Targeting Withdrawal Symptoms in Men Addicted to Methamphetamine With Transcranial Magnetic Stimulation: A Randomized Clinical Trial

Abstract

This randomized clinical trial examines the use of transcranial magnetic stimulation targeting the left dorsal-lateral prefrontal cortex to modulate withdrawal symptoms in men addicted to methamphetamine.

Conflict of interest statement

Conflict of Interest Disclosures: None reported.

Figures

Figure 1.. Study Flowchart and Design

rTMS indicates repetitive transcranial magnetic stimulation.

Figure 2.. Repetitive Transcranial Magnetic Stimulation (rTMS) Intervention Effects on Withdrawal Symptoms, Craving, Quality of Sleep, and Depression and Anxiety Scores

A, Withdrawal symptoms showed a significant difference for time (F3,32 = 198.18; P < .001; ηp2 = 0.81) and for a time × group interaction effect (F3,132 = 20.27; P < .001; ηp2 = 0.31). Post hoc t tests (with Bonferroni correction for multiple comparisons) showed that withdrawal symptoms were significantly reduced for both the real rTMS group (t23 = 13.21; P < .001) and the sham rTMS group (t21 = 9.53, P < .001). B, Cue-induced craving showed a significant difference for time (F3,132 = 50.52; P < .001; ηp2 = 0.53) and for a time × group interaction effect (F3,132 = 22.93; P < .001; ηp2 = 0.34). Post hoc t tests (with Bonferroni correction for multiple comparisons) showed that the craving score was significantly reduced for the real rTMS group (t23 = 8.59; P < .001) but not for the sham rTMS group (t21 = 2.40; P = .046) after applying Bonferroni correction for multiple comparisons. C, Quality of sleep showed a significant difference for time (F3,132 = 32.76; P < .001; ηp2 = 0.42) and for a time × group interaction effect (F3,132 = 22.59; P < .001; ηp2 = 0.33). Post hoc t tests (with Bonferroni correction for multiple comparisons) showed that sleep difficulties were significantly reduced for the real rTMS group (t23 = 8.85; P < .001) but not for the sham rTMS group (t21 = 1.08; P = .290). D, Depression scores showed a significant difference for time (F3,132 = 83.43; P < .001; ηp2 = 0.65) and for a time × group interaction effect (F3,132 = 63.77; P < .001; ηp2 = 0.59). Post hoc t tests showed that depression was significantly reduced for the real rTMS group (t23 = 11.97; P < .001) but not for the sham group (t21 = 1.86; P = .076). E, Anxiety scores showed a significant difference for time (F3,132 = 25.59; P < .001; ηp2 = 0.36) and for a time × group interaction effect (F3,132 = 4.560; P = .01; ηp2 = 0.03). Further analyses (paired-samples t tests, 5% level) showed that anxiety was significantly reduced for the real rTMS group (t23 = 5.28; P < .001) but not for the sham rTMS group (t21 = 2.35; P = .03) after applying Bonferroni correction for multiple comparisons. F, Correlation between reduced craving was positively associated with reductions in withdrawal symptoms (P < .001). G, Correlation between reduced craving was positively associated with improvements in sleep (P < .001). H, Correlation between reduced craving was not positively associated with the depression score (P = .45). I, Correlation between reduced craving was positively associated with decreased severity of anxiety (P = .007).