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Brain Stimul. 2015 Nov-Dec;8(6):1168-74. doi: 10.1016/j.brs.2015.06.004. Epub 2015 Jun 16.

Transcranial Magnetic Stimulation Combined With Nicotine Replacement Therapy for Smoking Cessation: A Randomized Controlled Trial.

Author information

1
Department of Psychiatry and Addictology, University Hospital of Dijon, 21079 Dijon, France; EA 4452, LPPM, University of Burgundy, 21000 Dijon, France. Electronic address: benoit.trojak@chu-dijon.fr.
2
Department of Psychiatry and Addictology, University Hospital of Dijon, 21079 Dijon, France.
3
Addiction Division, Department of Mental Health and Psychiatry, University Hospitals of Geneva, 1202 Geneva, Switzerland.
4
Department of Psychiatry, Strasbourg University Hospital, 67091 Strasbourg, France; INSERM U 1114, FMTS, Strasbourg University Hospital, 67091 Strasbourg, France.
5
Department of Psychiatry and Addictology, University Hospital of Dijon, 21079 Dijon, France; EA 4452, LPPM, University of Burgundy, 21000 Dijon, France.

Abstract

BACKGROUND:

Further evidence suggests that repetitive Transcranial Magnetic Stimulation (rTMS) is an effective method to reduce tobacco craving among smokers.

HYPOTHESIS:

As relapse is common within a few days after smoking cessation, we hypothesized that combining the anti-craving effects of rTMS with Nicotine replacement therapy (NRT) to attenuate withdrawal symptoms could increase abstinence rates in smokers with severe nicotine dependence who quit smoking.

METHODS:

Thirty-seven smokers who failed to quit with the usual treatments were randomly assigned to two treatment groups to receive either active (n = 18) or sham (n = 19) 1-Hz rTMS of the right dorsolateral prefrontal cortex. The day after quitting smoking, each patient combined NRT (21-mg patch) with active or sham rTMS (10 sessions) for 2 weeks. Cessation support was then continued with NRT alone using lower-dose patches. Abstinence rates and self-report craving scales were used to assess the therapeutic results during the combined treatment and for up to 12 weeks after quitting.

RESULTS:

At the end of the combined treatment, there were significantly more abstinent participants in the active rTMS group (n = 16) than in the sham rTMS group (n = 9) (P = 0.027). The craving scales analysis revealed that active rTMS (P = 0.011) but not sham rTMS (P = 0.116) led to a significant decrease in the compulsive factor. However, no lasting rTMS effect was found.

CONCLUSIONS:

1-Hz rTMS combined with NRT improved the success rate of abstinence in smokers during tobacco cessation. The stimulation-induced reduction in compulsivity may explain this result.

KEYWORDS:

Cessation; Combination; Craving; Nicotine; Tobacco; Transcranial magnetic stimulation

PMID:
26590478
DOI:
10.1016/j.brs.2015.06.004
[Indexed for MEDLINE]

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