title: Establishing an effective TMS protocol for craving in substance addiction: Is it possible?
abstract: OBJECTIVE
  Repetitive transcranial magnetic stimulation (TMS) is a non-invasive tool with known therapeutic efficacy in various neuropsychiatric disorders, such as depression, schizophrenia, mania, and anxiety disorders. We hereby, briefly present a brief review and meta-analysis on the use of TMS for craving in substance addiction.
  
  
  METHODS
  We present our brief review and meta-analysis following the recommendations of the Cochrane group. A total of eight randomized controlled trials fulfilled eligibility criteria and were selected. A total of 199 patients were studied.
  
  
  RESULTS
  We found active stimulation to be superior than sham protocols only for trials focused on right DLPFC (with Hedge's g = 1.48; ES (95%CI: 0.126-2.834), p = 0.032.
  Main meta-analysis limitations include small number of studies, high heterogeneity among studies, and high publication bias. However challenging, our exploratory analysis underscored the amelioration of craving in substance addiction for trials using high frequency TMS protocols over the right DLPFC. We hereby, propose the use of this particular TMS protocol as a promising tool in clinical research.
authors.affiliation: Clinical Neuromodulation Laboratory-Santa Casa School of Medicine, São Paulo, Brazil.
authors.forename: Mailu
authors.initials: M
authors.lastname: Enokibara
authors.affiliation: Clinical Neuromodulation Laboratory-Santa Casa School of Medicine, São Paulo, Brazil.
authors.forename: Alisson
authors.initials: A
authors.lastname: Trevizol
authors.affiliation: Clinical Neuromodulation Laboratory-Santa Casa School of Medicine, São Paulo, Brazil.
authors.forename: Pedro
authors.initials: P
authors.lastname: Shiozawa
authors.affiliation: Clinical Neuromodulation Laboratory-Santa Casa School of Medicine, São Paulo, Brazil.
authors.forename: Quirino
authors.initials: Q
authors.lastname: Cordeiro
mesh_terms: D066249:Craving; D006801:Humans; D017397:Prefrontal Cortex / Q000502:physiology*; D019966:Substance-Related Disorders / Q000517:prevention & control / Q000628:therapy*; D050781:Transcranial Magnetic Stimulation / Q000379:methods*