving real rTMS treatments.
This group will be referred to as real METH (RM).
|
A real magnet will be used during rTMS treatments, which will look identical to the sham magnet.
The participants and treatment facilitator will be blinded to which magnet will be used.
High frequency repetitive transmagnetic stimulation (rTMS) will be directed at left dorsolateral prefrontal cortex (DLPFC) during 10 daily treatments within two weeks then 6 more treatments during the following month.
Other Names:
Just before each rTMS session, participants will be shown methamphetamine-related pictures
|
Active Comparator: Treatment rTMS + neutral pictures
Participants in this group will receive real repetitive transcranial magnetic stimulation treatments.
Before each rTMS session they will be exposed to a series of neutral pictures to evaluate response to neutral visual cues while receiving real rTMS treatments.
This group will be referred to as real neutral (RN).
|
A real magnet will be used during rTMS treatments, which will look identical to the sham magnet.
The participants and treatment facilitator will be blinded to which magnet will be used.
High frequency repetitive transmagnetic stimulation (rTMS) will be directed at left dorsolateral prefrontal cortex (DLPFC) during 10 daily treatments within two weeks then 6 more treatments during the following month.
Other Names:
Just before each rTMS session, participants will be shown neutral pictures
|
Sham Comparator: Sham rTMS + meth pictures
Participants in this group will receive sham repetitive transcranial magnetic stimulation treatments.
Before each rTMS session they will be exposed to a series of methamphetamine-related pictures to evaluate response to methamphetamine visual cues while receiving sham rTMS treatments.
This group will be referred to as sham METH (SM).
|
Just before each rTMS session, participants will be shown methamphetamine-related pictures
A sham magnet will be used during rTMS treatments, which will look identical to the real magnet.
The participants and treatment facilitator will be blinded to which magnet will be used.
The sham rTMS treatments will be directed at left dorsolateral prefrontal cortex (DLPFC) during 10 daily treatments within two weeks then 6 more treatments during the following month.
|
Sham Comparator: Sham rTMS + neutral pictures
Participants in this group will receive sham repetitive transcranial magnetic stimulation treatments.
Before each rTMS session they will be exposed to a series of neutral pictures to evaluate response to neutral visual cues while receiving sham rTMS treatments.
This group will be referred to as sham neutral (SN).
|
Just before each rTMS session, participants will be shown neutral pictures
A sham magnet will be used during rTMS treatments, which will look identical to the real magnet.
The participants and treatment facilitator will be blinded to which magnet will be used.
The sham rTMS treatments will be directed at left dorsolateral prefrontal cortex (DLPFC) during 10 daily treatments within two weeks then 6 more treatments during the following month.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Effect of rTMS directed at left DLPFC on craving for methamphetamine as assessed by the Severity of Dependence Scale.
Time Frame: 6 weeks
|
The Severity of Dependence Scale (SDS) is a 5-item questionnaire that provides a score indicating the severity of dependence on methamphetamine.
Each of the five items is scored on a 4-point scale (0-3).
The total score is obtained through the addition of the 5-item ratings and will range from 0 to 15.
The higher the score the higher the level of dependence.
Pre and post differences in craving will be assessed.
|
6 weeks
|
Effect of rTMS directed at left DLPFC on craving for methamphetamine as assessed by a Visual Analog Scale (VAS).
Time Frame: 6 weeks
|
The visual analogue scale (VAS) is a fixed-length horizontal line on which the participant draws a line between the two anchors of "no cravings at all" and "most intense craving imaginable".
The distance between the "no cravings at all" anchor and the participants line is measured and reported as a value between 0 and 100.
The higher the value, the more intense the participants cravings are.
Pre and post differences in craving will be assessed.
|
6 weeks
|
Effect of rTMS directed at left DLPFC on craving for methamphetamine as assessed by the Stimulant Craving Questionnaire (STCQ).
Time Frame: 6 weeks
|
The Stimulant Craving Questionnaire-Brief (STCQ) is a 10-item self-report measure that assesses current craving for methamphetamine, using a seven-point scale, with answers ranging from 0 ("strongly disagree") to 6 ("strongly agree").
A composite score is generated for each participant by averaging the responses over all 10 questions.
The scores can range from 0 to 6.
The higher the composite score, the stronger the current craving.
Pre and post differences in craving will be assessed.
|
6 weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Effect of craving for methamphetamine on relapse status after rTMS directed at left DLPFC.
Time Frame: 5 months
|
Relapse will be determined by self-report and/or positive urine drug screens.
|
5 months
|
Effect of cue type (methamphetamine versus neutral) on methamphetamine craving after rTMS treatment.
Time Frame: 6 weeks
|
A composite craving score will be generated by adding each of the three craving measure scores (Severity of Dependence, Visual Analog Scale, and Stimulant Craving Questionnaire) for each participant who received real rTMS treatments.
The composite score can range from 0 to 121, where 0 indicates no cravings for methamphetamine and 121 is the strongest possible cravings for methamphetamine.
Pre and post differences in craving will be compared between participants who were exposed to methamphetamine cues before each session and those who were exposed to neutral cues.
|
6 weeks
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
February 7, 2018
Primary Completion (Anticipated)
September 1, 2023
Study Completion (Anticipated)
September 1, 2023
Study Registration Dates
First Submitted
February 7, 2018
First Submitted That Met QC Criteria
March 16, 2018
First Posted (Actual)
March 20, 2018
Study Record Updates
Last Update Posted (Actual)
September 22, 2021
Last Update Submitted That Met QC Criteria
September 16, 2021
Last Verified
September 1, 2021
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Mental Disorders
- Chemically-Induced Disorders
- Substance-Related Disorders
- Physiological Effects of Drugs
- Adrenergic Agents
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Autonomic Agents
- Peripheral Nervous System Agents
- Neurotransmitter Uptake Inhibitors
- Membrane Transport Modulators
- Dopamine Agents
- Dopamine Uptake Inhibitors
- Central Nervous System Stimulants
- Sympathomimetics
- Adrenergic Uptake Inhibitors
- Methamphetamine
Other Study ID Numbers
- GPSYC0236A
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
No
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
Yes
product manufactured in and exported from the U.S.
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Transcranial Magnetic Stimulation
-
University Hospital, GrenobleUnknownHealthy | Transcranial Magnetic Stimulation | Transcranial Direct Current StimulationFrance
-
Florida State UniversityNational Institute of Mental Health (NIMH)Recruiting
-
Florida State UniversityNational Institute of Mental Health (NIMH)Recruiting
-
Florida State UniversityNational Institute of Mental Health (NIMH)Completed
-
University of RegensburgCompletedTranscranial Magnetic Stimulation
-
Institut National de la Santé Et de la Recherche...CompletedTranscranial Magnetic StimulationFrance
-
Yi YangRecruitingTranscranial Magnetic StimulationChina
-
University of ZurichUniversity Hospital Inselspital, BerneRecruitingTranscranial Magnetic Stimulation | Electric Stimulation TherapySwitzerland
-
NYU Langone HealthWithdrawn
-
Aalborg UniversityRecruitingTranscranial Magnetic Stimulation | Electroencephalography | Repetitive Transcranial Magnetic Stimulation | Motor Cortex | Pain ThresholdsDenmark
Clinical Trials on Real Repetitive transcranial magnetic stimulation
-
The Hong Kong Polytechnic UniversityNot yet recruitingChemotherapy-induced Peripheral Neuropathy
-
Peking Union Medical College HospitalUniversity of Pennsylvania; Chinese Academy of SciencesCompleted
-
Dongtan Sacred Heart HospitalCompletedPatients With Subjective TinnitusKorea, Republic of
-
Ruyao LiuCompleted
-
Assiut UniversityCompletedAdverse Effect of Drug Therapy LevodopaEgypt
-
Inje UniversityDongtan Sacred Heart HospitalNot yet recruiting
-
State University of New York - Upstate Medical...RecruitingHeadache | Brain Concussion | Mild Traumatic Brain Injury | Post-Concussion SymptomsUnited States
-
Xuzhou Central HospitalThe Affiliated Hospital of Xuzhou Medical UniversityNot yet recruitingFunctional Magnetic Resonance Imaging | Executive Function Disorder
-
Al-Azhar UniversityCompleted
-
Guangzhou Psychiatric HospitalCompletedCognitive Impairment | Bipolar Disorder | RelapseChina