AUTHOR=Bolloni Corinna , Panella Riccardo , Pedetti Mariano , Frascella Anna Grazia , Gambelunghe Cristiana , Piccoli Tommaso , Maniaci Giuseppe , Brancato Anna , Cannizzaro Carla , Diana Marco 

TITLE=Bilateral Transcranial Magnetic Stimulation of the Prefrontal Cortex Reduces Cocaine Intake: A Pilot Study

JOURNAL=Frontiers in Psychiatry

VOLUME=7

YEAR=2016

URL=https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2016.00133

DOI=10.3389/fpsyt.2016.00133

ISSN=1664-0640

ABSTRACT=<sec id="ST1"><title>Background</title><p>Chronic cocaine consumption is associated with a decrease in mesolimbic dopamine transmission that maintains drug intake. transcranial magnetic stimulation (TMS) is gaining reliability, a useful therapeutic tool in drug addiction, since it can modulate cortico-limbic activity resulting in reduction of drug craving.</p></sec><sec id="ST2"><title>Aims</title><p>In the present study, we investigated the therapeutic effect of bilateral TMS of prefrontal cortex (PFC) in reducing cocaine intake, in a sample of treatment-seeking patients with current cocaine use disorder (DSM-V).</p></sec><sec id="ST3"><title>Methods</title><p>Ten cocaine addicts (DSM-V) were randomly assigned to the active or sham stimulation protocol in a double-blind experimental design. Twelve repetitive TMS (rTMS) sessions were administered three times a week for 4 weeks at 100% of motor threshold, over bilateral PFC. Cocaine intake (ng/mg) was assessed by hair analysis at baseline (before treatment, T0), after 1 month (end of treatment, T1), 3 (T2), and 6 (T3) months later. All subjects received psychological support weekly.</p></sec><sec id="ST4"><title>Results</title><p>The two-way ANOVA for repeated measures did not show a significant effect of the interaction between time and treatment (<italic>F</italic><sub>4,32</sub> = 0.35; <italic>p</italic> = 0.87). Despite that result indicated no difference in the effect of the two conditions (active vs. sham) along time, a decreasing trend in cocaine consumption in active TMS group (<italic>F</italic><sub>3,23</sub> = 3.42; <italic>p</italic> = 0.04) vs. sham (<italic>F</italic><sub>3,15</sub> = 1.88; <italic>p</italic> = 0.20) was observed when we performed exploratory analysis with time as factor. Indeed, <italic>Post hoc</italic> comparisons showed a significant reduction in the amount of cocaine detected from the onset to 3 months later (T0–T2; <italic>p</italic> = 0.02) and to the end of treatment (T0–T3; <italic>p</italic> = 0.01) in addicts from the active group.</p></sec><sec id="ST5"><title>Conclusion</title><p>Bilateral rTMS of PFC at 10 Hz did not show a significant effect on cocaine intake compared to sham. However, a long-term reduction on cocaine intake in active TMS-treated patients was observed when we considered the time as factor. Further studies are required to confirm these encouraging but preliminary findings, in order to consolidate rTMS as a valid tool to treat cocaine addiction.</p></sec>