Using Combined EEG and Non-invasive Brain Stimulation to Examine and Improve Reward Functioning in Opioid Use Disorder
Condition: Opioid-use Disorder
MeSH terms: Opioid-Related Disorders; Substance-Related Disorders
Study type: Interventional

Summary: 
      The primary aims of this study are to identify impaired cognitive control in opioid use
      disorder (OUD) and subsequently to examine the effects of transcranial magnetic stimulation
      (TMS) on reward processing, as measured by the reward positivity (an electrophysiological
      signal) in people with OUD. To this end, the investigators will adopt a randomized
      sham-controlled trial to evaluate the efficacy of Ri-TMS on cognitive control in OUD.

      The investigators hypothesize that Ri-TMS will be successful in modulating the reward
      positivity in opioid users in the active TMS condition.
    

Detailed description: 
      The design is primarily a randomized control-trial design, comparing the effects of placebo
      (sham) and active TMS stimulation on reward processing across two groups of participants -
      healthy controls and opioid users.

      Participants will be asked to engage in a virtual T-maze task, a reward-based choice task
      that elicits robust reward positivities. During this task participants will receive
      simultaneous EEG/TMS, while they engage in the virtual T-maze decision making task, used in
      our previous reward positivity studies on SUDs. ERPs will be recorded throughout the T-Maze
      task, and the reward positivity will be measured as the difference in maximum amplitude
      between reward and no-reward feedback conditions.

      The TMS coil will be positioned using a an Adept Viper s850 robotic arm (SmartMove, ANT
      Neuro, Enschede, The Netherlands), providing precise targeting of the predetermined left
      dorsolateral prefrontal (DLPFC) coordinate (< 10 mm from the scalp, orientated at a 45º
      angle). Participants in the active TMS condition will receive rTMS pulses throughout the
      duration of the T-Maze task, with a maximum of 2000 pulses delivered to each participant.
      Identical parameters will be applied to the SHAM group with the exception that the TMS coil
      will be flipped 180º to mimic auditory stimulation.
    

Intervention name(s): Active repetitive transcranial magnetic stimulation (rTMS); Sham repetitive transcranial magnetic stimulation (rTMS)
Intervention type(s): Device; Device
Intervention description(s): rTMS will be used to stimulate neuronal activity of the dorsolateral prefrontal cortex (DLPFC). Participants will receive no more than 2000 pulses of rTMS at 110% of participants' resting motor threshold at 10 Hz continuously for the duration of the t-maze task.; Sham TMS will be used to mimic the auditory sensation of the Active rTMS condition. Protocols for the sham condition will be the same as the active condition, however the TMS coil will be flipped 180 degrees so that participants in this condition will not receive any active stimulation.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: Transcranial magnetic stimulation; Reward processing; Cognitive control