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Increased Delta Connectivity Within Brain Networks Predicts Adherence to an rTMS-Based Treatment Program in Cocaine
Elena De Rossi1, Luis J Gómez Pérez2, Stefano Cardullo2,3
1Experimental and Applied Psychology Laboratory, Department of Health and Life Sciences, European University of Rome, Rome, Italy.
Journal of Studies on Alcohol and Drugs
|May 24, 2025
Summary
Adherence to repetitive transcranial magnetic stimulation (rTMS) treatment for cocaine use disorder (CUD) is linked to higher resting-state functional connectivity in the frontoparietal network (FPN) and default mode network (DMN). This connectivity may predict treatment success and reduce dropout rates.
Area of Science:
- Neuroscience
- Addiction Medicine
- Psychiatry
Background:
- Cocaine use disorder (CUD) poses significant challenges for treatment adherence.
- Repetitive transcranial magnetic stimulation (rTMS) is an emerging therapeutic approach for CUD.
- Understanding neurophysiological predictors of treatment adherence is crucial for improving outcomes.
Purpose of the Study:
- To investigate the association between adherence to an rTMS treatment program and resting-state (RS) functional connectivity in patients with CUD.
- To examine connectivity within the frontoparietal network (FPN) and default mode network (DMN) in relation to treatment adherence.
- To identify neurophysiological markers that predict dropout from CUD treatment.
Main Methods:
- Resting-state electroencephalography (EEG) and psychopathological assessments were conducted before treatment initiation.
- Exact Low-Resolution Brain Electromagnetic Tomography (eLORETA) software was used for EEG connectivity analysis.
- Patients were categorized into adherence and dropout groups based on treatment completion within 3 months.
Main Results:
- Adherent patients exhibited significantly higher pre-treatment delta connectivity in both the FPN and DMN compared to dropouts.
- Multivariable Cox proportional hazard models indicated that both DMN and FPN connectivity were significant predictors of prolonged treatment adherence.
- Increased FPN functional connectivity was associated with a reduced probability of dropout during the initial 12 weeks of treatment.
Conclusions:
- Enhanced functional connectivity within the FPN and DMN may reflect improved goal-driven cognitive integration in patients who adhere to CUD treatment.
- Pre-treatment neurophysiological markers, specifically FPN and DMN connectivity, can predict treatment adherence and dropout.
- Identifying these predictors allows for the early implementation of targeted support for CUD patients, potentially improving treatment retention and outcomes.
