A preliminary randomized controlled trial of repetitive transcranial magnetic stimulation applied to the left dorsolateral prefrontal cortex in treatment seeking participants with cannabis use disorder.

BACKGROUND: Cannabis use disorder (CUD) is a common and consequential disorder. When applied to the dorsolateral prefrontal cortex (DLPFC), repetitive transcranial magnetic stimulation (rTMS) reduces craving across substance use disorders and may have therapeutic clinical effects when applied in serial-sessions. The present study sought to preliminarily determine whether serial-sessions of rTMS applied to the DLPFC had a therapeutic effect in CUD. METHODS: This study was a two-site, phase-2, double-blind, randomized-controlled-trial. Seventy-two treatment-seeking participants (37.5% Women, mean age 30.2±9.9SD) with ≥moderate-CUD were randomized to active or sham rTMS (Beam-F3, 10Hz, 20-total-sessions, two-sessions-per-visit, two-visits-per-week, with cannabis cues) while undergoing a three-session motivational enhancement therapy intervention. The primary outcome was the change in craving between pre- and post- treatment (Marijuana Craving Questionnaire Short-Form-MCQ-SF). Secondary outcomes included the number of weeks of abstinence and the number of days-per-week of cannabis use during 4-weeks of follow-up. RESULTS: There were no significant differences in craving between conditions. Participants who received active-rTMS reported numerically, but not significantly, more weeks of abstinence in the follow-up period than those who received sham-rTMS (15.5%-Active; 9.3%-Sham; rate ratio = 1.66 [95% CI: 0.84, 3.28]; p=0.14). Participants who received active-rTMS reported fewer days-per-week of cannabis use over the final two-weeks of the follow-up period than those receiving sham-rTMS (Active vs. Sham: -0.72; Z=-2.33, p=0.02). CONCLUSIONS: This trial suggests rTMS is safe and feasible in individuals with CUD and may have a therapeutic effect on frequency of cannabis use, though further study is needed with additional rTMS-sessions and a longer follow-up period.

A Preliminary Investigation Of Repetitive Transcranial Magnetic Stimulation Applied To The Left Dorsolateral Prefrontal Cortex In Treatment Seeking Participants With Cannabis Use Disorder.

Background: Cannabis use disorder (CUD) is a common and consequential disorder. When applied to the dorsolateral prefrontal cortex (DLPFC), repetitive transcranial magnetic stimulation (rTMS) reduces craving across substance use disorders and may have a therapeutic clinical effect when applied in serial sessions. The present study sought to preliminarily determine whether serial sessions of rTMS applied to the DLPFC had a therapeutic effect in CUD. Methods: This study was a two-site, phase-2, double-blind, randomized-controlled-trial. Seventy-two treatment-seeking participants (37.5% Women, mean age 30.2±9.9SD) with ≥moderate-CUD were randomized to active or sham rTMS (Beam-F3, 10Hz, 20-total-sessions, with cannabis cues) while undergoing a three-session motivational enhancement therapy intervention. The primary outcome was the change in craving between pre- and post-treatment (Marijuana Craving Questionnaire Short-Form-MCQ-SF). Secondary outcomes included the number of weeks of abstinence and the number of days-per-week of cannabis use during 4-weeks of follow-up. Results: There were no significant differences in craving between conditions. Participants who received active rTMS reported numerically, but not significantly, more weeks of abstinence in the follow-up period than those who received sham rTMS (15.5%-Active; 9.3%-Sham; rate ratio = 1.66 [95% CI: 0.84, 3.28]; p=0.14). Participants who received active rTMS reported fewer days-per-week of cannabis use over the final two-weeks of the follow-up period (Active vs. Sham: -0.72; Z=-2.33, p=0.02). Conclusions: This trial suggests rTMS is safe and feasible in individuals with CUD and may have a therapeutic effect on frequency of cannabis use, though further study is needed with additional rTMS-sessions and a longer follow-up period.

Musical Training Facilitates Exogenous Temporal Attention via Delta Phase Entrainment within a Sensorimotor Network.

Temporal orienting of attention plays an important role in our day-to-day lives and can use timing information from exogenous or endogenous sources. Yet, it is unclear what neural mechanisms give rise to temporal attention, and it is debated whether both exogenous and endogenous forms of temporal attention share a common neural source. Here, older adult nonmusicians (N = 47, 24 female) were randomized to undergo 8 weeks of either rhythm training, which places demands on exogenous temporal attention, or word search training as a control. The goal was to assess (1) the neural basis of exogenous temporal attention and (2) whether training-induced improvements in exogenous temporal attention can transfer to enhanced endogenous temporal attention abilities, thereby providing support for a common neural mechanism of temporal attention. Before and after training, exogenous temporal attention was assessed using a rhythmic synchronization paradigm, whereas endogenous temporal attention was evaluated via a temporally cued visual discrimination task. Results showed that rhythm training improved performance on the exogenous temporal attention task, which was associated with increased intertrial coherence within the δ (1-4 Hz) band as assessed by EEG recordings. Source localization revealed increased δ-band intertrial coherence arose from a sensorimotor network, including premotor cortex, anterior cingulate cortex, postcentral gyrus, and the inferior parietal lobule. Despite these improvements in exogenous temporal attention, such benefits were not transferred to endogenous attentional ability. These results support the notion that exogenous and endogenous temporal attention uses independent neural sources, with exogenous temporal attention relying on the precise timing of δ band oscillations within a sensorimotor network.SIGNIFICANCE STATEMENT Allocating attention to specific points in time is known as temporal attention, and may arise from external (exogenous) or internal (endogenous) sources. Despite its importance to our daily lives, it is unclear how the brain gives rise to temporal attention and whether exogenous- or endogenous-based sources for temporal attention rely on shared brain regions. Here, we demonstrate that musical rhythm training improves exogenous temporal attention, which was associated with more consistent timing of neural activity in sensory and motor processing brain regions. However, these benefits did not extend to endogenous temporal attention, indicating that temporal attention relies on different brain regions depending on the source of timing information.