Cargando…

rTMS Reduces Psychopathological Burden and Cocaine Consumption in Treatment-Seeking Subjects With Cocaine Use Disorder: An Open Label, Feasibility Study

Introduction: Cocaine use disorder (CUD) currently represents a notable public health concern, linked with significant disability, high chances of chronicity, and lack of effective pharmacological or psychological treatments. Repetitive transcranial magnetic stimulation (rTMS) is supposed to be a po...

Descripción completa

Detalles Bibliográficos
Autores principales: Pettorruso, Mauro, Martinotti, Giovanni, Santacroce, Rita, Montemitro, Chiara, Fanella, Fabrizio, di Giannantonio, Massimo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6739618/
https://www.ncbi.nlm.nih.gov/pubmed/31543838
http://dx.doi.org/10.3389/fpsyt.2019.00621
_version_ 1783450975341641728
author Pettorruso, Mauro
Martinotti, Giovanni
Santacroce, Rita
Montemitro, Chiara
Fanella, Fabrizio
di Giannantonio, Massimo
author_facet Pettorruso, Mauro
Martinotti, Giovanni
Santacroce, Rita
Montemitro, Chiara
Fanella, Fabrizio
di Giannantonio, Massimo
author_sort Pettorruso, Mauro
collection PubMed
description Introduction: Cocaine use disorder (CUD) currently represents a notable public health concern, linked with significant disability, high chances of chronicity, and lack of effective pharmacological or psychological treatments. Repetitive transcranial magnetic stimulation (rTMS) is supposed to be a potential therapeutic option for addictive disorders. Aim of this study was to evaluate the feasibility of rTMS on (1) cocaine craving and consumption and (2) other comorbid psychiatric symptoms. Methods: Twenty treatment seeking CUD subjects underwent 2 weeks of intensive rTMS treatment (15Hz; 5 days/week, twice a day for a total of 20 stimulation sessions) of the left dorsolateral prefrontal cortex, followed by 2 weeks of maintenance treatment (15Hz, 1 day/week, twice a day). Sixteen patients completed the study. Patients were evaluated at baseline (T0), after 2 weeks of treatment (T1), and at the end of the study (T2; 4 weeks), with the following scales: Cocaine Selective Severity Assessment (CSSA), Zung Self-Rating Anxiety Scale, Beck Depression Inventory (BDI), Symptom Checklist-90 (SCL-90), and the Insomnia Severity Index. Results: After four weeks of rTMS treatment, 9 out of 16 subjects (56.25%) had a negative urinalysis test, with a significant conversion rate with respect to baseline (Z = −3.00; p = 0.003). Craving scores significantly improved only at T2 (p = 0.020). The overall psychopathological burden, as measured by the SCL-90 Global Severity Index (GSI), significantly decreased during the study period (Z = −2.689; p = 0.007), with a relevant improvement with regards to depressive symptoms, anhedonia, and anxiety. Subjects exhibiting lower baseline scores on the SCL-90 were more likely to be in the positive outcome group at the end of the study (Z = −3.334; p = 0.001). Discussion: Findings from this study are consistent with previous contributions on rTMS use in subjects with cocaine use disorder. We evidenced a specific action on some psychopathological areas and a consequent indirect effect in terms of relapse prevention and craving reduction. A double-blind, sham-controlled, neuro-navigated rTMS study design is needed, in order to confirm the potential benefits of this technique, opening new scenarios in substance use disorders treatment.
format Online
Article
Text
id pubmed-6739618
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-67396182019-09-20 rTMS Reduces Psychopathological Burden and Cocaine Consumption in Treatment-Seeking Subjects With Cocaine Use Disorder: An Open Label, Feasibility Study Pettorruso, Mauro Martinotti, Giovanni Santacroce, Rita Montemitro, Chiara Fanella, Fabrizio di Giannantonio, Massimo Front Psychiatry Psychiatry Introduction: Cocaine use disorder (CUD) currently represents a notable public health concern, linked with significant disability, high chances of chronicity, and lack of effective pharmacological or psychological treatments. Repetitive transcranial magnetic stimulation (rTMS) is supposed to be a potential therapeutic option for addictive disorders. Aim of this study was to evaluate the feasibility of rTMS on (1) cocaine craving and consumption and (2) other comorbid psychiatric symptoms. Methods: Twenty treatment seeking CUD subjects underwent 2 weeks of intensive rTMS treatment (15Hz; 5 days/week, twice a day for a total of 20 stimulation sessions) of the left dorsolateral prefrontal cortex, followed by 2 weeks of maintenance treatment (15Hz, 1 day/week, twice a day). Sixteen patients completed the study. Patients were evaluated at baseline (T0), after 2 weeks of treatment (T1), and at the end of the study (T2; 4 weeks), with the following scales: Cocaine Selective Severity Assessment (CSSA), Zung Self-Rating Anxiety Scale, Beck Depression Inventory (BDI), Symptom Checklist-90 (SCL-90), and the Insomnia Severity Index. Results: After four weeks of rTMS treatment, 9 out of 16 subjects (56.25%) had a negative urinalysis test, with a significant conversion rate with respect to baseline (Z = −3.00; p = 0.003). Craving scores significantly improved only at T2 (p = 0.020). The overall psychopathological burden, as measured by the SCL-90 Global Severity Index (GSI), significantly decreased during the study period (Z = −2.689; p = 0.007), with a relevant improvement with regards to depressive symptoms, anhedonia, and anxiety. Subjects exhibiting lower baseline scores on the SCL-90 were more likely to be in the positive outcome group at the end of the study (Z = −3.334; p = 0.001). Discussion: Findings from this study are consistent with previous contributions on rTMS use in subjects with cocaine use disorder. We evidenced a specific action on some psychopathological areas and a consequent indirect effect in terms of relapse prevention and craving reduction. A double-blind, sham-controlled, neuro-navigated rTMS study design is needed, in order to confirm the potential benefits of this technique, opening new scenarios in substance use disorders treatment. Frontiers Media S.A. 2019-09-05 /pmc/articles/PMC6739618/ /pubmed/31543838 http://dx.doi.org/10.3389/fpsyt.2019.00621 Text en Copyright © 2019 Pettorruso, Martinotti, Santacroce, Montemitro, Fanella, di Giannantonio and the rTMS stimulation group http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Psychiatry
Pettorruso, Mauro
Martinotti, Giovanni
Santacroce, Rita
Montemitro, Chiara
Fanella, Fabrizio
di Giannantonio, Massimo
rTMS Reduces Psychopathological Burden and Cocaine Consumption in Treatment-Seeking Subjects With Cocaine Use Disorder: An Open Label, Feasibility Study
title rTMS Reduces Psychopathological Burden and Cocaine Consumption in Treatment-Seeking Subjects With Cocaine Use Disorder: An Open Label, Feasibility Study
title_full rTMS Reduces Psychopathological Burden and Cocaine Consumption in Treatment-Seeking Subjects With Cocaine Use Disorder: An Open Label, Feasibility Study
title_fullStr rTMS Reduces Psychopathological Burden and Cocaine Consumption in Treatment-Seeking Subjects With Cocaine Use Disorder: An Open Label, Feasibility Study
title_full_unstemmed rTMS Reduces Psychopathological Burden and Cocaine Consumption in Treatment-Seeking Subjects With Cocaine Use Disorder: An Open Label, Feasibility Study
title_short rTMS Reduces Psychopathological Burden and Cocaine Consumption in Treatment-Seeking Subjects With Cocaine Use Disorder: An Open Label, Feasibility Study
title_sort rtms reduces psychopathological burden and cocaine consumption in treatment-seeking subjects with cocaine use disorder: an open label, feasibility study
topic Psychiatry
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6739618/
https://www.ncbi.nlm.nih.gov/pubmed/31543838
http://dx.doi.org/10.3389/fpsyt.2019.00621
work_keys_str_mv AT pettorrusomauro rtmsreducespsychopathologicalburdenandcocaineconsumptionintreatmentseekingsubjectswithcocaineusedisorderanopenlabelfeasibilitystudy
AT martinottigiovanni rtmsreducespsychopathologicalburdenandcocaineconsumptionintreatmentseekingsubjectswithcocaineusedisorderanopenlabelfeasibilitystudy
AT santacrocerita rtmsreducespsychopathologicalburdenandcocaineconsumptionintreatmentseekingsubjectswithcocaineusedisorderanopenlabelfeasibilitystudy
AT montemitrochiara rtmsreducespsychopathologicalburdenandcocaineconsumptionintreatmentseekingsubjectswithcocaineusedisorderanopenlabelfeasibilitystudy
AT fanellafabrizio rtmsreducespsychopathologicalburdenandcocaineconsumptionintreatmentseekingsubjectswithcocaineusedisorderanopenlabelfeasibilitystudy
AT digiannantoniomassimo rtmsreducespsychopathologicalburdenandcocaineconsumptionintreatmentseekingsubjectswithcocaineusedisorderanopenlabelfeasibilitystudy
AT rtmsreducespsychopathologicalburdenandcocaineconsumptionintreatmentseekingsubjectswithcocaineusedisorderanopenlabelfeasibilitystudy