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Clinical and functional connectivity outcomes of 5-Hz repetitive transcranial magnetic stimulation as an add-on treatment in cocaine use disorder: a double-blind randomized controlled trial

dc.creatorGarza-Villarreal, Eduardo A.es_ES
dc.creatorAlcala-Lozano, Ruthes_ES
dc.creatorFernandez-Lozano, Sofiaes_ES
dc.creatorMorelos-Santana, Erikes_ES
dc.creatorDávalos, Alanes_ES
dc.creatorVillicaña, Vivianaes_ES
dc.creatorAlcauter, Saraeles_ES
dc.creatorCastellanos, Xavier F.es_ES
dc.creatorGonzalez-Olvera, Jorge J.es_ES
dc.date2021
dc.date.accessioned2023-11-13T19:49:56Z
dc.date.available2023-11-13T19:49:56Z
dc.date.issued2021
dc.identifierJC01SIC20es_ES
dc.identifier.issn2451-9022
dc.identifier.urihttp://repositorio.inprf.gob.mx/handle/123456789/7825
dc.identifier.urihttps://doi.org/10.1016/j.bpsc.2021.01.003
dc.descriptionBACKGROUND: Cocaine use disorder (CUD) is a global condition lacking effective treatment. Repetitive transcranial magnetic stimulation (rTMS) may reduce craving and frequency of cocaine use, but little is known about its efficacy and neural effects. We sought to elucidate short- and long-term clinical benefits of 5-Hz rTMS as an add-on to standard treatment in patients with CUD and discern underlying functional connectivity effects using magnetic resonance imaging. METHODS: A total of 44 patients with CUD were randomly assigned to complete the 2-week double-blind randomized controlled trial (acute phase) (sham [n = 20, 2 female] and active [n = 24, 4 female]), in which they received two daily sessions of rTMS on the left dorsolateral prefrontal cortex (PFC). Subsequently, 20 patients with CUD continued to an open-label maintenance phase for 6 months (two weekly sessions for up to 6 mo). RESULTS: rTMS plus standard treatment for 2 weeks significantly reduced craving (baseline: 3.9 6 3.6; 2 weeks: 1.5 6 2.4, p = .013, d = 0.77) and impulsivity (baseline: 64.8 6 16.8; 2 weeks: 53.1 6 17.4, p = .011, d = 0.79) in the active group. We also found increased functional connectivity between the left dorsolateral PFC and ventromedial PFC and between the ventromedial PFC and right angular gyrus. Clinical and functional connectivity effects were maintained for 3 months, but they dissipated by 6 months. We did not observe reduction in positive results for cocaine in urine; however, self-reported frequency and grams consumed for 6 months were reduced. CONCLUSIONS: With this randomized controlled trial, we show that 5-Hz rTMS has potential promise as an adjunctive treatment for CUD and merits further research.es_ES
dc.formatPDFes_ES
dc.language.isoenges_ES
dc.publisherElsevieres_ES
dc.relation6(7) 745-757
dc.rightsAcceso Cerradoes_ES
dc.titleClinical and functional connectivity outcomes of 5-Hz repetitive transcranial magnetic stimulation as an add-on treatment in cocaine use disorder: a double-blind randomized controlled triales_ES
dc.typeArtículoes_ES
dc.contributor.affiliationInstituto de Neurobiología, Universidad Nacional Autónoma de México (UNAM) campus Juriquilla, Queretaro, Mexico.
dc.contributor.emailegarza@comunidad.unam.mx (Eduardo A. Garza-Villarreal)
dc.relation.jnabreviadoBIOL PSYCHIATRY COGN NEUROSCI NEUROIMAGING
dc.relation.journalBiological Psychiatry. Cognitive Neuroscience and Neuroimaging
dc.identifier.placeEstados Unidos
dc.date.published2021
dc.identifier.organizacionInstituto Nacional de Psiquiatría Ramón de la Fuente Muñiz
dc.identifier.eissn2451-9030
dc.identifier.doi10.1016/j.bpsc.2021.01.003
dc.subject.kwAddiction
dc.subject.kwCocaine use disorder
dc.subject.kwImaging
dc.subject.kwRepetitive transcranial magnetic stimulation
dc.subject.kwResting state
dc.subject.kwSubstance use disorders


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