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Paired-pulse rTMS Treatment for Methamphetamine Use Disorder Based on the Frontopolar-Cerebellum

Not Applicable
Recruiting
Conditions
Amphetamine Use Disorders
Interventions
Device: 10Hz rTMS based on cerebellum and FPC
Device: 10Hz rTMS based on cerebellum or FPC
Registration Number
NCT06457230
Lead Sponsor
Shanghai Mental Health Center
Brief Summary

To investigate the mechanism and efficacy of a novel repetitive transcranial magnetic stimulation (rTMS) intervention model with paired frontopolar cortex (FPC) -cerebellar pulses on episodic methamphetamine use in patients on methadone maintenance treatment and to develop a novel physiotherapeutic intervention to optimise the treatment and management of addicted patients.

Detailed Description

Numerous studies have shown that impaired FPC-cerebellar functional connectivity leads to impaired social preferences and behavioural flexibility and more persistent drug use in addicts. Cerebellar and FPC paired-pulse rTMS interventions may enhance functional connectivity, effectively modulate cerebellar-prefrontal loops, reduce craving, improve cognitive flexibility, and reduce relapse risk. The aim of this project is to explore the mechanism and efficacy of a novel FPC-cerebellar paired-pulse rTMS intervention model on occasional methamphetamine use in methadone maintenance patients, to develop novel physiotherapy interventions, and to optimise the treatment and management of addicted patients.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
40
Inclusion Criteria
  • Individuals aged between 18 and 60 years, irrespective of gender, having completed a minimum of 9 years of education and capable of effectively cooperating in questionnaire evaluations.

    • Meet the diagnostic criteria set forth by the DSM-V concerning the amphetamine-type substance addiction.
    • A history of utilizing amphetamine-type substances for a duration not less than one year, with a frequency of use being at least once per week.
    • Consent to actively cooperate in the completion of subsequent follow-up assessments.
Exclusion Criteria
  • Severe cognitive functional impairments manifested through a history of head trauma, cerebrovascular diseases, epilepsy, etc., or usage of cognitive enhancement drugs in the past 6 months; an intellectual disability with an IQ score less than 70.

    • A diagnosis of schizophrenia or other severe mental illnesses as per the DSM-5 criteria.
    • Abuse or dependence on other psychoactive substances (excluding nicotine) within the past 5 years.
    • Severe organic diseases that might compromise study participation.
    • Contraindications to rTMS, such as a history of epileptic seizures or the presence of metallic implants in proximity to the head.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Paired-pulse rTMS based on cerebellum and FPC for substance use disorder10Hz rTMS based on cerebellum and FPCRandomly assigned cerebellar + FPC sequential intervention group (20 people). The cerebellar + FPC sequential intervention group was designed with a block programme of cerebellar and FPC stimulation at 100 ms intervals (each block: cerebellar 10 Hz rTMS stimulation - 100 ms interval - frontal pole 10 Hz rTMS stimulation).
Single pulse rTMS based on cerebellar or FPC for substance use disorder10Hz rTMS based on cerebellum or FPCParticipants will be subjected to 10 Hz rTMS based on cerebellar or FPC (20 people). The randomised intervention group randomly intervened in either the cerebellum or the FPC, with the stimulation parameters remaining the same as in the experimental group.
Primary Outcome Measures
NameTimeMethod
Change of Craving assessed by Visual Analog Scale (VAS)through study completion, an average of 1 month

The intensity of psychological craving in MA dependents was assessed using the Visual Analogue Scale (VAS), where individuals rated their cravings on a scale from 0 to 10, with higher scores indicating greater levels of craving. The VAS scores were utilized based on two conditions: during a resting state and when subjected to cue induction involving images associated with methamphetamine, serving as the criteria for evaluation.

Secondary Outcome Measures
NameTimeMethod
Depressionthrough study completion, an average of 1 month

The reduction rate in the Beck Depression Inventory (BDI) scores was calculated before and after the intervention to evaluate the rate of reduction in their levels of depression.

Addiction stroop taskthrough study completion, an average of 1 month

By testing reaction time and rate of correct response to detect multiple cognitive abilities such as attention selection, processing speed, executive functions, and cognitive inhibition by testing reaction time and correct response rate.

Anxietythrough study completion, an average of 1 month

The reduction rate in the Beck Anxiety Inventory (BAI) scores was calculated before and after intervention to assess the rate of decrease in anxiety levels among MA dependents.

Changes of electroencephalogram power spectrumthrough study completion, an average of 1 month

Resting-state EEG can be used to extract power spectra and electrode functional connectivity; on-task EEG can be used to isolate time-frequency features during non-stimulated trials to extract alpha, beta, theta, and gamma band energy of the parietal and occipital electrodes. Both can be used to assess changes in neural activity before, during, and after their restimulation.

Probabilistic inversion learning taskthrough study completion, an average of 1 month

The matching of symbols and colours was reversed without informing the subjects and their cognitive flexibility in the reversed condition was assessed

Trial Locations

Locations (1)

Min Zhao, PhD

🇨🇳

Shanghai, Shanghai, China

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