Background: Repetitive
transcranial magnetic stimulation (rTMS) shows potential
therapeutic effects for individuals with addiction, but few studies have examined individuals with
opioid use disorder (OUD).Objectives: We conducted an add-on double-blinded,
sham-controlled rTMS feasibility pilot trial to examine OUD participants undergoing
methadone maintenance
therapy (
MMT). The current report focused on the effects of rTMS on (1) craving and
heroin use behavior and (2) depression, impulsivity, and attention.Methods: Active or
sham rTMS treatment was applied to the left dorsolateral prefrontal cortex (DLPFC) over a total of 11 sessions in 4 weeks (15-Hz frequency, 4 seconds per train, intertrain interval of 26 seconds, 40 trains per session) in OUD participants (ClinicalTrials.gov registration number: NCT03229642). Craving,
heroin use severity, urine
morphine tests, the Hamilton Depression Rating Scale (HDRS), the Barratt Impulsiveness Scale-11 (BIS-11), and the Continuous Performance Tests (CPTs) were measured.Results: Twenty-two OUD participants were enrolled, of which eleven (8 males) were undergoing active rTMS and nine (8 males) were in the
sham rTMS group. After 12 weeks of follow-up, the active rTMS group did not show significantly greater improvements than the
sham group with respect to craving,
heroin use, or urine
morphine test results. However, HDRS scores, BIS-11 attentional subscales, and CPTs commission T-scores (C-TS) were significantly lower in the active rTMS group (P = .003, 0.04, and 0.02, respectively) than in the
sham group.Conclusion: Add-on rTMS did not appear to improve
heroin use behavior but may have benefitted depressive symptoms, impulse control and attention in OUD participants undergoing
MMT.