Mishra 201033 | Randomized single blind sham controlled, 1 month follow-up | Age:18–60 years, CIWA-Ar score 10 or less | 10 Hz; Figure-of-8 coil; 110% MT | Right DLPFC | 10 | 1)15.3 years in active 13.5 years in sham | Sham 15 + Active 30 = 45 | Significant effect of treatment over time for ACQ-NOW(p < 0.0005). |
Hoppner 201134 | Randomized sham controlled, 10 days follow-up | Mean age(years): Real: 43.1; Sham: 48; Females only | 20 Hz; 90% MT | Left DLPFC | 10 | 1) 8 years in real; 6.7 years in sham; 2) 14 days after detoxification | Sham 9 + Active 10 = 19 | OCDS: No significant difference in craving between real and sham groups. |
Herremans 201235 | Randomized single blind sham controlled, between subjects, 3 days follow up | Age: 18–65 years | 20 Hz; Figure of 8 coil; 110 % of MT | Right DLPFC | 1 | 2) Detoxified (Substitution phase completed in mean duration of 12 days) | Sham 16 + Active 15 = 31 | OCDS: Significant main effect of time (p = 0.02). However, no significant main effect for group. In delayed effects of one stimulation session, no main effects for test moment (Saturday, Sunday, Monday) or for Group. |
Herremans 201336 | Randomized single blind sham controlled, crossover design | Age: 18–65 years | 20 Hz; Figure of 8 coil; 110% MT | Right DLPFC | 1 | 2) Detoxified (Diazepam substitution completed in mean duration = 14 days and then benzodiazepine-free period 7 days) | 29 patients, crossover design | OCDS: A significant main effect for time (p = 0.03). |
Mishra 201537 | Single-blind, active- comparator. 10 days follow up | Age: 18–60 years, Male CIWA = Ar score 10 or less | 10 Hz; Figure of 8 coil; 110% MT | Right vs Left DLPFC | 10 | 1) 16.9 years in Right, 17.7 years in Left; 2) 3 days of detoxification | 10 Right + 10 Left = 20 | ACQ-NOW: No main effect of group (right & left DLPFC) but significant main effect of time (p < 0.0001). The interaction effect between group and time was not significant. GCI:No main effect of group (right & left DLPFC) but significant main effect of time (p < 0.0001). The interaction effect between group and time was not significant. |
Girardi 201538 | Open label add-on compared to standard treatment, 6 months follow up | Age: 16–65 years >5-year duration of illness | 20 Hz; H1 coil; Deep TMS; 120% MT | Bilateral DLPFC | 20 | 1) 9.6 years in add-on 12.6 years in standard; 2) Detoxified for 1 month; 3) Dysthymic disorder | Add-on dTMS 10 + standard treatment 10 = 20 | Add-on deep TMS to standard leads to significant reduction in craving, OCDS. Reduction of OCDS from baseline was significantly larger in the experimental than in the control group at all time-points(p < 0.01). |
Ceccanti 201510 | Randomized double blind placebo controlled, 6 months follow up | Mean age(yeats): Real: 43; Sham: 47; Males only | 20 Hz; H coil; Deep TMS; 120% MT | Medial PFC | 10 | 1) 26 years in real, 25 years in sham; 2) 10 days of residential withdrawal for benzodiazepines flush out. TMS only therapy provided. | Sham 9 + Real 9 = 18 | Daily alcohol consumption(drinks/day): Real vs sham not significantly different. DMAI: Real vs sham not significantly different. VAS: Real vs sham not significantly different. |
Herremans 201539 | 2-part study: Experimental part: single blind sham controlled between subjects; Treatment part: open label | Age: 18–65 years | 20 Hz; figure-of 8 coil; 110% MT | Right DLPFC | 15 (in 4 days) | 1) Mean 12 years, # of days patients drank more than 5units/day: 19.6; 2) No alcohol for at least 7 days, 2 weeks washout period for those on anti-craving medications | Experimental part:13 Sham + 13 Active = 26 in 1 rTMS session; reatment part: All 23 subjects in Accelerated HF-rTMS treatment part | Experimental part: TLS (ten-point Likert scales): Active v sham (1 rTMS session) No significant effect on TLS-scores for the active stimulation and the sham stimulation. No significant difference in TLS between both (active vs sham) stimulation groups. Accelerated HF-rTMS treatment part: Significant decrease for both the OCDS (p = 0.02) and the AUQ (p = 0.02) after HF-rTMS treatment. A significant effect between all TLS of the first scan compared with all TLS of the last scan (all p < 0.05). However, all other TLS comparisons were not significant. |
Herremans 201640 | Open label; 4 weeks follow up | Age: 18–65 years | 20 Hz; Figure of 8 coil; 110% MT | Right DLPFC | 15 (in 4 days) | 1) 14.5 years in relapsers, 9.8 years abstainers# of days patients drank more than 5units/day: Relapsers; 17.7. Abstainers: 20 2) At least 1 week diazepam free before stimulation | 19 | Relapse rate of 68% (13/19) at 1 month with no significant difference in characteristics of relapsers and abstainers. |
Del Felice 201641 | Add-on rTMS with disulfiram, Single blind, randomized sham controlled1 month Follow up | Age: 18–65 years | 10 Hz; Figure of 8 coil; 100% MT | Left DLPFC | 4 | 2) Abstained for more than 6 days before the beginning of the rTMS sessions | Sham 10 + Active 10 = 20 | Alcohol intake: No significant modifications over time or group Craving (VAS): No significant modifications over time or group. Attentional bias (Mean Numeric Stroop scores): Improved from 0.311 to 0.901 at 1 month (p = 0.004). Go/No-Go task: Improved from 0.450 to 0.966 at 1 month (p = 0.0.015) |
Addolorato 201713 | Double blind, randomized sham controlled trial | Age: 39–64 years Alcohol withdrawal CIWA-AW score 10 or less. | H coil, 10Hz (deep rTMS); 100% MT | BilateralDLPFC | 12 | 1) 17 years; ADS:13.8 ± 7.5 | Sham 6 + active 5 = 11 | OCDS: Craving did not significantly change in the real and sham group. Alcohol intake (Abstinence days, number of drinking days number of drinks per drinking days and total drinks): Significantly reduced alcohol intake(p = 0.008) in real group only, with time. |
Hanlon 201742 | Single blind sham controlled crossover study | Mean age in years: 27 | cTBS; 5Hz; Figure of 8 coil; 110% MT | Left Frontal pole(MPFC) | 1 | 1) Duration of use:13.2 ± 12; AUDIT:14.2; TLFB:11.7; 2) Allowed to drink but undetectable blood alcohol levels in the lab. | 24 | Self-reported craving (VAS): Significant main effect of time (F(2,132) = 3.62), but no interaction nor effect of condition (real versus sham). |
McNeill 201843 | Counterbalanced, within-participants, controlled stimulation | Age: 18 - 27 years | cTBS, 50 Hz; Figure of 8 coil; 80% MT | Right DLPFC | 1 | 1) AUDIT: 11.75 ± 4.4; TLFB:39.6 units; 2) Actively consuming | 20 | Alcohol consumption: Participants consumed significantly more beer following active stimulation compared with control stimulation (p < 0.001). |
Kearney-Ramos 201844 | Single blind, active-sham controlled | Age: 21–54 years | 5Hz; cTBS; Figure of 8 coil; 110% MT | Left Ventral MPFC | 1 | 1) Years of alcohol use: 10 ± 5.1, AUDIT:14.2 ± 4.8; 2) Time since last alcohol use:2.8 ± 2.6 days | Sham 12 + active 12 = 24 | Self-reported alcohol craving: No significant main or interaction effects of time (pre/post) or treatment (real/sham) on self-reported alcohol craving (p ≥ .05). |
Schluter 201945 | Single blind Randomized Controlled Trial | Age: 20- 65 years; Less than 4 months after detoxification | 10 Hz; Figure of 8 coil; 110% MT | Right DLPFC | 10 | 1) 11 years in active, 10 years in sham; 3) Active group taking antidepressants significantly | Sham 40 + active 40 = 80 | DDT: No significant main effects of session, or treatment group; GNGT:No significant main effects of session or treatment group. SST: No significant main effects of session, or treatment group. |
Jansen 201946 | Single blind, sham controlled | Mean age in years: AUD: 42; HC: 44 | 10 Hz; Figure of 8 coil; 110% MT | Right DLPFC | 1 | 1) Mean AUDIT of all participants: 22.11; 2) Sober for at least 3 weeks | Sham 18 + active 20 = 38 (AUD; n = 39) and healthy controls (HC; n = 36) | AUQ: No differential effect on change in craving over time (pre and post) for AUD patients and/or HC. |
Irene 202047 | Double-blind, randomized, sham-controlled, clinical trial. 12 weeks follow up | 25–64 years, postmenopausal or negative UPT females | 10 Hz; H8 coil; 120%; MT | Insular cortex, bilaterally, excluding prefrontal areas | 15 | 1) ADS: 19.3 in rTMS group, 16.7 in sham group, Peth 0.9–1.1, TLFB 39–48%. 3) Mild cognitive impairment (MMSE not less than 24) | Sham 22 + active 23 = 45 | AUQ: Significant main effect of time during treatment, for both (p < 0.001). PACS: Significant main effect of time during treatment (p = 0.01). However, no between group effect. |
Maayan Harel 202148 | Randomized double blind, sham controlled, 12 weeks Follow up | Mean age in years: Active: 43.7; Sham: 42.5 | 10 Hz; H7 coil; Deep TMS; 100% of MT | MPFC and ACC | 20 | AUDIT active 24.5 (7.2); 26.1 (6.3); ADS 16.5 (7.5); 17.8 (6.2); TLFB, HDD, % 36.8% (32%); 37.6% (27%); 2) Abstinent from alcohol for at least 5 days (but no more than 1 month) | Sham 24 + active 27 = 51 | pHDD: Significantly lower in the active group than the sham group (p = 0.037). PACS: During follow up craving levels increased in the sham group but less so in the active group. |
Maarten Belgers 202249 | Single blind randomized sham controlled12 months Follow up | Age: 20 to 65years | Figure of 8 coil; 10 Hz; 110% MT | Right DLPFC | 10 | 1) Years of problematic use add on tms 16.4 (6.5) years; 14.3 (7.4) years; 2) Detoxification less than 6 weeks; 3) Some patients with PTSD | Sham 16 + active 14 = 30 | VAS, OCDS-5, and AUQ: In the follow-up period, from after rTMS, increased craving over time for all participants but less increased craving over time in the rTMS group versus sham (p < 0.05 for main effect of time and group and interaction effect of group by time). Alcohol use (alcohol use per day and the total amount of alcohol): Decreased alcohol use in the rtms group vs sham p = 0.001. Percentage abstinence: The percentage abstinence at the endpoint did not differ between groups. |