Title: To examine the change in craving following high frequency rTMS stimulation of the right dorsolateral prefrontal cortex (DLPFC) in patients with opioid dependence: A prospective hospital based study
Authors: Dr Daljeet Singh Ranawat, Dr Bhanu Pratap Singh, Dr Christoday RJ Khess, Dr Abhimanyu Singh, Dr Neeti Mahala, Dr Mukesh Choudhary
Background: Opioid craving presents as an irresistible urge to take or as intense thoughts about opioid. The aim of this study to examine the change in craving following high frequency rTMS stimulation of the right dorsolateral prefrontal cortex (DLPFC) in patients with opioid dependence.
Material & Methods: This is a prospective, hospital-based, randomized, sham-controlled transcranial magnetic stimulation study conducted at the Centre of Cognitive Neurosciences Department of Central Institute of Psychiatry (C.I.P.), Ranchi, India. The hospital has bed strength of 673 with more than 53,500 patients attending the outpatient clinic every year. The selected 40 patients were divided into active and sham group by purposive sampling. Written informed consent was obtained from the patient prior to the study after explaining the procedure in detail.
Results: The active group consists of 30 patients in the age range of 25.06(5.55) years while the sham control group had 10 patients with age range of 26.40(7.87) years. The comparison of mean scores of Temperament and character dimensions between active and sham group, there was significant difference found in harm avoidance (p 0.50) between active compared to sham groups with no other dimensions showing significant difference seen. The comparison of mean scores of active and sham with ASI Subscales, no significant difference was observed between the two groups on all the dimensions.
Conclusion: We concluded that High frequency right prefrontal rTMS was found to have short-term anti-craving effects and trend towards sustaining the effects in opioid dependent patients.
Keywords: Opioid craving, rTMS, dorsolateral prefrontal cortex, ASI, OCDUS