Effects of Intermittent Theta Burst on Multiple Measures of Craving in Those With Alcohol Use Disorder

Reduction in alcohol craving has often been specified as an outcome for alcohol use disorder (AUD) interventions. This study evaluated changes in multiple craving measures from a double-blind randomized clinical trial (RCT) evaluating the efficacy of intermittent theta burst stimulation (iTBS) to the left dorsolateral prefrontal cortex for the treatment of AUD. We predicted that veterans in AUD residential treatment, who received active iTBS (Active; n = 22), would show greater reductions than those who received sham iTBS (Sham; n = 22).

Twenty iTBS sessions (1,200 pulses/session) were delivered over 2 weeks. Craving measures were administered before iTBS sessions (Baseline) and following completion of sessions (Post-Assessment). Craving measures administered were the Alcohol Craving Questionnaire Short Form-Revised Total Score, Abstinence Self-Efficacy Scale (AASE) Tempted Cravings and Urges subscale, and Obsessive Compulsive Drinking Scale (OCDS).

All craving measures showed reductions in scores (time main effect), collapsed across Active and Sham groups; however, the absence of significant Group × Time interactions indicated that active iTBS did not produce statistically greater reductions than sham. Exploratory post hoc simple effects analyses were conducted to further examine the significant main effect of time. Active participants showed reductions on the AASE Tempted Cravings and Urges and all OCDS measures, whereas the Sham group showed no significant changes on any measure.

Active iTBS did not produce a statistically greater reduction in craving symptomatology than sham, as indicated by the absence of significant Group × Time interactions. However, the exploratory post hoc results can guide future larger-scale transcranial magnetic stimulation RCTs for AUD on the utility of the acquired craving measures.