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A single session of repetitive transcranial magnetic stimulation of the prefrontal cortex reduces cue-induced craving in patients with gambling disorder

Published online by Cambridge University Press:  03 February 2017

A. Gay ,
C. Boutet ,
T. Sigaud ,
A. Kamgoue ,
J. Sevos ,
J. Brunelin  and
C. Massoubre
A. Gay*
Affiliation:
University hospital center of Saint-Étienne, university department of psychiatry and addiction, 42055Saint-Étienne, France TAPE laboratory, EA7423, Jean-Monnet university, Saint-Étienne, France
C. Boutet
Affiliation:
INSERM, U1059, university of Lyon, 42023Saint-Étienne, France Radiology department, university hospital center of Saint-Étienne, 42055Saint-Étienne, France
T. Sigaud
Affiliation:
University hospital center of Saint-Étienne, university department of psychiatry and addiction, 42055Saint-Étienne, France TAPE laboratory, EA7423, Jean-Monnet university, Saint-Étienne, France
A. Kamgoue
Affiliation:
University hospital center of Saint-Étienne, university department of psychiatry and addiction, 42055Saint-Étienne, France
J. Sevos
Affiliation:
University hospital center of Saint-Étienne, university department of psychiatry and addiction, 42055Saint-Étienne, France TAPE laboratory, EA7423, Jean-Monnet university, Saint-Étienne, France
J. Brunelin
Affiliation:
INSERM, U1028, CNRS, UMR5292, Lyon neuroscience research center, university of Lyon, ΨR2 Team, 69000Lyon, France Lyon 1 university, 69000Villeurbanne, France Hospital center Le Vinatier, 69678Bron, France
C. Massoubre
Affiliation:
University hospital center of Saint-Étienne, university department of psychiatry and addiction, 42055Saint-Étienne, France TAPE laboratory, EA7423, Jean-Monnet university, Saint-Étienne, France
*
⁎Corresponding author at: university hospital center of Saint-Étienne, university department of psychiatry and addiction, North hospital, 42055 Saint-Étienne cedex, France. E-mail address: [email protected] (A. Gay).
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Abstract

Background

Gambling disorder (GD) is common and disabling addictive disorder. In patients with substance use disorders, the application of repetitive transcranial magnetic stimulation (rTMS) over the dorsolateral prefrontal cortex (DLPFC) offers promise to alleviate craving. We hypothesized that applying real compared to sham rTMS over the left DLPFC would reduce gambling craving in patients with GD.

Methods

In a randomized sham-controlled crossover design, 22 treatment-seeking patients with GD received real or sham treatment with high frequency rTMS over the left DLPFC followed a week later by the other type of treatment. Before and after each rTMS session, participants rated their gambling craving (from 0 to 100) before and after viewing a gambling video used as a cue. We used the Yale-Brown Obsessive Compulsive Scale adapted for Pathological Gambling to assess gambling behavior before and 7 days after each rTMS session.

Results

As compared to sham (mean +0.74; standard deviation ± 3.03), real rTMS significantly decreased cue-induced craving (−2.12 ± 3.39; F(1,19) = 4.87; P = 0.04; partial η2 = 0.05; 95% CI: 0.00–0.21). No significant effect of rTMS was observed on gambling behavior.

Conclusions

Patients with GD reported decreased cue-induced craving following a single session of high frequency rTMS applied over the left DLPFC. Further large randomized controlled studies are needed to determine the usefulness of rTMS in GD.

Keywords

CravingDorsolateral prefrontal cortexGambling behaviorGambling disorderRepetitive transcranial magnetic stimulation
Type
Original article
Information
European Psychiatry , Volume 41 , Issue 1 , March 2017 , pp. 68 - 74
Copyright
Copyright © European Psychiatric Association 2017

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Footnotes

☆

Clinical Trials Registration: registry name: clinicaltrials.gov; URL: https://www.clinicaltrials.gov;_registration_number:_NCT02552524.

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