Deep Transcranial Magnetic Stimulation in Patients With Opioid Use Disorder: A Double‐Blind, Placebo‐Controlled Randomized Trial

PMCID: PMC12178270

PMID: 40536869

DOI: 10.1111/adb.70057

Journal: Addiction biology

Publication Date: 2025-6-19

Authors: Guldas S, Tumkaya S, Yucens B

Key Points

• First double-blind, randomized controlled trial evaluating wide-volume TMS for opioid use disorder
• No serious adverse events were observed, suggesting the safety of the wvTMS approach
• Further research is needed with more precise neuroimaging-guided targeting and exploration of alternative brain regions

Summary

This randomized, double-blind, sham-controlled study investigated the efficacy of wide-volume transcranial magnetic stimulation (wvTMS) using a double-cone coil in patients with opioid use disorder (OUD). The research targeted the left dorsolateral prefrontal cortex (DLPFC) with an accelerated protocol of twice-daily sessions over two weeks, aiming to assess the potential of brain stimulation in reducing opioid craving and associated symptoms.

Despite applying an intensive stimulation protocol with 3000 pulses per session across 20 total sessions, the study did not demonstrate statistically significant improvements in opioid craving, depression, anxiety, or impulsivity compared to sham treatment. While the active TMS group showed trends toward reduced craving and less pronounced increases in buprenorphine-naloxone dosage, these differences did not reach statistical significance. The researchers noted that the lack of conclusive results might be related to the specific brain region targeted, coil design, or targeting methodology.