Concerto Carmen, Bella Fabrizio, Chiarenza Cecilia, White Ilenia, Micieli Raffaele, Madonia Saverio, Lanzafame Stefania, Spigarelli Riccardo, Pagano Vera, Cutuli Cristiano, Brogna Fabio, Caponnetto Pasquale, Rodolico Alessandro, Signorelli Maria Salvina, Petralia Antonino
Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, Catania 95124, Italy.
Service for Addictions Unit, ASP Catania, Catania 95100, Italy.
Addict Behav Rep. 2025 Aug 5;22:100627. doi: 10.1016/j.abrep.2025.100627. eCollection 2025 Dec.
Gambling Disorder is a chronic and debilitating condition, often associated with impulsivity, mood disturbances, and significant social and financial consequences. Despite various pharmacological and psychotherapeutic approaches, standardized treatment is lacking. Repetitive transcranial magnetic stimulation (rTMS) has recently emerged as a potential neuromodulatory intervention for addictions. We report the case of a male patient in his sixties with severe Gambling Disorder who underwent TMS treatment with high-frequency rTMS targeting the left dorsolateral prefrontal cortex as a first-line therapy. The patient completed a six-week protocol. Clinical assessment was conducted at baseline, after six weeks, and after three months using multiple validated scales, including the South Oaks Gambling Screen, the Visual Analog Scale for craving, the Barratt Impulsiveness Scale, the Hamilton Anxiety and Depression Scales and the Canadian Problem Gambling Index. The patient's South Oaks Gambling Screen score decreased from 20.5 to 2.0, and craving assessed via Visual Analog Scale reduced from 85 to 15 over three months. Reductions in anxiety, depression, and impulsivity were also observed, along with improvements in emotional stability and extroversion. Cognitive performance remained stable, and no adverse effects were reported throughout the treatment. This case highlights the potential of rTMS as a safe and effective intervention for Gambling Disorder, particularly in patients who are not willing to undergo a psychotherapy or pharmacological treatment. The progressive reduction in craving highlights the role of high rTMS in regulating compulsive behaviour and impulsive control.
赌博障碍是一种慢性且使人衰弱的病症，常与冲动性、情绪障碍以及严重的社会和经济后果相关联。尽管有各种药物和心理治疗方法，但缺乏标准化治疗。重复经颅磁刺激（rTMS）最近已成为一种针对成瘾的潜在神经调节干预手段。我们报告了一例60多岁患有严重赌博障碍的男性患者的病例，该患者接受了以左侧背外侧前额叶皮质为靶点的高频rTMS治疗作为一线治疗。患者完成了为期六周的治疗方案。在基线、六周后和三个月后使用多种经过验证的量表进行临床评估，包括南橡树赌博筛查量表、渴求视觉模拟量表、巴拉特冲动性量表、汉密尔顿焦虑和抑郁量表以及加拿大问题赌博指数。患者的南橡树赌博筛查量表得分从20.5降至2.0，通过视觉模拟量表评估的渴求在三个月内从85降至15。还观察到焦虑、抑郁和冲动性降低，以及情绪稳定性和外向性有所改善。认知表现保持稳定，整个治疗过程中未报告有不良反应。该病例突出了rTMS作为一种安全有效的赌博障碍干预手段的潜力，特别是对于那些不愿意接受心理治疗或药物治疗的患者。渴求的逐渐降低突出了高频rTMS在调节强迫行为和冲动控制方面的作用。
