Systematic review and meta-analysis: Combining transcranial magnetic stimulation or direct current stimulation with pharmacotherapy for treatment of substance use disorders

Nicholas L. Bormann; Tyler S. Oesterle; Stephan Arndt; Victor M. Karpyak; Paul E. Croarkin

doi:10.1111/ajad.13517

Back

Systematic review and meta-analysis: Combining transcranial magnetic stimulation or direct current stimulation with pharmacotherapy for treatment of substance use disorders

Journal article

Open access

Peer reviewed

Systematic review and meta-analysis: Combining transcranial magnetic stimulation or direct current stimulation with pharmacotherapy for treatment of substance use disorders

Nicholas L. Bormann, Tyler S. Oesterle, Stephan Arndt, Victor M. Karpyak and Paul E. Croarkin

The American journal on addictions, Vol.33(3), pp.269-282

05/01/2024

DOI: 10.1111/ajad.13517

PMID: 38273429

Files and links (1)

url

https://doi.org/10.1111/ajad.13517View

Published (Version of record) Open Access

Abstract

Background and ObjectivesTranscranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) have evidence for their potential in the treatment of substance use disorders (SUD). Medication for addiction treatment (MAT) is underutilized and not always effective. We identified randomized controlled trials (RCTs) and case studies that evaluated the effectiveness of TMS or tDCS used concurrently with MAT in SUD treatment. MethodsA systematic review of published literature following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted on 6/1/2023 by a medical librarian. Craving-related scales were extracted for an effect size calculation. The Physiotherapy Evidence Database (PEDro) scale assessed study quality. ResultsEight studies (7 RCT, 1 case) including 253 individuals were published from 2015 to 2022, 5 of which had available data for meta-analysis. TMS or tDCS combined with MAT significantly reduced craving-related measures relative to sham stimulation (Hedges' g = -0.42, confidence interval: -0.73 to -0.11, p < .01). Opioid use disorder, methadone, and the dorsolateral prefrontal cortex were the most commonly studied SUD, MAT, and target region. Discussion and ConclusionsOur results show a significant effect; however, is limited by a small number of studies with heterogeneous methodology across intervention methods and SUDs. Additional trials are needed to fully assess the clinical impact and mechanisms of combined brain stimulation and pharmacotherapy. We discuss a possible mechanism for synergism from these treatment combinations. Scientific SignificanceAdds the first systematic review of combination treatment with TMS or tDCS and MAT in SUD patients to the literature and estimates its overall effect size.

Life Sciences & Biomedicine

Science & Technology

Substance Abuse

Details

Title: Subtitle: Systematic review and meta-analysis: Combining transcranial magnetic stimulation or direct current stimulation with pharmacotherapy for treatment of substance use disorders
Creators: Nicholas L. Bormann - Mayo Clinic
Tyler S. Oesterle - Mayo Clinic
Stephan Arndt - University of Iowa
Victor M. Karpyak - Mayo Clinic
Paul E. Croarkin - Mayo Clinic
Resource Type: Journal article
Publication Details: The American journal on addictions, Vol.33(3), pp.269-282
DOI: 10.1111/ajad.13517
PMID: 38273429
NLM abbreviation: Am J Addict
ISSN: 1055-0496
eISSN: 1521-0391
Publisher: Wiley
Number of pages: 14
Language: English
Date published: 05/01/2024
Academic Unit: Psychiatry; Biostatistics; Nursing; Injury Prevention Research Center
Record Identifier: 9985132077702771

Metrics

1 Record Views

See more details