Deep Transcranial Magnetic Stimulation in Patients With Opioid Use Disorder: A Double-Blind, Placebo-Controlled...

Area of Science:

• Neuroscience
• Psychiatry
• Addiction Medicine

Background:

• Opioid use disorder (OUD) is a chronic, relapsing brain disorder with ongoing treatment challenges.
• Brain stimulation methods show promise for OUD treatment, but deep transcranial magnetic stimulation (dTMS) efficacy remains under-explored.
• Wide-volume TMS, a dTMS technique, has not been previously investigated for OUD.

Purpose of the Study:

• To evaluate the efficacy of wide-volume TMS using a double-cone coil as an add-on treatment for OUD.
• To assess the impact of wide-volume TMS on opioid craving, depression, anxiety, and impulsivity in OUD patients.

Main Methods:

• A randomized, double-blind, sham-controlled study involving 55 OUD patients.
• Participants received either active wide-volume TMS (10 Hz, twice daily for 2 weeks) or sham TMS targeting the left dorsolateral prefrontal cortex (DLPFC).
• Assessments included Opioid Craving Visual Analogue Scale (OC-VAS), Hamilton Depression/Anxiety Rating Scales (HDRS/HARS), and Barratt Impulsiveness Scale-11 (BIS-11).

Main Results:

• 21 patients in the active TMS group and 19 in the sham group completed the study.
• The active TMS group showed a trend towards greater craving reduction and less buprenorphine-naloxone dose increase, but these did not reach statistical significance.
• No statistically significant differences were observed between active and sham TMS for craving, depression, anxiety, or impulsivity.

Conclusions:

• Wide-volume TMS applied to the left DLPFC was well-tolerated in OUD patients.
• The treatment did not yield statistically significant improvements in primary or secondary outcome measures compared to sham.
• Observed trends suggest potential for wide-volume TMS, warranting further research with larger samples and optimized protocols.