The effect of rTMS combined with physical exercise on people with methamphetamine use disorders: An acute experimental study.

BACKGROUND

The benefits of acute physical exercise for substance use disorders have received extensive attention, but it is currently unclear whether adding repetitive transcranial magnetic stimulation (rTMS) based on exercise can achieve the superposition of benefits. This study aims to explore the acute effect and potential mechanism of rTMS combined with physical exercise on people with methamphetamine use disorders (MUD), and reveal the differences in effects among different models.

METHODS

64 men with MUD were randomly divided into the physical exercise group (PEG), low-frequency rTMS + physical exercise group (LF rTMS + PEG), high-frequency rTMS + physical exercise group (HF rTMS + PEG), and control group (CG) by an acute experimental study. The PEG was required to complete 35 min of moderate-intensity physical exercise, and the LF- and HF rTMS + PEG were required to complete the 1Hz and 10Hz rTMS tasks of 10 min based on the exercise group, respectively, while the CG only performed the reading task.

RESULTS

Three acute interventions not only significantly reduce depression, anxiety, and psychological cravings in people with MUD but also enhance internal inhibition (particularly in the HF rTMS + PEG) and increase the levels of DA, β-EP, and 5-HT in the blood. Meanwhile, these acute effects persisted for up to 60 min post-intervention (except for anxiety), and the HF rTMS + PEG demonstrated relatively stronger sustainability of these effects. Moreover, electrophysiological data revealed that compared to neutral cues, people with MUD exhibited abnormal prefrontal activation (manifested as significantly lower Fz-alpha wave power) when exposed to drug-related cues at baseline. Then all three intervention groups showed significantly increased Fz-alpha wave power during drug-cue tasks immediately after intervention, and both the LF rTMS + PEG and HF rTMS + PEG maintained significantly higher values compared to the CG at 60 min post-intervention.

CONCLUSION

A single session of moderate-intensity physical exercise demonstrates acute benefits for both psychological and physiological withdrawal recovery in people with MUD. More importantly, it is essential to combine rTMS (particularly 10 Hz) with physical exercise, as this integrated approach can strengthen the sustainability of benefits and serve as an effective supplementary method to promote both physical and psychological recovery in this population.