Research On The Program Of Repeated Transcranial Magnetic Stimulation For The Treatment Of Female Methamphetamine Addicts

In recent years,many studies have found that repeated transcranial magnetic stimulation(rTMS)targeting left dorsilateral prefrontal cortex(DLPFC)can reduce craving in different types of drug addiction,including meth,cocaine,heroin,etc.Researchers have made a lot of explorations on the application of rTMS in the treatment of substance addiction,including the stimulus site and frequency.However,most studies failed to elucidate the potential gender discrepancies for the treatment effects,due to the small percentage of female subjects enrolled.In fact,men and women differ in their responses to addictive drugs and rTMS,and for small sample sized intervention studies,gender distribution in recruited patient population could bias the results preferentially to male subjects.Although there have been many studies using rTMS to treat drug addiction,there are no studies directly exploring the effect of rTMS on female addicts.Therefore,the present study prospectively recruited female methamphetamine dependents for TMS treatment.In addition,the effects of rTMS at different sessions are still controversial,and most studies have clarified that the more the sessions,the better the effect.Therefore,the second purpose of this study is to explore whether there is a dose-effect of rTMS treatment for female addiction,so as to provide a reference for the treatment of female addiction in the future.Ninety female methamphetamine dependents were randomly assigned into the control group(routine addiction rehabilitation)or add-on 10 Hz group(routine addiction rehabilitation plus 20 times rTMS treatments)in the first study from Hangzhou Moganshan Female addiction rehabilitation center.The add-on 10 Hz group received rTMS treatment for 4 weeks,5 times a week;while the control group received no rTMS treatment.Demographic information(age,intake years,maximum dosage per time,maximum dosage per month)and craving scores to drug associated cues were collected at three time points:the day before the treatment(day 1),the first day after treatment(day 30)and 30th day after treatment(day 60).In the first study,the results showed that add-on rTMS treatment was as well effective in female methamphetamine dependents,and the effect lasted for at least 30 days after treatment the effects of TMS treatment was more pronounced in the subgroup with higher each dosage and baseline craving.The baseline craving of female addicts was negatively correlated with their age and positively correlated with their each dosage and monthly dosage.The delta craving at day 30 predicted the change of craving at day 60 in 10 Hz group,as well as the control group.The results of study one suggested that 20 sessions of rTMS may be effective in reducing craving of female addicts,but it remains uncertain whether this regimen is optimal for female methamphetamine addicts.Since the existing studies did not clarify the optimal amount of stimulation for the rTMS treatment,the second study plans to further explore the effect of rTMS treatment with different amounts of stimulation on reducing the craving of female addicts.At the same time,the first study found that subjects with different demographic characteristics had different responses to the rTMS treatment.Therefore,the second study will match the best stimulation parameters for addicts with different demographic characteristics.In the second study,142 female methamphetamine dependents were randomly divided into the control group(7/14/20 routine addiction rehabilitation)or add-on 10 Hz group(routine addiction rehabilitation plus 7/14/20 times rTMS treatments)in the second study.Demographic information and craving scores to drug associated cues were collected before and after rTMS treatment.The stimulation site and frequency were the same as the first study.The results showed that rTMS treatment at 14 and 20 sessions were effective in reducing cravings and did not differ significantly,whereas 7 sessions rTMS were ineffective.The demographic characteristics of addicts had no effect on the reduction of craving with different sessions of rTMS.In a word,the rTMS protocol for male addiction treatment(10 Hz,DLPFC)is also effective in female addicts,and can significantly reduce the craving of female methamphetamine addicts.14 sessions of rTMS treatment is the optimal program,which can improve the treatment efficiency.