Add-on repetitive transcranial magnetic stimulation in patients with opioid use disorder undergoing methadone maintenance therapy

Tsung Yu Tsai, Tzu Yun Wang, Yu Chia Liu, Po Wei Lee, Wei Hung Chang, Tsung Hua Lu, Huai Hsuan Tseng, Sheng Yu Lee, Yun Hsuan Chang, Yihong Yang, Po See Chen, Kao Chin Chen, Yen Kuang Yang, Ru Band Lu

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)


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 ( 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.

Original languageEnglish
Pages (from-to)330-343
Number of pages14
JournalAmerican Journal of Drug and Alcohol Abuse
Issue number3
Publication statusPublished - 2021

All Science Journal Classification (ASJC) codes

  • Medicine (miscellaneous)
  • Clinical Psychology
  • Psychiatry and Mental health


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