Table 6.

Acute and longer-terms effects of DTMS on SUD: synthesis of results from k = 9 studies

Study; na	Substance/ SUDb/ Scale	Study design/ Treatmentc	Coil/ Frequency /Intensity (%MT)	Primary outcomes		Secondary outcomes (acute & at follow-up)e
				Acute (after daily DTMS)	Last follow-up (months since DTMS)d
Rapinesi et al., 2013 [17]; n = 3	Alcohol/ AUD/ OCDS	Open-label/ Add-on	H1/ 20 Hz/ 120%	Post-DTMS (20 sessions) vs. baseline:	Post-DTMS (6 months) vs. baseline:	↓ HDRS
				↓ craving	↓ craving
Rapinesi et al., 2014 [19]; n = 1	Alcohol/ AUD/ OCDS	Open-label/ Add-on	H1/ 18 Hz/ 120%	Post-DTMS (20 sessions) vs. baseline:	Post-DTMS (12 months) vs. baseline:	↓ HDRS
				↓ craving	↓ craving; ↑ abstinence
Ceccanti et al., 2015 [20]f; n = 9 (n = 9 sham)	Alcohol/ AUD/ VAS	RCT/ Monotherapy	H1 (+cue)/ 20 Hz/ 120% (vs. sham)	Post-DTMS vs. sham (10 sessions):	Post-DTMS vs. sham (2–3 months):	–
				↓ craving, daily use/maximum use, blood cortisol (stress hormone), blood prolactin (marker of dopamine activity)	(trend) ↓ craving, daily use/maximum use
				Post-DTMS (10 sessions) vs. baseline:	Post-DTMS (2–3 months) vs. baseline:
				↓ craving, daily use/maximum use, blood cortisol and prolactin	(trend) ↓ craving, maximum use; ↓ daily use
Girardi et al., 2015 [21]; n = 10	Alcohol/ AUD/ OCDS	Open-label/ Add-on	H1/ 20 Hz/ 120%	Post-DTMS (20 sessions) vs. baseline:	Post-DTMS (6 months) vs. baseline:	↓ HDRS
				↓ craving	↓ craving
Rapinesi et al., 2015 [22]; n = 11	Alcohol/ AUD/ OCDS	Open-label/ Add-on	H1/ 18 Hz/ 120%	Post-DTMS (20 sessions) vs. baseline:	Post-DTMS (6 months) vs. baseline:	↓ HDRS
				↓ craving	↓ craving
Addolorato et al., 2017 [25]; n = 5 (n = 6 sham)	Alcohol/ AUD/ OCDS	RCT/ Monotherapy	H/ 10 Hz/ 100% (vs. sham)	Post-DTMS (12 sessions) vs. baseline:	–	–
				↔ craving; ↓ daily use/total use, striatal dopamine transporter (SPECT); ↑ abstinence
				Post-sham (12 sessions) vs. baseline:
				↔ all effects (no change from baseline)
Dinur-Klein et al., 2014 [18]f; 10 Hz + cue: n = 16 (n = 15 sham); 10 Hz–cue: n = 16 (n = 16 sham); 1 Hz + cue: n = 7; 1 Hz–cue: n = 7	Nicotine/ no SUD/ sTCQ; FTND	RCT/ Monotherapy	HADD (+ or –cue)/ 10 Hz/ 120%/ vs. 1 Hz/ 120% (vs. sham)	Post-DTMS (10 Hz) vs. sham (13 sessions):	Post-DTMS (10 Hz) vs. sham (6 months):	–
				(trend) ↑ efficacy +cue vs. –cue; ↔ craving; ↓ cigarettes/day, dependence, consumption (urine cotinine); ↑ abstinence (25–44% vs. 0–13% sham), response (50% ↓ in consumption); 1 Hz DTMS discontinued due to poor efficacy	↓ cigarettes/day; ↑ abstinence (23–33% vs. 0–9% sham)
Bolloni et al., 2016 [24]; n = 6 (n = 4 sham)	Cocaine/ CUD/ no scale	RCT/ Monotherapy	H1/ 10 Hz/ 100% (vs. sham)	Post-DTMS vs. sham (12 sessions):	Post-DTMS vs. sham (6 months):	–
				↔ consumption (hair cocaine)	↔ consumption (hair cocaine)
				Post-DTMS (12 sessions) vs. baseline:	Post-DTMS (6 months) vs. baseline:
				↓ consumption (hair cocaine)	↓ consumption (hair cocaine)
Rapinesi et al., 2016 [23]; n = 7	Cocaine/ CUD/ VAS	Open-label/ Add-on	H1/ 15 Hz/ 100%	Post-DTMS (12 sessions) vs. baseline:	Post-DTMS (2 months) vs. baseline:	–
				↓ craving	↓ craving

Abbreviations: AUD alcohol use disorder, CUD cocaine use disorder, DTMS deep transcranial magnetic stimulation, FTND Fagerstrom Test for Nicotine Dependence, HDRS Hamilton Depression Rating Scale, k number of studies, MT resting motor threshold, n sample size at baseline in DTMS groups, OCDS Obsessive Compulsive Drinking Scale, RCT double-blind randomized controlled trial with inactive sham control group, SPECT single photon emission computed tomography, sTCQ the short Tobacco Craving Questionnaire, SUD substance use disorder (dependence and/or abuse), VAS visual analogue scale for craving

^aCases with SUD who received DTMS; ^bSUD according to DSM-IV, −TR or –V; ^cAdd-on means DTMS with concurrent pharmacotherapy; ^dNo maintenance DTMS during the follow-up phases; ^eStudies with comorbid SUD and MDD or dysthymic disorder (DSM-IV-TR); ^fCue conditions were substance-related stimuli presented before DTMS