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A Retrospective Comparative Study in Patients With Cocaine Use Disorder Comorbid With Attention Deficit Hyperactivity Disorder Undergoing an rTMS Protocol Treatment

Background: Adult attention-deficit/hyperactivity disorder (ADHD) is associated with high comorbidity with other psychiatric diseases, including cocaine use disorder (CocUD). Given the common fronto-striatal dysfunction, ADHD patients often use cocaine as self-medication for ameliorating symptoms by...

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Autores principales: Cardullo, Stefano, Gómez Pérez, Luis J., Cuppone, Diego, Sarlo, Michela, Cellini, Nicola, Terraneo, Alberto, Gallimberti, Luigi, Madeo, Graziella
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8026860/
https://www.ncbi.nlm.nih.gov/pubmed/33841218
http://dx.doi.org/10.3389/fpsyt.2021.659527
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author Cardullo, Stefano
Gómez Pérez, Luis J.
Cuppone, Diego
Sarlo, Michela
Cellini, Nicola
Terraneo, Alberto
Gallimberti, Luigi
Madeo, Graziella
author_facet Cardullo, Stefano
Gómez Pérez, Luis J.
Cuppone, Diego
Sarlo, Michela
Cellini, Nicola
Terraneo, Alberto
Gallimberti, Luigi
Madeo, Graziella
author_sort Cardullo, Stefano
collection PubMed
description Background: Adult attention-deficit/hyperactivity disorder (ADHD) is associated with high comorbidity with other psychiatric diseases, including cocaine use disorder (CocUD). Given the common fronto-striatal dysfunction, ADHD patients often use cocaine as self-medication for ameliorating symptoms by increasing striatal dopamine release. Yet, comorbidity with ADHD is related to poor treatment outcomes. CocUD has been treated with transcranial magnetic stimulation (TMS), but no studies investigated the outcomes in patients comorbid with ADHD. Methods: Twenty-two ADHD/CocUD and 208 CocUD-only participants received a high-frequency (15 Hz) rTMS treatment stimulating the left-DLPFC. We investigated whether both groups of patients shared similar demographic and clinical characteristics at baseline. Then, we monitored the effect of treatment testing for potential differences between groups. Results: At baseline demographic, toxicology and clinical features were not different between the two groups except for global severity index (GSI from SCL-90): patients of ADHD/CocUD group reported higher general symptomatology compared to the CocUD-only group. Concerning the effect of treatment, both groups significantly improved over time regarding cocaine use, craving, and other negative affect symptoms. No differences were observed between groups. Conclusions: To our knowledge, this is the first study comparing the demographic characterization and rTMS clinical improvements of patients with a dual diagnosis of ADHD and CocUD against CocUD-only patients. Cocaine use and common self-reported withdrawal/abstinence symptoms appear to benefit from rTMS treatment with no differences between groups. Future studies are needed to further investigate these preliminary results.
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spelling pubmed-80268602021-04-09 A Retrospective Comparative Study in Patients With Cocaine Use Disorder Comorbid With Attention Deficit Hyperactivity Disorder Undergoing an rTMS Protocol Treatment Cardullo, Stefano Gómez Pérez, Luis J. Cuppone, Diego Sarlo, Michela Cellini, Nicola Terraneo, Alberto Gallimberti, Luigi Madeo, Graziella Front Psychiatry Psychiatry Background: Adult attention-deficit/hyperactivity disorder (ADHD) is associated with high comorbidity with other psychiatric diseases, including cocaine use disorder (CocUD). Given the common fronto-striatal dysfunction, ADHD patients often use cocaine as self-medication for ameliorating symptoms by increasing striatal dopamine release. Yet, comorbidity with ADHD is related to poor treatment outcomes. CocUD has been treated with transcranial magnetic stimulation (TMS), but no studies investigated the outcomes in patients comorbid with ADHD. Methods: Twenty-two ADHD/CocUD and 208 CocUD-only participants received a high-frequency (15 Hz) rTMS treatment stimulating the left-DLPFC. We investigated whether both groups of patients shared similar demographic and clinical characteristics at baseline. Then, we monitored the effect of treatment testing for potential differences between groups. Results: At baseline demographic, toxicology and clinical features were not different between the two groups except for global severity index (GSI from SCL-90): patients of ADHD/CocUD group reported higher general symptomatology compared to the CocUD-only group. Concerning the effect of treatment, both groups significantly improved over time regarding cocaine use, craving, and other negative affect symptoms. No differences were observed between groups. Conclusions: To our knowledge, this is the first study comparing the demographic characterization and rTMS clinical improvements of patients with a dual diagnosis of ADHD and CocUD against CocUD-only patients. Cocaine use and common self-reported withdrawal/abstinence symptoms appear to benefit from rTMS treatment with no differences between groups. Future studies are needed to further investigate these preliminary results. Frontiers Media S.A. 2021-03-25 /pmc/articles/PMC8026860/ /pubmed/33841218 http://dx.doi.org/10.3389/fpsyt.2021.659527 Text en Copyright © 2021 Cardullo, Gómez Pérez, Cuppone, Sarlo, Cellini, Terraneo, Gallimberti and Madeo. https://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
Cardullo, Stefano
Gómez Pérez, Luis J.
Cuppone, Diego
Sarlo, Michela
Cellini, Nicola
Terraneo, Alberto
Gallimberti, Luigi
Madeo, Graziella
A Retrospective Comparative Study in Patients With Cocaine Use Disorder Comorbid With Attention Deficit Hyperactivity Disorder Undergoing an rTMS Protocol Treatment
title A Retrospective Comparative Study in Patients With Cocaine Use Disorder Comorbid With Attention Deficit Hyperactivity Disorder Undergoing an rTMS Protocol Treatment
title_full A Retrospective Comparative Study in Patients With Cocaine Use Disorder Comorbid With Attention Deficit Hyperactivity Disorder Undergoing an rTMS Protocol Treatment
title_fullStr A Retrospective Comparative Study in Patients With Cocaine Use Disorder Comorbid With Attention Deficit Hyperactivity Disorder Undergoing an rTMS Protocol Treatment
title_full_unstemmed A Retrospective Comparative Study in Patients With Cocaine Use Disorder Comorbid With Attention Deficit Hyperactivity Disorder Undergoing an rTMS Protocol Treatment
title_short A Retrospective Comparative Study in Patients With Cocaine Use Disorder Comorbid With Attention Deficit Hyperactivity Disorder Undergoing an rTMS Protocol Treatment
title_sort retrospective comparative study in patients with cocaine use disorder comorbid with attention deficit hyperactivity disorder undergoing an rtms protocol treatment
topic Psychiatry
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8026860/
https://www.ncbi.nlm.nih.gov/pubmed/33841218
http://dx.doi.org/10.3389/fpsyt.2021.659527
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