The aim of this study is to investigate the effects of transcranial magnetic stimulation (TMS) on craving in individuals treated with buprenorphine for opioid use disorder. In this study, individuals will receive 10 sessions of TMS (twice daily for 5 days). The investigators will assess craving, substance use, and mood throughout the study and 1-2 weeks post-treatment.
The aim of this study is to investigate the effects of transcranial magnetic stimulation (TMS) on craving in individuals treated with buprenorphine for opioid use disorder. Investigators will enroll subjects aged 18-65 years old who are currently in treatment with buprenorphine for opioid use disorder. Included subjects will have initiated treatment with buprenorphine in the last 3 months, be able to read, write, and understand English, and, if female, agree to use contraception. Subjects will be excluded if they have a history of bipolar or psychotic illness, current depression, use substances other than opioids, take medications that lower seizure threshold or impair neuroplasticity, have chronic pain, have a history of seizure or any other uncontrolled medical issue, or have a device or ferromagnetic implant in the head or neck. Enrolled subjects will receive 10 (twice daily for 5 days) sessions of active TMS (intermittent theta burst stimulation) to the left dorsolateral prefrontal cortex (L DLPFC) on consecutive weekdays. Investigators will assess craving, substance use, and mood throughout the study and 1-2 weeks post-treatment completion.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
TMS is a form of noninvasive brain stimulation. An external electromagnetic coil is placed on the head, and a large current is passed through an insulated wire coil held flat on the surface of a subject's scalp in a fraction of a millisecond. This pulse of current induces a weak electrical current within the surface brain cortex. Repetitive trains of TMS pulses (repetitive TMS or rTMS) can transiently modulate corticospinal excitability following the rTMS train. When current is delivered at high frequency (10 Hz), it may simultaneously increase the activity of the brain at this site. In this study, individuals will receive 10 treatments with intermittent theta burst stimulation (twice daily for 5 days).
Brigham & Women's Hospital
Boston, Massachusetts, United States
Cue-Induced Craving, as measured by 0-100 Visual Analog Scale
Visual Analog Scale (0-100, where 0 = no craving, 100 = maximum craving)
Time frame: End of TMS Treatments (1 week)
Drug Craving, as measured by 0-100 Visual Analog Scale
Visual Analog Scale (0-100, where 0 = no craving, 100 = maximum craving)
Time frame: End of TMS Treatments (1 week)
Opioid Use and Relapse, as measured by Timeline Followback Calendar (days of opioid use)
Timeline Followback calendar, which measures days of opioid use over the past 2 weeks
Time frame: End of TMS Treatments (1 week)
Retention in Buprenorphine Treatment
Treatment Retention: subjects actively engaged in buprenorphine treatment, attending appointments
Time frame: End of TMS Treatments (1 week)
Symptoms of Depression, as measured by the Quick Inventory of Depressive Symptomatology-Self-Report (QIDS-SR-16)
Quick Inventory of Depressive Symptomatology-Self-Report (QIDS-SR-16), where higher score indicates more severe depressive symptoms
Time frame: End of TMS Treatments (1 week)
Drug Craving, as measured by 0-100 Visual Analog Scale
Visual Analog Scale (0-100, where 0 = no craving, 100 = maximum craving)
Time frame: 1-2 weeks after completion of TMS treatments
Opioid Use and Relapse, as measured by Timeline Followback Calendar (days of opioid use)
Timeline Followback calendar, which measures days of opioid use over the past month
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Time frame: 1-2 weeks after completion of TMS treatments
Retention in Buprenorphine Treatment
Treatment Retention: subjects actively engaged in buprenorphine treatment, attending appointments
Time frame: 1-2 weeks after completion of TMS treatments
Symptoms of Depression, as measured by the Quick Inventory of Depressive Symptomatology-Self-Report (QIDS-SR-16)
Quick Inventory of Depressive Symptomatology-Self-Report (QIDS-SR-16), where higher score indicates more severe depressive symptoms
Time frame: 1-2 weeks after completion of TMS treatments
Neuropsychologic Testing Battery
Penn Computerized Neuropsychologic Battery
Time frame: End of TMS treatment (1 week)
Impulsivity
Barratt Impulsivity Scale
Time frame: End of TMS treatment (1 week)