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http://bura.brunel.ac.uk/handle/2438/32795| Title: | Effects of repetitive transcranial magnetic stimulation (rTMS) on craving and substance consumption in patients with substance dependence: a systematic review and meta‐analysis |
| Authors: | Zhang, JJQ Fong, KNK Ouyang, R Siu, AMH Kranz, GS |
| Keywords: | addiction;craving;meta-analysis;substance dependence;systematic review;transcranial magnetic stimulation |
| Issue Date: | 22-Jul-2019 |
| Publisher: | Wiley on behalf of the Society for the Study of Addiction |
| Citation: | Zhang, J.J.Q. et al. (2019) 'Effects of repetitive transcranial magnetic stimulation (rTMS) on craving and substance consumption in patients with substance dependence: a systematic review and meta‐analysis', Addiction, 114 (12), pp. 2137 - 2149. doi: 10.1111/add.14753. |
| Abstract: | Background and Aims: Repetitive transcranial magnetic stimulation (rTMS) is increasingly used as an intervention for treating substance dependence. We aimed to assess evidence of the anti-craving and consumption-reducing effects of rTMS in patients with alcohol, nicotine and illicit drug dependence. Methods: A systematic review and meta-analysis of 26 randomized controlled trials (RCTs) published from January 2000 to October 2018 that investigated the effects of rTMS on craving and substance consumption in patients with nicotine, alcohol and illicit drug dependence (n = 748). Craving, measured using self-reported questionnaires or visual analog scale, and substance consumption, measured using self-report substance intake or number of addiction relapse cases, were considered as primary and secondary outcomes, respectively. Substance type, study design and rTMS parameters were used as the independent factors in the meta-regression. Results: Results showed that excitatory rTMS of the left dorsolateral pre-frontal cortex (DLPFC) significantly reduced craving [Hedges' g = −0.62; 95% confidence interval (CI) = −0.89 to −0.35; P < 0.0001], compared with sham stimulation. Moreover, meta-regression revealed a significant positive association between the total number of stimulation pulses and effect size among studies using excitatory left DLPFC stimulation (P = 0.01). Effects of other rTMS protocols on craving were not significant. However, when examining substance consumption, excitatory rTMS of the left DLPFC and excitatory deep TMS (dTMS) of the bilateral DLPFC and insula revealed significant consumption-reducing effects, compared with sham stimulation. Conclusion: Excitatory repetitive transcranial magnetic stimulation of the dorsolateral pre-frontal cortex appears to have an acute effect on reducing craving and substance consumption in patients with substance dependence. The anti-craving effect may be associated with stimulation dose. |
| Description: | Supporting Information is available online at: https://onlinelibrary.wiley.com/doi/full/10.1111/add.14753?saml_referrer#support-information-section . |
| URI: | https://bura.brunel.ac.uk/handle/2438/32795 |
| DOI: | https://doi.org/10.1111/add.14753 |
| ISSN: | 0965-2140 |
| Other Identifiers: | ORCiD: Jack J. Q. Zhang https://orcid.org/0000-0002-4656-1909 ORCiD: Kenneth N. K. Fong https://orcid.org/0000-0001-5909-4847 ORCiD: Rang-ge Ouyang https://orcid.org/0000-0003-0625-520X ORCiD: Andrew M. H. Siu https://orcid.org/0000-0002-8117-2829 ORCiD: Georg S. Kranz https://orcid.org/0000-0002-3892-1804 |
| Appears in Collections: | Dept of Health Sciences Research Papers |
Files in This Item:
| File | Description | Size | Format | |
|---|---|---|---|---|
| FullText.pdf | Copyright © 2019 Society for the Study of Addiction. This is the peer reviewed version of the following article: Zhang, J. J. Q., Fong, K. N. K., Ouyang, R., Siu, A. M. H., and Kranz, G. S. (2019) Effects of repetitive transcranial magnetic stimulation (rTMS) on craving and substance consumption in patients with substance dependence: a systematic review and meta-analysis. Addiction, 114: 2137–2149., which has been published in final form at https://doi.org/10.1111/add.14753.. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited (see: https://authorservices.wiley.com/author-resources/Journal-Authors/licensing/self-archiving.html). | 12.48 MB | Adobe PDF | View/Open |
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