"A Theta Burst Stimulation on Pre-SMA: Proof-of-Concept of Transcranial Magnetic Stimulation in Gambling Disorder"

J Gambl Stud. 2022 Dec;38(4):1529-1537. doi: 10.1007/s10899-022-10129-3. Epub 2022 May 21.

Abstract

Gambling Disorder (GD) is a condition constituting a public health concern, with a burden of harm which is much greater than that of drug addiction. Patients with GD are generally reluctant to pharmacologic treatment and seem to prefer nonpharmacological interventions. Therefore, this proof-of-concept study aimed to investigate the feasibility of continuous Theta Burst Stimulation (cTBS) on the pre-SMA in six patients (5 males, 1 female), aged 30-64 years, with a DSM-5 diagnosis of Gambling Disorder and no comorbid mood disorders. Participants received over 10 sessions of Continuous TBS (cTBS) over pre-SMA bilaterally and have been evaluated using rating scales, including the PG-YBOCS and the CGI, before treatment (T0), at day 10 of treatment (T1) and at day 30 after treatment (T2); cTBS intervention was safe and without side effects. Since the design of our study does not allow us to draw conclusions on the effectiveness of the intervention with respect to the improvement of the functioning of the subject with GD, a more in-depth study, including a sham condition, neurocognitive measures of disinhibition and decision making, and collecting follow-up data on the sustained effect of TBS over a longer period is ongoing.

Keywords: Gambling disorder; Neuromodulation; Neuroplasticity; Pre-supplementary motor area; theta-burst stimulation.

MeSH terms

  • Diagnostic and Statistical Manual of Mental Disorders
  • Female
  • Gambling* / psychology
  • Humans
  • Male
  • Motor Cortex* / physiology
  • Transcranial Magnetic Stimulation / methods