BACKGROUND AND AIMS Repetitive transcranial magnetic stimulation (rTMS) of the left dorsolateral prefrontal cortex (DLPFC) can effectively reduce cravings in methamphetamine use disorder (MUD). However, a considerable group still fails to respond. Cognitive and emotional disturbance, as well as impulsive features, are widespread in patients with MUD and might mediate the treatment response of rTMS. The purpose of this study is to figure out whether these variables can help predicting patients' responses to rTMS treatment. METHODS Ninety-seven patients with severe MUD and thirty-one gender- and age-matched healthy subjects were included. Patients were randomized to receive 20 sessions of real or sham rTMS. Intermittent theta burst protocols (iTBS) or sham iTBS were applied every weekday over the DLPFC for 20 daily sessions. Both groups received regular treatment. Craving induced by drug-related cue was measured before and after stimulation. Cognition was evaluated by using the CogState Battery. Baseline characteristics were collected through the Addiction Severity Index, Patient Health Questionnaire-9, General Anxiety Disorder Scale-7, and Barrett Impulsivity Scale-11. RESULTS Results showed that patients with MUD have worse spatial working memory, problem-solving ability, as well as depression and anxiety symptoms compared with healthy controls. Cognition and emotion differed between responders (craving decrease ≥60%) and non-responders in real rTMS group but not in the sham group. Better cognitive and emotional functions means that patients have higher possibility for better response to real rTMS treatment. CONCLUSIONS This study suggests that cognitive, emotional and impulsive features could be used to predict the prospective treatment responses of rTMS in patients with MUD.

中文翻译：

---

甲基苯丙胺使用障碍中真实与假性重复经颅磁刺激治疗反应的认知和情感预测因子。

背景与目的重复性经颅磁刺激（rTMS）对左背外侧前额叶皮层（DLPFC）可以有效减少对甲基苯丙胺使用障碍（MUD）的渴望。但是，仍然有相当一部分人没有回应。认知和情绪障碍以及冲动特征在MUD患者中广泛存在，并可能介导rTMS的治疗反应。这项研究的目的是弄清楚这些变量是否可以帮助预测患者对rTMS治疗的反应。方法纳入了97例重度MUD患者和31例性别和年龄相匹配的健康受试者。患者被随机分配接受20次真实或假rTMS疗程。每周20天，在DLPFC上应用间歇式theta突发协议（iTBS）或伪iTBS。两组均接受常规治疗。在刺激之前和之后，测量由药物相关提示引起的渴望。使用CogState电池评估认知度。通过成瘾严重性指数，患者健康问卷9，一般焦虑障碍量表7和巴雷特冲动量表11收集基线特征。结果结果表明，与健康对照组相比，MUD患者的空间工作记忆，解决问题的能力以及抑郁和焦虑症状更差。在真正的rTMS组中，响应者（渴望减少≥60％）和无响应者之间的认知和情感有所不同，而在假模拟组中没有。更好的认知和情感功能意味着患者更有可能对实际的rTMS治疗做出更好的反应。结论本研究表明认知，