Efficacy of Repetitive Transcranial Magnetic Stimulation in Patients With Methamphetamine Use Disorder: A Systematic Review and Meta-Analysis of Double-Blind Randomized Controlled Trials

Frontiers in Psychiatry

Meng-Fen Liou¹  Chieh-Yu Liu²  Shaw-Ji Chen³  Chun-Hung Chang⁴  Wei-Hsin Lu⁵ 

[1] An Nan Hospital, China Medical University, Tainan City, Taiwan;Biostatistical Consulting Lab, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan;Department of Medicine, Mackay Medical College, New Taipei City, Taiwan;Department of Psychiatry and Brain Disease Research Center, China Medical University Hospital, Taichung City, Taiwan;Department of Psychiatry, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City, Taiwan;Department of Psychiatry, Taitung MacKay Memorial Hospital, Taitung, Taiwan;Institute of Clinical Medical Science, China Medical University, Taichung City, Taiwan;National Taipei University of Nursing and Health Sciences, Taipei, Taiwan;

关键词: repetitive transcranial magnetic stimulation (rTMS);    methamphetamine;    craving;    theta-burst stimulation;    substance use disorder;   

DOI  :  10.3389/fpsyt.2022.904252

来源: DOAJ

【 摘 要 】

BackgroundRepetitive transcranial magnetic stimulation (rTMS) has demonstrated therapeutic potential for treating patients with methamphetamine use disorder (MUD). However, the most effective target and stimulation frequency of rTMS for treating MUD remains unclear. This meta-analysis explored the effect of rTMS on MUD.MethodsIn this study, PubMed, Cochrane Systematic Reviews, and the Cochrane Collaboration Central Register of Controlled Clinical Trials were searched electronically for double-blind randomized controlled trials that used rTMS for treating MUD. We used published trials to investigate the efficacy of rTMS in MUD up to March 5, 2022, and pooled studies using a random-effect model to compare rTMS treatment effects. Patients who were diagnosed with MUD according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders were recruited. Clinical craving scores between baseline and after rTMS were compared using the standardized mean difference (SMD) with 95% confidence intervals (CIs). The heterogeneity of the included trials was evaluated through a visual inspection of funnel plots and the I2 statistic.ResultsWe identified seven trials with 462 participants with MUD that met the inclusion criteria. All the studies evaluated craving scores, with rTMS demonstrating a more significant effect than the sham treatment on reducing craving scores (SMD = 0.983, CI = 0.620–1.345, p ≤ 0.001). A subgroup meta-analysis revealed that intermittent theta-burst stimulation (iTBS) had a greater positive effect than 10-Hz rTMS. A metaregression revealed that the SMDs increased with the increase in baseline craving scores, whereas they decreased with the increase in the proportion of men and duration of abstinence.ConclusionThe meta-analysis suggests that rTMS may be associated with treatment effect on craving symptoms in patients with MUD. iTBS may have a greater positive effect on craving reduction than 10-z rTMS.

【 授权许可】

Unknown