No Effects of rTMS on Performance Monitoring and Attentional Bias in Patients With Alcohol Use Disorder: A Pilot Study.

Repetitive transcranial magnetic stimulation (rTMS) presents a promising approach for treating patients with alcohol use disorder (AUD). However, its neuropsychological working mechanisms are to be elucidated. Therefore, we investigated the effect of rTMS treatment on event-related potentials (ERPs) evoked by a flanker task and a passive picture task using electro-encephalography, in 30 recently detoxified patients. Participants were randomly assigned to receive either 10 sessions of rTMS or sham rTMS. Measurements were made at baseline, and after 5 and 10 treatments. The results revealed no significant effect of rTMS on any of the assessed ERPs (N100, N200, and P300). These findings suggest that high-frequency rTMS applied over the right dlPFC, in addition to treatment as usual (TAU), does not impact performance monitoring or attentional bias in recently detoxified patients with AUD. Bayesian analyses did suggest a potential effect of rTMS on N100 amplitude at frontal electrode FZ. These preliminary findings warrant further study of the effects of rTMS on ERP outcomes in AUD patients, and exploration of ERPs related to performance monitoring and attentional bias as potential neuropsychological markers for the clinical effects of rTMS. However, other neuropsychological markers, like brain network connectivity, should also be explored. CLINICAL TRIAL REGISTRATION: Registered in a trial Register (ClinicalTrials.gov Identifier: NCT01973127)f.