Istituto di Neuroscienze, Florence, Italy.
Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
J Gambl Stud. 2022 Dec;38(4):1529-1537. doi: 10.1007/s10899-022-10129-3. Epub 2022 May 21.
Gambling Disorder (GD) is a condition constituting a public health concern, with a burden of harm which is much greater than that of drug addiction. Patients with GD are generally reluctant to pharmacologic treatment and seem to prefer nonpharmacological interventions. Therefore, this proof-of-concept study aimed to investigate the feasibility of continuous Theta Burst Stimulation (cTBS) on the pre-SMA in six patients (5 males, 1 female), aged 30-64 years, with a DSM-5 diagnosis of Gambling Disorder and no comorbid mood disorders. Participants received over 10 sessions of Continuous TBS (cTBS) over pre-SMA bilaterally and have been evaluated using rating scales, including the PG-YBOCS and the CGI, before treatment (T0), at day 10 of treatment (T1) and at day 30 after treatment (T2); cTBS intervention was safe and without side effects. Since the design of our study does not allow us to draw conclusions on the effectiveness of the intervention with respect to the improvement of the functioning of the subject with GD, a more in-depth study, including a sham condition, neurocognitive measures of disinhibition and decision making, and collecting follow-up data on the sustained effect of TBS over a longer period is ongoing.
赌博障碍（GD）是一种构成公共卫生关注的病症，其危害负担远大于药物成瘾。GD 患者通常不愿意接受药物治疗，似乎更倾向于非药物干预。因此，这项概念验证研究旨在探讨连续 theta 爆发刺激（cTBS）对 6 名（5 名男性，1 名女性）年龄在 30-64 岁、DSM-5 诊断为赌博障碍且无共病心境障碍的患者的 SMA 前区的可行性。参与者接受了超过 10 次双侧 SMA 前区连续 TBS（cTBS）治疗，并在治疗前（T0）、治疗第 10 天（T1）和治疗后第 30 天（T2）使用评定量表（包括 PG-YBOCS 和 CGI）进行评估；cTBS 干预是安全的，没有副作用。由于我们的研究设计不允许我们就干预对改善 GD 患者的功能的效果得出结论，因此正在进行一项更深入的研究，包括假条件、抑制和决策的神经认知测量，以及收集 TBS 在更长时间内的持续效果的随访数据。
