Clinical trial NCT02862093: Transcranial Magnetic Stimulation in Alcohol Use Disorder
Official title: Transcranial Magnetic Stimulation in Alcohol Use Disorder: Effects on Dopamine Transporter and Alcohol Intake
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Alcohol Dependence
Lead sponsor: Catholic University of the Sacred Heart
Sponsor class: OTHER
First posted: 2016-08-10
Enrollment: 14
Sex: ALL
Minimum age (years): 18
Maximum age (years): 65
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: Repetitive Transcranial Magnetic Stimulation (rTMS) of the dorsolateral prefrontal cortex may affect neuro-adaptations associated with alcohol use disorder (AUD), potentially influencing craving and alcohol intake.

Investigators investigated alcohol intake and dopamine transporter (DAT) availability by Single Photon Emission Computed Tomography (SPECT) in the striatum of AUD patients before and after deep rTMS.

Detailed description: The study included AUD patients. Patients were enrolled by the alcohol addiction unit of the Internal Medicine, Gastroenterology and Hepatology Department of the Catholic University in Rome, Italy, according to the inclusion criteria. Screening collection of medical history, physical, neurological and psychiatric examinations as well as laboratory tests were performed. Moreover, patients were underwent to baseline SPECT assessment of striatal DAT availability using 123I-N-ω-fluoropropyl-2β-carbomethoxy-3β-(4-iodophenyl) nortropane (123I-FP-CIT) as the radiotracer. Subsequently, patients were randomized in two groups (matched for gender and age) by a computer program for the REAL deep rTMS or SHAM. After weekly sessions of deep rTMS for four weeks, patients were underwent to the same clinical assessment as in the screening phase and second SPECT .

Moreover, the alcohol intake during both the four weeks prior to the enrollment and the 4 weeks of rTMS sessions were assessed through the Timeline Followback (TLFB) interview, an instrument providing a retrospective estimation of the number of drinks per drinking days, the number of drinking days, the number of abstinence days, the number of heavy drinking days and the total number of drinks. Patients were also evaluated with Alcohol Dependence Scale (ADS), Obsessive Compulsive Drinking Scale (OCDS), State-Trait Anxiety Inventory Scale (STAI Y1 and STAI Y2),Zung Self-Rating Depression Scale.

Eligibility criteria: Inclusion Criteria:

* At least two days a week of excessive alcohol consumption during the month prior to screening;
* Ability to provide informed consent;
* A Clinical Institute of Withdrawal Assessment in Alcohol Withdrawal score \< 10;
* Willingness to abstain from or substantially reduce alcohol consumption;
* Permanent residence.

Exclusion Criteria:

* Clinically significant psychiatric diseases;
* Past or current abuse or dependence on substances other than alcohol or nicotine;
* Neurological disorders;
* Unstable medical conditions;
* Pacemakers, implanted metallic pumps, metal implant;
* History of complicated withdrawal symptoms;
* Current use of psychoactive drugs;
* Epilepsy;
* Current use of anticonvulsants, insulin or oral hypoglycemic agents;
* Positive urine toxicological screening;
* Pregnancy;
* Participation in other clinical trial in the last 60 days;
* Involvement in a compulsory medical treatment or pending criminal proceedings.

Primary outcomes:
measure: Change From Baseline in Dopamine Transporter availability in the striatum throgh Single Photon Emission Computed Tomography (SPECT)
timeFrame: Week 4
Secondary outcomes:
measure: Change From Baseline in alcohol intake
timeFrame: Week 4
Other outcomes:
Locations:
city: Rome
country: Italy
facility: Catholic University of Rome
state: Rm
Study officials:
affiliation: Department of Internal Medicine, Catholic University of Rome, Italy
name: Giovanni Addolorato
role: PRINCIPAL_INVESTIGATOR
References: