Table 3.
Effectiveness results among the included studies.
| Cocaine Use | Craving | Anxiety | Depression | Psychopathology | Insomnia | |
|---|---|---|---|---|---|---|
| rTMS over the left-DLPFC | ||||||
| Terraneo et al., 2016 [13] (n = 36) RCT |
Negative urine test during treatment: rTMS: 11(69%) PT: 3 (19%) OR = 6.47 (IC95%: 1.14, 36.6). |
VAS 0–10: Significantly lower craving with rTMS ANOVA RM: F (1,27) = 4.74, p = 0.038 |
- | - | - | - |
| Madeo et al., 2020 [43] (n = 147) CS |
Days until relapse (median): rTMS: 91 (70–109) TAU: 51 (39–78) 147 patients followed for 84–974 days: Mean use <1.0 day/month (median 0). |
- | - | - | - | - |
| Gómez et al., 2020 [20] (n = 87) CS |
Days of cocaine use (mean): reduction at 30 days: −18.7 (97.3%) p < 0.001 reduction at 90 days: −18.3 (95.6%) p < 0.001 |
CCQ reduction at 30 days: −11.32 (89.3%) p < 0.001 reduction at 90 days: −8.86 (69.9%) p < 0.001 |
SAS reduction at 30 days: −11.96 (24.9%) p < 0.001 reduction at 90 days: −9.83 (20.5%) p < 0.001 |
BDI-II reduction at 30 days: −13.89 (73.1%) p < 0.001 reduction at 90 days: −12.26 (64.5%) p < 0.001 |
SCL-90-R reduction at 30 days: −18.24 (27.7%) p < 0.001 reduction at 90 days: −19.45 (29.5%) p < 0.001 |
PSQI reduction at 30 days: −4.24 (45.6%) p < 0.001 reduction at 90 days: −3.12 (33.8%) |
| Pettorruso et al., 2019 [47] (n = 20) CS |
Negative urine test at the end of treatment: 9 of 16 (56.25%) (Z = −3.00; p = 0.003). |
CSSA (craving) reduction at 4 weeks: −1.5 (33.9%) p = 0.020 |
SAS reduction at 4 weeks: −8.4 (23.0%) p = 0.001 |
BDI-II reduction at 4 weeks: −9.8 (57.1%) p = 0.008 |
SCL-90-R reduction at 4 weeks: −0.51 (52.0%) p < 0.001 |
ISI reduction at 4 weeks: −5.2 (59.7%) p = 0.077 |
| Politi et al., 2008 [48] (n = 36) CS |
- | Greater reduction with TMS ANOVA RM (time effect) F (30,270) = 4.96 p < 0.001 |
- | - | - | - |
| Steele et al., 2019 [42] (n = 19) CS |
Mean use (days/week): Reduction at 7 weeks: −3 (70.0%) p < 0.001 Money spent on consumption at 4 weeks: −167$ (78.0%) p < 0.001 |
Reduction at 7 weeks: CCQ: 37% CCS: 26% |
BAI Increase at 3 weeks: 33% |
MADRS Reduction at 3 weeks: 18% |
- | - |
| High frequency deep rTMS over the bilateral PFC | ||||||
| Bolloni et al., 2016 [41] (n = 18) RCT |
Amount of cocaine in hair analysis ANOVA RM (interaction) F = 0.35; p = 0.87 |
- | - | - | - | - |
| Rapinesi et al., 2016 [17] (n = 20) CS |
- | VAS 0–10 Craving reduction at the end of treatment: −6.3 (64.7%) p < 0.001 Craving reduction at one month follow-up: −3.8 (39.6%) p = 0.003 |
- | - | - | - |
| Medial prefrontal cortex (MPFC) stimulation | ||||||
| Martínez et al., 2018 [46] (n = 18) RCT |
Choice of cocaine vs. receiving money: lower with rTMS ANOVA RM (interaction) F = 5.36, p = 0.02 |
Negative binominal distribution with random effects F (2, 14) = 0.77, p = 0.48 |
- | - | - | - |
| Hanlon et al., 2015 [15] (n = 11) Crossover |
- | VAS 0–10 No significant different on mean change. Fewer patients getting worse and more patients remaining stables with TMS. χ2 = 19.14, p <0.001 |
- | - | - | - |
| Hanlon et al., 2017 [44] (n = 25) Crossover |
- | VAS 0–10 Post-treatment result not significant (p-value not reported): rTMS: 2.93 (2.78) Control: 2.90 (2.25) |
- | - | - | - |
| Comparison between bilateral deep stimulation protocols: iTBS vs. high frequency rTMS | ||||||
| Sanna et al., 2019 [41] (n = 49) nRCT |
Urine test and consumption statement ANOVA RM: Significant effect of time (F = 49.97; p <0.001) but not of treatment (F = 0.67) or interaction (F = 0.66). |
brief modified CCQ ANOVA RM: Significant effect of time (F = 127.3; p <0.001 but not of treatment (F = 1.48) or interaction (F = 0.03). |
- | - | - | - |
BAI: Beck Anxiety Inventory; BDI-II: Beck Depression Inventory-II; CCQ: Cocaine Craving Questionnaire; CS: case series; CSSA: Cocaine Selective Severity Assessment; DLPFC: dorsolateral prefrontal cortex; ISI: Insomnia Severity Index; MADRS: Montgomery–Asberg Depression rating scale; nRCT: non-randomized controlled trial; OR: odds ratio; PSQI: Pittsburgh Sleep Quality Index; PT: pharmacological treatment; RCT: randomized controlled trial; RM: repeated measures; rTMS: repetitive transcranial magnetic stimulation; SAS: Self-rating Anxiety Scale; SCL-90-R: Symptoms Checklist 90 revised; TAU: treatment as usual; VAS: visual analogue scale.