Psychological Effects of Repetitive Transcranial Magnetic Stimulation on Individuals With Methamphetamine Use Disorder: A Systematic Review and Meta-Analysis

Objective To evaluate the effects of rTMS on drug craving, depression, anxiety, sleep, and cognitive function in methamphetamine (MA) dependent individuals. Data sources and methods Randomized controlled trials (RCTs) of rTMS interventions for MA-dependent patients were searched through PubMed, Embase, Cochrane Library, Web of Science, Chinese National Knowledge Infrastructure (CNKI), Wanfang database, Chongqing Vipers (VIP) and China Biomedical Literature Database (CBLD). The included literature was statistically processed using Revman 5.4, and STATA 16.0 for sensitivity and bias analysis. Results A total of 13 papers were included, and the results of the meta-analysis showed that rTMS was effective in reducing craving scores (SMD = −1.53, 95%CI:−2.08 ∼ −0.98, p < 0.00001), improving depression (SMD = −0.32, 95%CI:-0.58 ∼ −0.07, p = 0.01) and sleep scores (WMD = −1.26, 95%CI:−2.26 ∼ −0.27, p = 0.01), but had no effect on anxiety scores (SMD = −0.42, 95%CI:−0.88 ∼ 0.03, p = 0.07); in terms of cognitive function, there were improvements in the international shopping list task (ISL), Groton maze learning task (GML) and continuous paired association learning task (CPAL), except for no effect on the social emotional cognition task (SEC) and two back task (TWOB). Subgroup analysis showed significant differences in the effects of different intervention period on craving in MA-dependent individuals. Conclusion rTMS was effective in reducing MA dependent individuals' cravings, alleviating depressive symptoms, improving sleep quality and language learning, collaborative learning and executive skills. Due to the small sample size of this study, a large number of RCTs are needed to validate this.