Dopaminergic and clinical correlates of high-frequency repetitive transcranial magnetic stimulation in gambling addiction: a SPECT case study

Addictive Behaviors
Mauro PettorrusoNST Study Group

Abstract

Repetitive Transcranial Magnetic Stimulation (rTMS) shows the potential to modulate local brain activity, thus resulting in a modulatory action on neurocircuitries implicated in the pathophysiology of Gambling Disorder (GD). We report the case of a GD patient treated with two weeks of high frequency (15 Hz) rTMS over the dorsolateral prefrontal cortex (DLPFC). At baseline and after rTMS treatment the patient underwent a SPECT examination with (123)I-FP-CIT tracer, to test changes in dopamine transporter (DAT) availability. The patient was followed up for six months, to explore safety and clinical correlates of a weekly high frequency rTMS maintenance treatment. Over the six-month follow-up the patient reported no episodes of gambling relapse. Also, the patient did not report craving for gambling or gambling-related symptoms. After two weeks of left DLPFC-rTMS treatment, we found a decrease in DAT availability in striatal regions, that represents a putative neurobiological substrate of dopaminergic pathways modulation. This study suggests that high frequency DLPFC-rTMS deserves further investigations in larger samples, using controlled study designs, to assess its real potential as a treatment for GD.

Citations

Sep 13, 2019·The American Journal on Addictions·Elena Gomis-VicentAlvaro Pascual-Leone
Oct 23, 2019·CNS Neuroscience & Therapeutics·Maria Chiara SpanoMassimo di Giannantonio
May 1, 2020·Frontiers in Psychiatry·Andrea MiuliMassimo di Giannantonio
Oct 6, 2020·Frontiers in Neuroscience·Chiara ZucchellaStefano Tamburin
Aug 14, 2021·Translational Psychiatry·Julian Cheron, Alban de Kerchove d'Exaerde

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