School of Psychology, Northwest Normal University, Lanzhou, Gansu, China; Key Laboratory of Behavioral and Mental Health of Gansu Province, Lanzhou, Gansu, China.
School of Psychology, Northwest Normal University, Lanzhou, Gansu, China.
J Psychiatr Res. 2022 Aug;152:375-383. doi: 10.1016/j.jpsychires.2022.06.010. Epub 2022 Jun 13.
Impaired behavioral inhibition is a critical factor in drug addiction and relapse. Repetitive transcranial magnetic stimulation (rTMS) reduces the craving of heroin-addicted individuals for drug-related cues. However, it is unclear whether this technique also improves impaired behavioral inhibition and how improved behavioral inhibition affects craving.
The intermittent theta-burst stimulation (iTBS) has been recently shown to be non-inferior relative to rTMS for depression. Here, we aim to investigate the effect of iTBS on heroin-addicted individuals' behavioral inhibition and cue-induced craving and the relationship between the alteration of behavioral inhibition and craving.
42 of 56 initially recruited individuals with the heroin-use disorder in the abstinent-course treatment were randomized to undergo active or sham iTBS to the left dorsolateral prefrontal cortex and received three daily iTBS treatments for 10 consecutive days. We measured participants' performance during a two-choice oddball task (80% standard and 20% deviant trials) and heroin-related cue-induced craving before and immediately after treatment.
The group that received active iTBS showed significantly improved two-choice oddball task performance after 10 days of intervention compared to both pre-intervention and the group who received sham iTBS. Similarly, a significant reduction in cue-induced craving was observed after following the intervention in the active iTBS group but not the sham iTBS group. The moderation model indicated that iTBS categories play a significant moderating role in the relationship between accuracy cost changing and altered cue-induced craving.
The iTBS treatment protocol positively affects behavioral inhibition in patients with heroin addiction. Improvements in behavioral inhibition can substantially reduce craving.
行为抑制受损是药物成瘾和复吸的一个关键因素。重复经颅磁刺激（rTMS）可降低海洛因成瘾者对药物相关线索的渴望。然而，目前尚不清楚该技术是否也能改善行为抑制受损的情况，以及改善的行为抑制如何影响渴望。
间歇性经颅磁刺激（iTBS）最近已被证明在治疗抑郁症方面与 rTMS 相当。在这里，我们旨在研究 iTBS 对海洛因成瘾者行为抑制和线索诱导渴望的影响，以及行为抑制改变与渴望之间的关系。
在最初招募的 56 名处于戒断期治疗的海洛因使用障碍患者中，有 42 名被随机分配到接受左背外侧前额叶皮质的活性或假 iTBS，并接受为期 10 天的每日 3 次 iTBS 治疗。我们在两项选择的Oddball 任务（80%标准和 20%偏差试验）和海洛因相关线索诱导的渴望之前和治疗后立即测量参与者的表现。
接受活性 iTBS 的组在 10 天的干预后，在两项选择的 Oddball 任务中的表现明显改善，与干预前和接受假 iTBS 的组相比。同样，在活性 iTBS 组中，在干预后观察到线索诱导的渴望明显减少，但在假 iTBS 组中没有观察到。调节模型表明，iTBS 类别在准确性成本变化和改变的线索诱导渴望之间的关系中发挥显著的调节作用。
iTBS 治疗方案对海洛因成瘾患者的行为抑制有积极影响。行为抑制的改善可以显著减少渴望。
