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

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Title: Systematic review and meta‐analysis: Combining transcranial magnetic stimulation or direct current stimulation with pharmacotherapy for treatment of substance use disorders.
Authors: Bormann, Nicholas L. (AUTHOR), Oesterle, Tyler S. (AUTHOR), Arndt, Stephan (AUTHOR), Karpyak, Victor M. (AUTHOR), Croarkin, Paul E. (AUTHOR)
Source: American Journal on Addictions. May2024, Vol. 33 Issue 3, p269-282. 14p.
Subjects: Transcranial direct current stimulation, Substance abuse, Transcranial magnetic stimulation, Opioid abuse, Brain stimulation
Abstract: Background and Objectives: Transcranial 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. Methods: A 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. Results: Eight 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 Conclusions: Our 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 Significance: Adds 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. Answer questions and earn CME credit [ABSTRACT FROM AUTHOR]
Copyright of American Journal on Addictions is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Systematic review and meta‐analysis: Combining transcranial magnetic stimulation or direct current stimulation with pharmacotherapy for treatment of substance use disorders.
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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Bormann%2C+Nicholas+L%2E%22&quot;&gt;Bormann, Nicholas L.&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Oesterle%2C+Tyler+S%2E%22&quot;&gt;Oesterle, Tyler S.&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Arndt%2C+Stephan%22&quot;&gt;Arndt, Stephan&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Karpyak%2C+Victor+M%2E%22&quot;&gt;Karpyak, Victor M.&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Croarkin%2C+Paul+E%2E%22&quot;&gt;Croarkin, Paul E.&lt;/searchLink&gt; (AUTHOR)
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22American+Journal+on+Addictions%22&quot;&gt;American Journal on Addictions&lt;/searchLink&gt;. May2024, Vol. 33 Issue 3, p269-282. 14p.
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  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Transcranial+direct+current+stimulation%22&quot;&gt;Transcranial direct current stimulation&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Substance+abuse%22&quot;&gt;Substance abuse&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Transcranial+magnetic+stimulation%22&quot;&gt;Transcranial magnetic stimulation&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Opioid+abuse%22&quot;&gt;Opioid abuse&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Brain+stimulation%22&quot;&gt;Brain stimulation&lt;/searchLink&gt;
– Name: Abstract
  Label: Abstract
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  Data: Background and Objectives: Transcranial 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. Methods: A 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. Results: Eight 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&#39; g = −0.42, confidence interval: −0.73 to −0.11, p &lt;.01). Opioid use disorder, methadone, and the dorsolateral prefrontal cortex were the most commonly studied SUD, MAT, and target region. Discussion and Conclusions: Our 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 Significance: Adds 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. Answer questions and earn CME credit [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
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  Data: &lt;i&gt;Copyright of American Journal on Addictions is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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        Value: 10.1111/ajad.13517
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      – Code: eng
        Text: English
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        PageCount: 14
        StartPage: 269
    Subjects:
      – SubjectFull: Transcranial direct current stimulation
        Type: general
      – SubjectFull: Substance abuse
        Type: general
      – SubjectFull: Transcranial magnetic stimulation
        Type: general
      – SubjectFull: Opioid abuse
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      – SubjectFull: Brain stimulation
        Type: general
    Titles:
      – TitleFull: Systematic review and meta‐analysis: Combining transcranial magnetic stimulation or direct current stimulation with pharmacotherapy for treatment of substance use disorders.
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            NameFull: Bormann, Nicholas L.
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            NameFull: Oesterle, Tyler S.
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            – D: 01
              M: 05
              Text: May2024
              Type: published
              Y: 2024
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              Value: 33
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