Phase 1 Open-Label Pilot Trial of H4 dTMS for Moderate-to-Severe Cannabis Use Disorder
| Journal | Neuromodulation: journal of the International Neuromodulation Society |
| Study Type | Randomized Trial |
| Population | Human participants |
This item covers developments relevant to cannabis medicine and clinical practice. Clinicians monitoring evidence in this area should review the source material.
Cannabis use disorder (CUD) is a significant public health problem and no medical treatments have received regulatory approval to date. Deep repetitive transcranial magnetic stimulation (dTMS) provides brief powerful bursts of electromagnetic stimulation to brain networks implicated in psychiatric disorders and the Hesed (H)-4 coil, which targets the lateral prefrontal cortex and anterior insula, is approved for tobacco use disorder. This phase 1 open-label pilot study evaluated the feasibility and tolerability of H4 dTMS in conjunction with standard care for adults with moderate-to-severe CUD who were seeking treatment. Participants received 18 sessions of H4 dTMS (three weeks of five sessions per week, one week of three sessions) in conjunction with standard care. Feasibility was operationalized as treatment completion and attainment of therapeutic dose (≥ 90% resting motor threshold). Tolerability was operationalized as adverse events. Exploratory clinical and mechanistic outcomes w
“This is a development worth tracking. The clinical implications will become clearer as more evidence accumulates.”
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FAQ
Are there any approved medical treatments for cannabis use disorder?
No. According to the article, cannabis use disorder is a significant public health problem, and no medical treatments have received regulatory approval for it to date. This pilot study tested the feasibility and tolerability of deep transcranial magnetic stimulation, added to standard care, in adults with moderate-to-severe cannabis use disorder.
What is H4 deep transcranial magnetic stimulation?
Deep repetitive transcranial magnetic stimulation (dTMS) delivers brief, powerful bursts of electromagnetic stimulation to brain networks implicated in psychiatric disorders. The Hesed (H)-4 coil used in this study targets the lateral prefrontal cortex and the anterior insula, and it is already approved for tobacco use disorder.
How many dTMS sessions did participants in this trial receive?
Participants received 18 sessions of H4 dTMS: five sessions per week for three weeks, plus one week of three sessions. The stimulation was given in conjunction with standard care, and participants were adults with moderate-to-severe cannabis use disorder who were seeking treatment.
What was this phase 1 pilot study designed to measure?
It was an open-label pilot focused on feasibility and tolerability. Feasibility meant completing treatment and reaching the therapeutic dose, defined as at least 90% of resting motor threshold. Tolerability was measured by adverse events. The study also included exploratory clinical and mechanistic outcomes.
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