While Transcranial Magnetic Stimulation (TMS) is only official approved for treatment of depression found unresponsive to first-line treatment, there are currently at least 26 clinical trials registered to test the use of TMS in the treatment of addiction withdrawal.
Researcher in China are saying rTMS (Repetitive Transcranial Magnetic Stimulation) that targets the left dorsolateral prefrontal cortex can lessen withdrawal symptoms in men addicted to amphetamines, and enhance detoxification. TMS has already been tested to reduce cravings in cocaine, heroin, and methamphetamines, as well as decrease reduce usage of cigarettes and alcohol. This latest study is the first to apply TMS for acute withdrawal symptoms and their correlation to mood and sleep.
In this study Dr Yuan divided 44 male methamphetamine addicts into either high rTMS treatment or ‘sham’ TMS treatment. The men were an average of 33 years old and had no significant variance in BMI, Age, race, education, length of methamphetamine absence, dosage or frequency of use. Both groups were treated for 5 days, followed by two days off, then another series of treatment for 5 days.
The group receiving actual treatment “demonstrated significant changes” based on analysis of various scores from the Chinese Methamphetamine withdrawal scale, the Pittsburgh Sleep Quality index, and self-rated depression, anxiety and cue-induced cravings. The reduced craving scores correlated to with overall reduction is symptoms associated with withdrawal, improvements in sleep, and severity of anxiety.
While these findings are encouraging, more research is needed to determine if TMS treatment has a long-lasting affect, and can reduce instances of relapse. Additional research is also needed to determine the proper targets, intensity and frequency of treatment tailored to the individual, whether or not incorporating medication can enhance results, and whether TMS can address the risky “criminal behaviors of addicts.”
Dr Yuan noted some patients will be more responsive than other based on various factors including but not limited to:
- Sex hormones (which impact TMS effectiveness)
- Genetics affecting plasticity responses
- Variation in brain/ skull shape
With estimates of over 2.5 million addicts in China, 10-13 million of which are addicted to methamphetamines and heroin, Dr Yuan expressed the need for them to collaborate with other international studies to further the research.
He concluded, "Larger studies across different sites would be the next step towards establishing a clinical treatment indication," he concluded. "It would be interesting to include neurophysiologic studies including brain imaging or evoked potentials to demonstrate a change in the brain's response beyond symptom rating scales."
