Wen Yatong, Hao Xuemin, Chen Xijing, Qiao Siyue, Li Qianling, Winkler Markus H, Wang Fenglan, Yan Xiaoli, Wang Fang, Wang Liang, Jiang Feng, Pauli Paul, Dong Xinwen, Li Yonghui
Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.
Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
Front Psychiatry. 2022 Jul 5;13:903242. doi: 10.3389/fpsyt.2022.903242. eCollection 2022.
Craving associated with drug-related memory is one of the key factors that induce the relapse of methamphetamine (MA). Disruption or modulation of the reconsolidation of drug-related memory may serve as an option for clinical treatment of MA addiction. This protocol proposes to use virtual reality (VR) to retrieve drug-associated memory and then use transcranial magnetic stimulation (TMS) at the neural circuit that encodes the reward value of drug cues to provide a non-invasive intervention during reconsolidation. We aim to evaluate the effectiveness of TMS treatment after VR retrieval on the reduction of cue reactivity and craving of MA.
This is a randomized, double-blind, sham-controlled, parallel group trial, targeting participants with MA use disorder aged from 18 to 45 years old. Forty-five eligible volunteers in Shanxi Drug Rehabilitation Center will be recruited and be randomly allocated into three parallel groups, receiving either 1) MA-related cues retrieval in VR combined with active TMS (MA VR scene + TBS) or 2) sham TMS (MA VR scene + sham TBS), or 3) neutral cues retrieval in VR combined with active TMS (neutral VR scene + TBS). Two sessions of post-VR-retrieval TBS will be scheduled on two separate days within 1 week. The primary outcome will detect the memory-related activity by the electroencephalography (EEG) reactivity to drug cues in VR scenes. Secondary outcomes are the self-reported MA craving in VR scene, the physiological parameter (cue-induced heart rate) and the scores of psychological questionnaires including anxiety, depression, and mood. All primary and secondary outcomes will be assessed at baseline, 1-week, and 1-month post-intervention. Assessments will be compared between the groups of 1) MA VR scene + TBS, 2) MA VR scene + sham TBS and 3) neutral VR scene + TBS.
This will be the first study to examine whether the TMS modulation after VR retrieval can reduce self-reported craving and drug-related cue reactivity. It will promote the understanding of the neural circuit mechanism of the reconsolidation-based intervention and provide an effective treatment for MA use disorder patients.
[Chinese Clinical Trial Registry], identifier [ChiCTR1900026902]. Registered on 26 October 2019.
与药物相关记忆相关的渴望是导致甲基苯丙胺（MA）复发的关键因素之一。破坏或调节药物相关记忆的重新巩固可能是MA成瘾临床治疗的一种选择。本方案提议使用虚拟现实（VR）来唤起与药物相关的记忆，然后在编码药物线索奖励价值的神经回路处使用经颅磁刺激（TMS），以便在重新巩固过程中提供一种非侵入性干预。我们旨在评估VR唤起后TMS治疗对降低MA线索反应性和渴望的有效性。
这是一项随机、双盲、假对照、平行组试验，目标是年龄在18至45岁的MA使用障碍参与者。将招募山西省戒毒中心的45名符合条件的志愿者，并随机分配到三个平行组，分别接受：1）VR中与MA相关的线索唤起联合主动TMS（MA VR场景+TBS）或2）假TMS（MA VR场景+假TBS），或3）VR中与中性线索唤起联合主动TMS（中性VR场景+TBS）。VR唤起后的TBS将在1周内的两个不同日期安排两次。主要结局将通过脑电图（EEG）对VR场景中药物线索的反应性来检测与记忆相关的活动。次要结局是VR场景中自我报告的MA渴望、生理参数（线索诱发心率）以及包括焦虑、抑郁和情绪在内的心理问卷得分。所有主要和次要结局将在干预前基线、干预后1周和1个月进行评估。将对1）MA VR场景+TBS、2）MA VR场景+假TBS和3）中性VR场景+TBS组之间的评估进行比较。
这将是第一项研究VR唤起后TMS调节是否能降低自我报告的渴望和与药物相关的线索反应性的研究。它将促进对基于重新巩固的干预的神经回路机制的理解，并为MA使用障碍患者提供一种有效的治疗方法。
[中国临床试验注册中心]，标识符[ChiCTR1900026902]。于2019年10月26日注册。
