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. 2022 Feb 11;11(4):951.
doi: 10.3390/jcm11040951.

rTMS Reduces Craving and Alcohol Use in Patients with Alcohol Use Disorder: Results of a Randomized, Sham-Controlled Clinical Trial

Maarten Belgers  1   2 , Philip Van Eijndhoven  3 , Wiebren Markus  1   2 , Aart H Schene  3 , Arnt Schellekens  3
Affiliations

rTMS Reduces Craving and Alcohol Use in Patients with Alcohol Use Disorder: Results of a Randomized, Sham-Controlled Clinical Trial

Maarten Belgers et al. J Clin Med. .

Abstract

(1) Background: Current evidence-based treatments for alcohol use disorder (AUD) are moderately effective. Studies testing repetitive transcranial magnetic stimulation (rTMS) in AUD commonly apply a limited number of rTMS sessions with different rTMS settings, showing inconsistent effects on craving for alcohol. This study tested the efficacy of a robust rTMS protocol on craving and alcohol use. (2) Methods: In a single-blind randomized controlled trial in recently detoxified patients with AUD, ten days of high-frequency rTMS over the right dorsolateral prefrontal cortex on top of treatment as usual (n = 14) was compared with sham rTMS (n = 16). Outcome measures were alcohol craving and use over a follow-up period of one year. Analysis was performed by means of repeated measures multivariate analysis of variance. (3) Results: The results showed a main group-by-time interaction effect on craving (Wilks' Λ = 0.348, F (12, 17) = 2.654, p = 0.032) and an effect of group on alcohol use (Wilk's Λ = 0.44, F (6, 23) = 4.9, p = 0.002), with lower alcohol craving and use in the group with active rTMS compared to the control group. Differences in craving between groups were most prominent three months after treatment. At 12 months follow-up, there was no effect of rTMS on craving or abstinence. (4) Conclusions: This small-scale randomized controlled trial showed the efficacy of high-frequency rTMS over the right dlPFC diminished alcohol craving and use in recently detoxified patients with AUD during the first months after detoxification. These findings suggest that rTMS might be an effective add-on in treating patients with AUD and warrant replication in future large-scale studies.

Keywords: abstinence; alcohol use disorder; craving; neuromodulation; relapse; transcranial magnetic stimulation.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Schematic overview of the study procedure. TAU = Treatment As Usual; AUD = Alcohol Use Disorder; rTMS = repetitive Transcranial Magnetic Stimulation.
Figure 2
Figure 2
Consort flowchart.
Figure 3
Figure 3
Effect means with 95% CI of rTMS on outcome measurements over time for (a) Visual analog scale (VAS), (b) Obsessive-compulsive drinking scale (OCDS-5), and (c) Alcohol urge questionnaire (AUQ).
See this image and copyright information in PMC

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