title: A single session of repetitive transcranial magnetic stimulation of the prefrontal cortex reduces cue-induced craving in patients with gambling disorder.
abstract: Gambling disorder (GD) is common and disabling addictive disorder. In patients with substance use disorders, the application of repetitive transcranial magnetic stimulation (rTMS) over the dorsolateral prefrontal cortex (DLPFC) offers promise to alleviate craving. We hypothesized that applying real compared to sham rTMS over the left DLPFC would reduce gambling craving in patients with GD.
  
  
  
  In a randomized sham-controlled crossover design, 22 treatment-seeking patients with GD received real or sham treatment with high frequency rTMS over the left DLPFC followed a week later by the other type of treatment. Before and after each rTMS session, participants rated their gambling craving (from 0 to 100) before and after viewing a gambling video used as a cue. We used the Yale-Brown Obsessive Compulsive Scale adapted for Pathological Gambling to assess gambling behavior before and 7 days after each rTMS session.
  
  
  
  As compared to sham (mean +0.74; standard deviation±3.03), real rTMS significantly decreased cue-induced craving (-2.12±3.39; F(1,19)=4.87; P=0.04; partial η2=0.05; 95% CI: 0.00-0.21). No significant effect of rTMS was observed on gambling behavior.
  
  
  
  Patients with GD reported decreased cue-induced craving following a single session of high frequency rTMS applied over the left DLPFC. Further large randomized controlled studies are needed to determine the usefulness of rTMS in GD.
authors.affiliation: University hospital center of Saint-Étienne, university department of psychiatry and addiction, 42055 Saint-Étienne, France; TAPE laboratory, EA7423, Jean-Monnet university, Saint-Étienne, France. Electronic address: aurelia.gay@chu-st-etienne.fr.
authors.forename: A
authors.initials: A
authors.lastname: Gay
authors.affiliation: INSERM, U1059, university of Lyon, 42023 Saint-Étienne, France; Radiology department, university hospital center of Saint-Étienne, 42055 Saint-Étienne, France.
authors.forename: C
authors.initials: C
authors.lastname: Boutet
authors.affiliation: University hospital center of Saint-Étienne, university department of psychiatry and addiction, 42055 Saint-Étienne, France; TAPE laboratory, EA7423, Jean-Monnet university, Saint-Étienne, France.
authors.forename: T
authors.initials: T
authors.lastname: Sigaud
authors.affiliation: University hospital center of Saint-Étienne, university department of psychiatry and addiction, 42055 Saint-Étienne, France.
authors.forename: A
authors.initials: A
authors.lastname: Kamgoue
authors.affiliation: University hospital center of Saint-Étienne, university department of psychiatry and addiction, 42055 Saint-Étienne, France; TAPE laboratory, EA7423, Jean-Monnet university, Saint-Étienne, France.
authors.forename: J
authors.initials: J
authors.lastname: Sevos
authors.affiliation: INSERM, U1028, CNRS, UMR5292, Lyon neuroscience research center, university of Lyon, ΨR2 Team, 69000 Lyon, France; Lyon 1 university, 69000 Villeurbanne, France; Hospital center Le Vinatier, 69678 Bron, France.
authors.forename: J
authors.initials: J
authors.lastname: Brunelin
authors.affiliation: University hospital center of Saint-Étienne, university department of psychiatry and addiction, 42055 Saint-Étienne, France; TAPE laboratory, EA7423, Jean-Monnet university, Saint-Étienne, France.
authors.forename: C
authors.initials: C
authors.lastname: Massoubre
mesh_terms: D000328:Adult; D016739:Behavior, Addictive / Q000628:therapy*; D066249:Craving / Q000502:physiology*; D003463:Cues; D005260:Female; D005715:Gambling / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017397:Prefrontal Cortex / Q000502:physiology; D050781:Transcranial Magnetic Stimulation / Q000379:methods*; D016896:Treatment Outcome
keywords: Craving; Dorsolateral prefrontal cortex; Gambling behavior; Gambling disorder; Repetitive transcranial magnetic stimulation