Closed-loop TMS for the Core Clinical Features of Methamphetamine Use Disorder

Condition(s) studied

Investigational drug(s) / intervention(s)

Closed-loop TMS: Participants receive theta burst stimulation (TBS) targeting l-DLPFC, triggered by real-time EEG signals recorded during a cue-reactivity task. This closed-loop protocol aims to deliver stimulation precisely during neural states associated with cue-induced craving.

Conventional TMS: Participants receive TBS targeting l-DLPFC, delivered at a standard iTBS protocol (3-pulse 50-Hz bursts given at every 200 ms (i.e. at 5 Hz), 2s on and 8s off, with 1200 pulses in total), without EEG or task engagement.

Random TMS: Participants receive TBS targeting l-DLPFC, triggered by a random sequence unrelated to real-time EEG features.

Study summary

The goal of this clinical trial is to evaluate whether closed-loop transcranial magnetic stimulation (TMS) targeting left-dorsolateral prefrontal cortex (l-DLPFC) can improve core clinical symptoms in individuals with methamphetamine use disorder (MUD), such as cue-reactivity and impaired inhibitory control.

The main questions it aims to answer are:

Can closed-loop TMS targeting l-DLPFC significantly reduce cue-reactivity, as measured by a Visual Analog Scale (VAS) and cue-reactivity task, compared to a conventional treatment protocol and random TMS ? Does closed-loop stimulation targeting l-DLPFC enhance cognitive control, assessed by performance on the Stop Signal Task (SST), more effectively than the other stimulation modes? Researchers will compare closed-loop, conventional, and random TMS conditions targeting l-DLPFC to determine whether closed-loop yields superior symptom improvement.

Participants will:

Be randomly assigned to one of the three stimulation groups (closed-loop, conventional and random) according to a pre-generated random number table, and receive the corresponding stimulation session targeting l-DLPFC.

Undergo cue-reactivity assessment using VAS and cue-reactivity task, and complete the SST before and after each stimulation session.

Eligibility

Primary outcome measure(s)

• Cue-Induced Neural Reactivity During Before and After Stimulation — During cue-reactivity task in training and stimulation phases of each session.
  EEG signals will be recorded while participants perform a cue-reactivity task during both the training phase (no stimulation) and the stimulation phase (with TMS). The primary outcome will be changes in cue-induced neural reactivity, defined by EEG features in response to methamphetamine-related cues identified in previous studies, which are also implemented to trigger stimulation in this trial. Comparisons will be made across phases (pre- vs. during stimulation) and stimulation conditions (closed-loop, conventional, random).

Trial sites (1)

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