| Background:There is a complex relationship between Alcohol consumption and the occurrence of disease.The main symptoms of Alcohol Use Disorder(AUD)are craving for Alcohol and deficiency in inhibiting Alcohol consumption control,as well as cognitive impairment of different degrees.Repetitive transcranial magnetic stimulation(rTMS),a novel non-invasive brain stimulation technique,is highly effective in improving drinking behavior and cognitive function in patients with alcohol use disorders,with better compliance and prospects.In this study,rTMS will be used to intervene patients with AUD to observe the improvement of their cognitive function and drinking behavior.Objectives:The patients with AUD were treated with rTMS for 14 days.Cognitive function,drinking behavior and impulsivity levels were compared before and after treatment.Methods:1.Eighty-four male patients with alcohol use disorder in Yunnan Psychiatric Hospital from October 2020 to April 2021 were collected and randomly divided into the experimental group(treated with rTMS)and the control group(false stimulation of rTMS)according to random number method.The Alcohol Dependence Scale(ADS)and the Alcohol Research Dependence Withdrawal Assessment Scale(CIWA-Ar)were used to assess the level of alcohol dependence and the presence of withdrawal symptoms.Before treatment(P0 at the time point)and after 2 weeks of treatment(P14 at the time point),the Montreal Cognitive Assessment Scale(MoCA)was used to assess the overall Cognitive level of patients,the Barratt Impulsiveness Scale(BIS-11)was used to evaluate behavioral impulsiveness level.The Obsessive Compulsory Drinking Scale(OCDS)assessed patients’ craving for alcohol.2.SPSS26.0 was used for statistical analysis,the scale scores of each group were presented as mean ± standard deviation(x±s),and the measurement data were tested for normality.Pair sample t test was used for the results before and after intervention in each group,two independent sample t test was used for the results between the two groups,and χ2 test was used for the classified data.Results:1.In terms of general information,there were no statistical differences in age,years of drinking,amount of drinking,years of education,marital status,scores of ADS scale and CIWA-Ar scale and drug use between the treatment group(rTMS group)and no treatment group(Sham group)(P>0.05).2.Before treatment(PO),there was no statistical difference in baseline values of total MoCA scores between rTMS group and Sham(P>0.05).Two weeks later(P14),the total score of MoCA scale in the rTMS group and the Sham group had increased compared with their baseline(P<0.05),and the total score of MoCA in the rTMS group was higher than that in the Sham group at the end of the intervention(P=0.009).3.There was no statistical difference in the total BIS scores between the rTMS group and the Sham group(P>0.05)at the baseline.At the end of intervention,the BIS score of rTMS group decreased(P<0.001),and there were significant changes in cognitive impulsivity(P<0.001)and non-planning impulsivity level(P<0.001),while there was no significant difference in motor impulsivity before and after intervention(P>0.05).In the Sham group,the total score of BIS Scale decreased with statistical significance before and after treatment(P<0.001),and the change of non-planning impulsivity before and after treatment was statistically significant(P<0.001),while the difference of cognitive impulsivity and motor impulsivity was not statistically significant.At the end of treatment,the total BIS score in rTMS group was significantly lower than that in Sham group(P<0.001).4.There was no statistical difference in the total OCDS Sscle’ scores between the rTMS group and the Sham group at baseline(P>0.05).At the end of intervention,the OCDS of rTMS group decreased before and after treatment,with statistical significance(P<0.001).The score of OCDS Scale also decreased in the Sham group(P<0.001).After the treatment,the difference between the rTMS group and the Sham group was statistically significant(P=0.034).5.Correlation analysis showed that age had no correlation with years of drinking,years of education,daily alcohol consumption,CIWA-Ar and ADS scores(P>0.05);years of drinking were positively correlated with years of education,daily alcohol consumption,CIWA-Ar score and ADS score(P<0.001);years of education were positively correlated with daily alcohol consumption,CIWA-Ar score and ADS score(P<0.001);daily alcohol consumption was positively correlated with the score of CIWA-Ar and the score of ADS(P<0.001);the score of CIWA-Ar was positively correlated with the score of ADS(P<0.001).6.Multiple regression analysis showed that BIS scale score before treatment=36.985+0.326*years of drinking+0.370*daily alcohol consumption+0.536*ADS scale score;MoCA scale score before treatment=14.167+0.370*years of drinking-0.198*years of education;OCDS score before treatment=16.178+0.358*years of drinking.Conclusions:1.rTMS combined with drug therapy can significantly improve the cognitive function of patients with AUD.2.rTMS combined with drug therapy can suppress impulsivity and reduce the craving for alcohol. |
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