Efficacy of repetitive transcranial magnetic stimulation in alcohol dependence: a sham-controlled study

• Published in: Addiction (Abingdon, England) Vol. 105; no. 1; pp. 49 - 55
• Main Authors: Mishra, Biswa R., Nizamie, S. Haque, Das, Basudeb, Praharaj, Samir K.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.01.2010; Blackwell
• Subjects: Addiction; Addictive behaviors; Adult; Adult and adolescent clinical studies; Alcohol; Alcoholism; Alcoholism - physiopathology; Alcoholism - therapy; Alcoholism and acute alcohol poisoning; Analysis of Variance; Biological and medical sciences; Clinical trials; craving; dorsolateral pre-frontal cortex (DLPFC); Drug addiction; Drugs; efficacy; Functional Laterality; Headache - etiology; Humans; Magnetism; Male; Medical sciences; Medical treatment; Middle Aged; Pain - etiology; Prefrontal Cortex - physiology; Prospective Studies; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Scalp; Severity of Illness Index; sham control; Substance abuse treatment; Substance Withdrawal Syndrome - prevention & control; Surveys and Questionnaires; Toxicology; transcranial magnetic stimulation (TMS); Transcranial Magnetic Stimulation - adverse effects; Transcranial Magnetic Stimulation - methods; Treatment Outcome; Young Adult; Human; Drug addiction; Transcranial magnetic stimulation; Alcoholism; Craving; Central nervous system; Frontal cortex; dorsolateral pre-frontal cortex (DLPFC); efficacy; Encephalon; Alcoholic beverage; Addiction; Surveillance; sham control; Dependence; transcranial magnetic stimulation (TMS)
• ISSN: 0965-2140; 1360-0443
• DOI: 10.1111/j.1360-0443.2009.02777.x

ABSTRACT Objective  To study the anticraving efficacy of high‐frequency repetitive transcranial magnetic stimulation (rTMS) of the right dorsolateral pre‐frontal cortex (DLPFC) in patients with alcohol dependence. Methods  We performed a prospective, single‐blind, sham‐controlled study involving 45 patients with alcohol dependence syndrome (according to ICD‐10 DCR), with Clinical Institute of Withdrawal Assessment in Alcohol Withdrawal (CIWA‐Ar) scores ≤10. Patients were allocated to active and sham rTMS in a 2 : 1 ratio, such that 30 patients received active and 15 patients sham rTMS to the right DLPFC (10 Hz frequency, 4.9 seconds per train, inter‐train interval of 30 seconds, 20 trains per session, total 10 sessions). The Alcohol Craving Questionnaire (ACQ‐NOW) was administered to measure the severity of alcohol craving at baseline, after the last rTMS session and after 1 month of the last rTMS session. Results  Two‐way repeated‐measures analysis of variance (ANOVA) showed significant reduction in the post‐rTMS ACQ‐NOW total score and factor scores in the group allocated active rTMS compared to the sham stimulation. The effect size for treatment with time interaction was moderate (η2 = 0.401). Conclusions  Right dorsolateral pre‐frontal high‐frequency rTMS was found to have significant anticraving effects in alcohol dependence. The results highlight the potential of rTMS which, combined with other anticraving drugs, can act as an effective strategy in reducing craving and subsequent relapse in alcohol dependence.