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Multiple comparison of different noninvasive brain stimulation and pharmacologic interventions in patients with methamphetamine use disorders: A network meta‐analysis of randomized controlled trials.

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Title: Multiple comparison of different noninvasive brain stimulation and pharmacologic interventions in patients with methamphetamine use disorders: A network meta‐analysis of randomized controlled trials.
Authors: Wu, Ming‐Kung (AUTHOR), Satogami, Kazumi (AUTHOR), Liang, Chih‐Sung (AUTHOR), Stubbs, Brendon (AUTHOR), Carvalho, Andre F. (AUTHOR), Brunoni, Andre R. (AUTHOR), Su, Kuan‐Pin (AUTHOR), Tu, Yu‐Kang (AUTHOR), Wu, Yi‐Cheng (AUTHOR), Chen, Tien‐Yu (AUTHOR), Li, Dian‐Jeng (AUTHOR), Lin, Pao‐Yen (AUTHOR), Hsu, Chih‐Wei (AUTHOR), Chen, Yen‐Wen (AUTHOR), Suen, Mein‐Woei (AUTHOR), Zeng, Bing‐Yan (AUTHOR), Takahashi, Shun (AUTHOR), Tseng, Ping‐Tao (AUTHOR), Li, Cheng‐Ta (AUTHOR)
Source: Psychiatry & Clinical Neurosciences. Dec2022, Vol. 76 Issue 12, p633-643. 11p. 1 Diagram, 1 Chart, 2 Graphs.
Subjects: Brain stimulation, Transcranial direct current stimulation, Randomized controlled trials, Transcranial magnetic stimulation, Methamphetamine, Multiple comparisons (Statistics)
Abstract: Aim: In recent decades, the prevalence of amphetamine and methamphetamine use disorders has at least doubled in some regions/countries, with accompanying high risks of drug overdose‐associated mortality. Noninvasive brain stimulation (NIBS) methods may be effective treatments. However, the comparative efficacy of the NIBS protocol for amphetamine/methamphetamine use disorder (AUD/MUD) remains unknown to date. The aim of this network meta‐analysis (NMA) was to compare the efficacy and acceptability of various NIBS methods/protocols for AUD/MUD management. Methods: A frequentist model‐based NMA was conducted. We included randomized controlled trials (RCTs) that investigated the efficacy of NIBS and guideline‐recommended pharmacologic treatments to reduce craving severity in patients with either AUD or MUD. Results: Twenty‐two RCTs including 1888 participants met the eligibility criteria. Compared with the sham/placebo group (study = 19, subjects = 891), a combination of intermittent theta burst stimulation over the left dorsolateral prefrontal cortex (DLPFC) and continuous TBS over the left ventromedial prefrontal cortex (study = 1, subjects = 19) was associated with the largest decreases in craving severity [standardized mean difference (SMD) = −1.50; 95% confidence intervals (95%CIs) = −2.70 to −0.31]. High‐frequency repetitive transcranial magnetic stimulation over the left DLPFC was associated with the largest improvements in depression and quality of sleep (study = 3, subjects = 86) (SMD = −2.48; 95%CIs = −3.25 to −1.71 and SMD = −2.43; 95%CIs = −3.38 to −1.48, respectively). The drop‐out rate of most investigated treatments did not significantly differ between groups. Conclusion: The combined TBS protocol over the prefrontal cortex was associated with the greatest improvement in craving severity. Since few studies were available for inclusion, additional large‐scale randomized controlled trials are warranted. [ABSTRACT FROM AUTHOR]
Copyright of Psychiatry & Clinical Neurosciences is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Multiple comparison of different noninvasive brain stimulation and pharmacologic interventions in patients with methamphetamine use disorders: A network meta‐analysis of randomized controlled trials.
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  Data: <searchLink fieldCode="AR" term="%22Wu%2C+Ming‐Kung%22">Wu, Ming‐Kung</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Satogami%2C+Kazumi%22">Satogami, Kazumi</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Liang%2C+Chih‐Sung%22">Liang, Chih‐Sung</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Stubbs%2C+Brendon%22">Stubbs, Brendon</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Carvalho%2C+Andre+F%2E%22">Carvalho, Andre F.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Brunoni%2C+Andre+R%2E%22">Brunoni, Andre R.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Su%2C+Kuan‐Pin%22">Su, Kuan‐Pin</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Tu%2C+Yu‐Kang%22">Tu, Yu‐Kang</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Wu%2C+Yi‐Cheng%22">Wu, Yi‐Cheng</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Chen%2C+Tien‐Yu%22">Chen, Tien‐Yu</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Li%2C+Dian‐Jeng%22">Li, Dian‐Jeng</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Lin%2C+Pao‐Yen%22">Lin, Pao‐Yen</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Hsu%2C+Chih‐Wei%22">Hsu, Chih‐Wei</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Chen%2C+Yen‐Wen%22">Chen, Yen‐Wen</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Suen%2C+Mein‐Woei%22">Suen, Mein‐Woei</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Zeng%2C+Bing‐Yan%22">Zeng, Bing‐Yan</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Takahashi%2C+Shun%22">Takahashi, Shun</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Tseng%2C+Ping‐Tao%22">Tseng, Ping‐Tao</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Li%2C+Cheng‐Ta%22">Li, Cheng‐Ta</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Psychiatry+%26+Clinical+Neurosciences%22">Psychiatry & Clinical Neurosciences</searchLink>. Dec2022, Vol. 76 Issue 12, p633-643. 11p. 1 Diagram, 1 Chart, 2 Graphs.
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  Data: <searchLink fieldCode="DE" term="%22Brain+stimulation%22">Brain stimulation</searchLink><br /><searchLink fieldCode="DE" term="%22Transcranial+direct+current+stimulation%22">Transcranial direct current stimulation</searchLink><br /><searchLink fieldCode="DE" term="%22Randomized+controlled+trials%22">Randomized controlled trials</searchLink><br /><searchLink fieldCode="DE" term="%22Transcranial+magnetic+stimulation%22">Transcranial magnetic stimulation</searchLink><br /><searchLink fieldCode="DE" term="%22Methamphetamine%22">Methamphetamine</searchLink><br /><searchLink fieldCode="DE" term="%22Multiple+comparisons+%28Statistics%29%22">Multiple comparisons (Statistics)</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Aim: In recent decades, the prevalence of amphetamine and methamphetamine use disorders has at least doubled in some regions/countries, with accompanying high risks of drug overdose‐associated mortality. Noninvasive brain stimulation (NIBS) methods may be effective treatments. However, the comparative efficacy of the NIBS protocol for amphetamine/methamphetamine use disorder (AUD/MUD) remains unknown to date. The aim of this network meta‐analysis (NMA) was to compare the efficacy and acceptability of various NIBS methods/protocols for AUD/MUD management. Methods: A frequentist model‐based NMA was conducted. We included randomized controlled trials (RCTs) that investigated the efficacy of NIBS and guideline‐recommended pharmacologic treatments to reduce craving severity in patients with either AUD or MUD. Results: Twenty‐two RCTs including 1888 participants met the eligibility criteria. Compared with the sham/placebo group (study = 19, subjects = 891), a combination of intermittent theta burst stimulation over the left dorsolateral prefrontal cortex (DLPFC) and continuous TBS over the left ventromedial prefrontal cortex (study = 1, subjects = 19) was associated with the largest decreases in craving severity [standardized mean difference (SMD) = −1.50; 95% confidence intervals (95%CIs) = −2.70 to −0.31]. High‐frequency repetitive transcranial magnetic stimulation over the left DLPFC was associated with the largest improvements in depression and quality of sleep (study = 3, subjects = 86) (SMD = −2.48; 95%CIs = −3.25 to −1.71 and SMD = −2.43; 95%CIs = −3.38 to −1.48, respectively). The drop‐out rate of most investigated treatments did not significantly differ between groups. Conclusion: The combined TBS protocol over the prefrontal cortex was associated with the greatest improvement in craving severity. Since few studies were available for inclusion, additional large‐scale randomized controlled trials are warranted. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
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  Data: <i>Copyright of Psychiatry & Clinical Neurosciences is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1111/pcn.13452
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        Text: English
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