Deep TMS, a non-invasive brain stimulation technique, is being more frequently utilized to treat psychiatric diseases, mainly depression. Deep TMS for smoking treatment may aid in the treatment of addiction, according to preliminary investigations, although multicenter randomized controlled trials (RCTs) are required for further analysis.
This multicenter double-blind RCT was designed to assess the efficacy and safety of Deep TMS across the bilateral prefrontal and insular cortex utilizing the H4 coil.
262 chronic smokers who met the DSM-5 criteria for tobacco use disorder and had made at least one prior unsuccessful attempt to quit—of whom 68% had made at least three—were enrolled in the study. They had once weekly Deep TMS for three weeks after three weeks of daily bilateral active or sham Deep TMS to the lateral prefrontal and insular cortices. Following a cue-induced seeking technique, each Deep TMS treatment was given, and individuals underwent six weeks of observation. For an additional 12 weeks, those who abstained were observed.
The major outcome measure was the intention-to-treat efficacy set’s four-week continuous quit rate (CQR) until Week 18 as determined by daily smoking diaries and confirmed by urine cotinine measurements.
The CQR up to Week 18 in the intent-to-treat analysis set (N=234) was 19.4% after active Deep TMS and 8.7% after sham Deep TMS (X2=5.655, p=0.017). The CQR till Week 18 was, respectively, 28.0% and 11.7% among completers (N=169) (X2=7.219, p=0.007). As early as two weeks into therapy, the active group showed a statistically significant reduction in cigarette use and craving compared to the sham group.
By activating pertinent brain circuits, this study offers a secure therapy strategy that encourages smoking cessation. It is the first significant multicenter RCT of brain stimulation in addiction treatment, and it has resulted in the US Food and Drug Administration’s first approval of Deep TMS as a smoking cessation assistance for adults.
Read the article here: 10.1002/wps.20905
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