Repetitive Transcranial Magnetic Stimulation (rTMS) as a Promising Treatment for Craving in Stimulant Drugs and Behavioral Addiction: A Meta-Analysis
Résumé
Addiction is a mental disorder with limited available treatment options. The therapeutic potential of repetitive transcranial magnetic stimulation (rTMS) on it, by targeting craving in particular, has been explored with heterogenous results. This meta-analysis uses updated evidence to assess overall rTMS efficacy on craving, differential effects between addiction types clustered into three groups (depressant (alcohol, cannabis, opiate), stimulant (nicotine, cocaine, methamphetamine), and behavioral addiction (gambling, eating disorder)), and stimulation settings. Studies on substance use, gambling, and eating disorders are included, with unrestricted stimulation settings, by searching the PubMed, Embase, PsycINFO, and Cochrane databases up to 30 April 2020. A total of 34 eligible studies (42 units of analysis) were identified. Because of highly significant heterogeneity in primary results, a sensitivity analysis was performed on a remaining sample of 26 studies (30 units of analysis). Analyses performed using random effects model revealed a small effect size favoring active rTMS over shamTMS stimulation in the reduction in craving. We found a significant difference between addiction types, with a persistent small effect only for stimulant and behavioral groups. In these groups we found no difference between the different combinations of target and frequency of stimulation, but a significant correlation between number of sessions and craving reduction. In conclusion, efficacy of rTMS on craving in stimulant and behavioral addiction was highlighted, but recommendations on optimal stimulation settings and its clinical application await further research.
Mots clés
- Cabe
- P.-M. Pereira
- J.
- De Chazeron
- I.
- Lambert
- C.
- Defour
- M.
- Bhoowabul
- V.
- Charpeaud
- T.
- Tremey
- Llorca
- P.-M.
- Pereira
- B.
- et al. Repetitive Transcranial Magnetic Stimulation (rTMS) as a Promising Treatment for Craving in addiction
- dorsolateral prefrontal cortex
- eating disorder
- Gay
- gambling disorder
- transcranial magnetic stimulation
- Addictive disorders assessment instrument craving sexual addiction sexual craving substance use disorder
- Addictive disorders
- assessment instrument
- craving
- sexual addiction
- sexual craving
- substance use disorder
- A.
- A. Cabe
- J. De Chazeron
- I. Lambert
- C. Defour
- M. Bhoowabul
- V. Charpeaud
- T. Tremey
- A. Llorca
- B. et al. Repetitive Transcranial Magnetic Stimulation (rTMS) as a Promising Treatment for Craving in addiction craving dorsolateral prefrontal cortex eating disorder gambling disorder transcranial magnetic stimulation substance use disorder
Domaines
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