Repetitive transcranial magnetic stimulation combined with cognitive behavioral therapy treatment in alcohol-dependent patients: A randomized, double-blind sham-controlled multicenter clinical trial.

Hu, Xiaorui; Zhang, Tian; Ma, Hongkun; Zhou, Xuhui; Wang, Hongxuan; Wang, Xiaohong; Cheng, Chang; Li, Yanfei; Duan, Ranran; Zhang, Bo; Wang, Huaizhi; Lu, Jia; Kang, Chuanyi; Zhao, Na; Zhang, Yingjie; Tian, Lu; Liu, Jun; Shi, Jingjing; Wang, Zhe; Zhou, Xinxin; Zhu, Shuang; Liu, Qingxia; Li, Xuemin; Wang, Honghui; Nie, Mingxuan; Yang, Mei; Yang, Jianzhong; Chi, Yong; Zhu, Xiaofeng; Hu, Jian; Jia, Yanjie; Peng, Ying; Liu, Lei

Hu, Xiaorui; Zhang, Tian; Ma, Hongkun; Zhou, Xuhui; Wang, Hongxuan; Wang, Xiaohong; Cheng, Chang; Li, Yanfei; Duan, Ranran; Zhang, Bo; Wang, Huaizhi; Lu, Jia; Kang, Chuanyi; Zhao, Na; Zhang, Yingjie; Tian, Lu; Liu, Jun; Shi, Jingjing; Wang, Zhe; Zhou, Xinxin; Zhu, Shuang; Liu, Qingxia; Li, Xuemin; Wang, Honghui; Nie, Mingxuan; Yang, Mei; Yang, Jianzhong; Chi, Yong; Zhu, Xiaofeng; Hu, Jian; Jia, Yanjie; Peng, Ying; Liu, Lei.

Afiliação

Hu X; Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.
Zhang T; The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Ma H; Department of Epidemiology and Health Statistics, Mudanjiang Medical University, Mudanjiang, China.
Zhou X; Hunan Provincial Brain Hospital, Changsha, China.
Wang H; Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
Wang X; Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.
Cheng C; Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.
Li Y; The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Duan R; The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Zhang B; Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.
Wang H; Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.
Lu J; Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.
Kang C; Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.
Zhao N; Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.
Zhang Y; Beijing Anding Hospital, Capital Medical University, Beijing, China.
Tian L; Beijing Anding Hospital, Capital Medical University, Beijing, China.
Liu J; The First Psychiatric Hospital of Harbin, Harbin, China.
Shi J; Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.
Wang Z; The First Psychiatric Hospital of Harbin, Harbin, China.
Zhou X; The First Psychiatric Hospital of Harbin, Harbin, China.
Zhu S; Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.
Liu Q; Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.
Li X; Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.
Wang H; Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.
Nie M; Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.
Yang M; Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen, China.
Yang J; The Second Affiliated Hospital of Kunming Medical University, Kunming, China.
Chi Y; Beijing Anding Hospital, Capital Medical University, Beijing, China.
Zhu X; Department of Physiology and Neurobiology, Mudanjiang Medical University, Mudanjiang, China.
Hu J; Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.
Jia Y; The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Peng Y; Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
Liu L; Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.

Front Psychiatry ; 13: 935491, 2022.

Article em En | MEDLINE | ID: mdl-36299538

ABSTRACT

ABSTRACT

Background:

Alcohol dependence (AD) is a complex addictive disorder with a high relapse rate. Previous studies have shown that both repetitive transcranial magnetic stimulation (rTMS) and cognitive behavioral therapy (CBT) may be effective for AD, and we aim to explore more effective treatment options to reduce relapse rates for AD. Materials and

methods:

A total of 263 AD patients were recruited. They were divided into six groups according to the location and the type of rTMS left dorsolateral prefrontal cortex (DLPFC), right DLPFC, sham stimulation, and whether they received CBT treatment with a fixed schedule (C1) and without a fixed plan (C0). There were included in sham rTMS + C0 group (n = 50), sham rTMS + C1 group (n = 37), right rTMS + C0 group (n = 45), right rTMS + C1 group (n = 42), left rTMS + C0 group (n = 49), left rTMS + C1 group (n = 40). We used obsessive compulsive drinking scale (OCDS), visual analogue scale (VAS), alcohol dependence scale (ADS), montreal cognitive assessment (MoCA), generalized anxiety disorder-7 (GAD-7), patient health questionnaire-9 items (PHQ-9), and Pittsburgh sleep quality index (PSQI) to assess alcohol cravings, alcohol dependence, cognition, anxiety, depression, and sleep quality. They were followed up and evaluated for relapse.

Results:

The sham rTMS + C0 group relapse rate was significantly higher than the right rTMS + C1 group (P = 0.006), the left rTMS + C0 group (P = 0.031), the left rTMS + C1 group (P = 0.043). The right rTMS + C0 group showed significantly higher relapse rate compared to the right rTMS + C1 group (P = 0.046). There was no significant difference in relapse rates between other groups. The repeated-measures ANOVA showed an interaction effect between group and time was significant in the rate of patient health questionnaire-9 items (PHQ-9) scale reduction (P = 0.020). Logistic analysis indicated that smoking and alcohol consumption were independent determinants of relapse (P < 0.05). At 24 weeks of follow-up, Kaplan-Meier survival analysis reveal that there is statistically significant relapse rate between six groups (P = 0.025), left rTMS + C1 group has the best treatment effect for alcohol dependent patients. Cox regression analysis confirmed that current smoking, total cholesterol, and total bilirubin (TBIL) level were risk factors of relapse (P < 0.05).