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左侧背外侧前额叶皮层高频重复经颅磁刺激可减少药物渴求,改善甲基苯丙胺使用障碍者的决策能力。

High-frequency repetitive transcranial magnetic stimulation of the left dorsolateral prefrontal cortex reduces drug craving and improves decision-making ability in methamphetamine use disorder.

机构信息

School of Mental Health, Bengbu Medical College, Bengbu, Anhui 233030, China.

Compulsory Isolated Drug Rehabilitation Center, Bengbu, Anhui 233030, China.

出版信息

Psychiatry Res. 2022 Nov;317:114904. doi: 10.1016/j.psychres.2022.114904. Epub 2022 Oct 12.

Abstract

Methamphetamine abuse is escalating worldwide. Its strong and irreversible neurotoxicity generally causes structural and functional changes in the brain. Repetitive transcranial magnetic stimulation (rTMS) as a non-invasive tool can be used to modulate neuronal activity, cortical excitability, and dopaminergic neurotransmission. This study aims to explore the efficacy of high-frequency rTMS in reducing drug craving and increasing decision-making ability for methamphetamine use disorder patients. Sixty-four methamphetamine use disorder patients were randomized to sham rTMS group and 10-Hz rTMS group. Visual analog scale (VAS) and Iowa game test (IGT) were used to evaluate drug craving and cognitive decision-making ability before and after treatment. Before the treatment, the two groups had no differences in the scores of VAS and IGT. After the intervention, VAS scores of 10-Hz rTMS group were significantly lower than that of sham rTMS group. In addition, the two groups had significant differences in the net score of IGT on block 4 and block 5, which favoured the 10-Hz rTMS group. Taken together, the present results suggest that High-frequency rTMS can be used to reduce drug craving and improve decision-making function for methamphetamine use disorder.

摘要

甲基苯丙胺滥用在全球范围内不断升级。其强烈且不可逆转的神经毒性通常会导致大脑的结构和功能发生变化。重复经颅磁刺激(rTMS)作为一种非侵入性工具,可用于调节神经元活动、皮质兴奋性和多巴胺能神经传递。本研究旨在探讨高频 rTMS 降低药物渴求和提高甲基苯丙胺使用障碍患者决策能力的疗效。将 64 名甲基苯丙胺使用障碍患者随机分为假刺激 rTMS 组和 10Hz rTMS 组。在治疗前后使用视觉模拟量表(VAS)和爱荷华赌博测试(IGT)评估药物渴求和认知决策能力。治疗前,两组 VAS 和 IGT 评分无差异。干预后,10Hz rTMS 组的 VAS 评分明显低于假刺激 rTMS 组。此外,两组在第 4 块和第 5 块的 IGT 净得分上有显著差异,这有利于 10Hz rTMS 组。综上所述,本研究结果表明,高频 rTMS 可用于降低甲基苯丙胺使用障碍患者的药物渴求和改善决策功能。

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