Repetitive Transcranial Magnetic Stimulation Over the Left Dorsolateral Prefrontal Cortex Reduced Cravings in Substance Dependent Individuals After 5 Consecutive Daily Treatments

This poster was presented at the 29th Annual U.S. Psychiatric & Mental Health Congress, held October 21-24, 2016, in San Antonio, Texas.

Background: Substance Use Disorders are a public health problem affecting 20 million individuals in USA. Craving is a predictor of subsequent substance use and is related to changes in brain activity in networks involving the prefrontal cortex.

Methods: We investigated the efficacy of 5 daily sessions of high frequency left sided repetitive transcranial magnetic stimulation (rTMS) to reduce craving in substance addicted subjects. Eight patients underwent 5 sessions of 10 Hz rTMS over left dorsolateral prefrontal cortex (DLPFC) over 5 consecutive days. Before and immediately after 5 sessions of rTMS we measured craving using Brief Craving Scale. The Patient Health Questionnaire 9 (PHQ 9) a measure of depressive symptoms was also performed at baseline and after 5 consecutive days of treatment.

Results: Left DLPFC stimulation significantly reduced craving after 5 consecutive daily treatments. 5/8 patients responded with at least a 50% reduction on the Brief Craving Scale for Primary Addictive Substance and 5/7 patients responded with at least a 50% reduction in Brief Craving Scale for Secondary Addictive Substance. 2/8 patients showed absence of any craving (0) for the Primary Substance and 4/7 showed absence of craving (0) on the Secondary Substance. On PHQ-9: 3/7 patients experienced a response with depressive symptoms (50% reduction) after 1 week of treatment and 2/7 experienced remission (<=5).

Conclusion: 5 consecutive daily sessions of 10 Hz rTMS over left DLPFC significantly reduced craving in substance dependent individuals. On Secondary measure, a significant minority of patients experienced response and remission of depressive symptoms. These results highlight the potential of non-invasive neuromodulation as a therapeutic tool for addiction and co-existing depression."