Investigating repetitive transcranial magnetic stimulation on cannabis use and cognition in people with schizophrenia

Cannabis use disorder (CUD) occurs at high rates in schizophrenia, which negatively impacts its clinical prognosis. These patients have greater difficulty quitting cannabis which may reflect putative deficits in the dorsolateral prefrontal cortex (DLPFC), a potential target for treatment development...

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Bibliographic Details
Published in:NPJ schizophrenia 2022-02, Vol.8 (1), p.2-2, Article 2
Main Authors: Bidzinski, Karolina Kozak, Lowe, Darby J. E., Sanches, Marcos, Sorkhou, Maryam, Boileau, Isabelle, Kiang, Michael, Blumberger, Daniel M., Remington, Gary, Ma, Clement, Castle, David J., Rabin, Rachel A., George, Tony P.
Format: Article
Language:English
Subjects:
631/378/1595/1636
692/699/476/1799
Cognitive Psychology
Marijuana
Medicine
Medicine & Public Health
Neurology
Neurosciences
Psychiatry
Schizophrenia
Transcranial magnetic stimulation
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Summary:Cannabis use disorder (CUD) occurs at high rates in schizophrenia, which negatively impacts its clinical prognosis. These patients have greater difficulty quitting cannabis which may reflect putative deficits in the dorsolateral prefrontal cortex (DLPFC), a potential target for treatment development. We examined the effects of active versus sham high-frequency (20-Hz) repetitive transcranial magnetic stimulation (rTMS) on cannabis use in outpatients with schizophrenia and CUD. Secondary outcomes included cannabis craving/withdrawal, psychiatric symptoms, cognition and tobacco use. Twenty-four outpatients with schizophrenia and CUD were enrolled in a preliminary double-blind, sham-controlled randomized trial. Nineteen participants were randomized to receive active ( n  = 9) or sham ( n  = 10) rTMS (20-Hz) applied bilaterally to the DLPFC 5x/week for 4 weeks. Cannabis use was monitored twice weekly. A cognitive battery was administered pre- and post-treatment. rTMS was safe and well-tolerated with high treatment retention (~90%). Contrast estimates suggested greater reduction in self-reported cannabis use (measured in grams/day) in the active versus sham group (Estimate = 0.33, p  = 0.21; Cohen’s d  = 0.72), suggesting a clinically relevant effect of rTMS. A trend toward greater reduction in craving (Estimate = 3.92, p  = 0.06), and significant reductions in PANSS positive (Estimate = 2.42, p  = 0.02) and total (Estimate = 5.03, p  = 0.02) symptom scores were found in the active versus sham group. Active rTMS also improved attention (Estimate = 6.58, p  
ISSN:2334-265X
2754-6993
2754-6993
2334-265X
DOI:10.1038/s41537-022-00210-6