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Hu X, Zhang T, Ma H, Zhou X, Wang H, Wang X, Cheng C, Li Y, Duan R, Zhang B, Wang H, Lu J, Kang C, Zhao N, Zhang Y, Tian L, Liu J, Shi J, Wang Z, Zhou X, Zhu S, Liu Q, Li X, Wang H, Nie M, Yang M, Yang J, Chi Y, Zhu X, Hu J, Jia Y, Peng Y, Liu L. Repetitive transcranial magnetic stimulation combined with cognitive behavioral therapy treatment in alcohol-dependent patients: A randomized, double-blind sham-controlled multicenter clinical trial. Front Psychiatry 2022; 13:935491. [PMID: 36299538 PMCID: PMC9590282 DOI: 10.3389/fpsyt.2022.935491] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 09/16/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Alcohol dependence (AD) is a complex addictive disorder with a high relapse rate. Previous studies have shown that both repetitive transcranial magnetic stimulation (rTMS) and cognitive behavioral therapy (CBT) may be effective for AD, and we aim to explore more effective treatment options to reduce relapse rates for AD. MATERIALS AND METHODS A total of 263 AD patients were recruited. They were divided into six groups according to the location and the type of rTMS: left dorsolateral prefrontal cortex (DLPFC), right DLPFC, sham stimulation, and whether they received CBT treatment: with a fixed schedule (C1) and without a fixed plan (C0). There were included in sham rTMS + C0 group (n = 50), sham rTMS + C1 group (n = 37), right rTMS + C0 group (n = 45), right rTMS + C1 group (n = 42), left rTMS + C0 group (n = 49), left rTMS + C1 group (n = 40). We used obsessive compulsive drinking scale (OCDS), visual analogue scale (VAS), alcohol dependence scale (ADS), montreal cognitive assessment (MoCA), generalized anxiety disorder-7 (GAD-7), patient health questionnaire-9 items (PHQ-9), and Pittsburgh sleep quality index (PSQI) to assess alcohol cravings, alcohol dependence, cognition, anxiety, depression, and sleep quality. They were followed up and evaluated for relapse. RESULTS The sham rTMS + C0 group relapse rate was significantly higher than the right rTMS + C1 group (P = 0.006), the left rTMS + C0 group (P = 0.031), the left rTMS + C1 group (P = 0.043). The right rTMS + C0 group showed significantly higher relapse rate compared to the right rTMS + C1 group (P = 0.046). There was no significant difference in relapse rates between other groups. The repeated-measures ANOVA showed an interaction effect between group and time was significant in the rate of patient health questionnaire-9 items (PHQ-9) scale reduction (P = 0.020). Logistic analysis indicated that smoking and alcohol consumption were independent determinants of relapse (P < 0.05). At 24 weeks of follow-up, Kaplan-Meier survival analysis reveal that there is statistically significant relapse rate between six groups (P = 0.025), left rTMS + C1 group has the best treatment effect for alcohol dependent patients. Cox regression analysis confirmed that current smoking, total cholesterol, and total bilirubin (TBIL) level were risk factors of relapse (P < 0.05). CONCLUSION This study is the first to suggest that the combination of rTMS and CBT may be a potentially effective treatment for reducing relapse.
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Affiliation(s)
- Xiaorui Hu
- Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Tian Zhang
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Hongkun Ma
- Department of Epidemiology and Health Statistics, Mudanjiang Medical University, Mudanjiang, China
| | - Xuhui Zhou
- Hunan Provincial Brain Hospital, Changsha, China
| | - Hongxuan Wang
- Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiaohong Wang
- Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Chang Cheng
- Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Yanfei Li
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ranran Duan
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Bo Zhang
- Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Huaizhi Wang
- Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Jia Lu
- Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Chuanyi Kang
- Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Na Zhao
- Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Yingjie Zhang
- Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Lu Tian
- Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Jun Liu
- The First Psychiatric Hospital of Harbin, Harbin, China
| | - Jingjing Shi
- Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Zhe Wang
- The First Psychiatric Hospital of Harbin, Harbin, China
| | - Xinxin Zhou
- The First Psychiatric Hospital of Harbin, Harbin, China
| | - Shuang Zhu
- Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Qingxia Liu
- Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Xuemin Li
- Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Honghui Wang
- Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Mingxuan Nie
- Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Mei Yang
- Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen, China
| | - Jianzhong Yang
- The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Yong Chi
- Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Xiaofeng Zhu
- Department of Physiology and Neurobiology, Mudanjiang Medical University, Mudanjiang, China
| | - Jian Hu
- Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Yanjie Jia
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ying Peng
- Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Lei Liu
- Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
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Zhang B, Wang G, Huang CB, Zhu JN, Xue Y, Hu J. Exploration of the Role of Serine Proteinase Inhibitor A3 in Alcohol Dependence Using Gene Expression Omnibus Database. Front Psychiatry 2021; 12:779143. [PMID: 35095596 PMCID: PMC8790540 DOI: 10.3389/fpsyt.2021.779143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 12/02/2021] [Indexed: 11/21/2022] Open
Abstract
Background: Alcohol dependence is an overall health-related challenge; however, the specific mechanisms underlying alcohol dependence remain unclear. Serine proteinase inhibitor A3 (SERPINA3) plays crucial roles in multiple human diseases; however, its role in alcohol dependence clinical practice has not been confirmed. Methods: We screened Gene Expression Omnibus (GEO) expression profiles, and identified differentially expressed genes (DEGs). Protein-protein interaction (PPI) networks were generated using STRING and Cytoscape, and the key clustering module was identified using the MCODE plugin. SERPINA3-based target microRNA prediction was performed using online databases. Functional enrichment analysis was performed. Fifty-eight patients with alcohol dependence and 20 healthy controls were recruited. Clinical variables were collected and follow-up was conducted for 8 months for relapse. Results: SERPINA3 was identified as a DEG. ELANE and miR-137 were identified after PPI analysis. The enriched functions and pathways included acute inflammatory response, response to stress, immune response, and terpenoid backbone biosynthesis. SERPINA3 concentrations were significantly elevated in the alcohol dependence group than in healthy controls (P < 0.001). According to the median value of SERPINA3 expression level in alcohol dependence group, patients were divided into high SERPINA3 (≥2677.33 pg/ml, n = 29) and low SERPINA3 groups (<2677.33 pg/ml, n = 29). Binary logistic analysis indicated that IL-6 was statistically significant (P = 0.015) Kaplan-Meier survival analysis did not indicate any difference in event-free survival between patients with low and high SERPINA3 levels (P = 0.489) after 8 months of follow-up. Receiver characteristic curve analysis revealed that SERPINA3 had an area under the curve of 0.921 (P < 0.0001), with a sensitivity and specificity of 93.1 and 80.0%, respectively. Cox regression analysis revealed that aspartate transaminase level was a negative predictor of relapse (β = 0.003; hazard ratio = 1.003; P = 0.03). Conclusions: SERPINA3 level was remarkably elevated in patients with alcohol dependence than healthy controls, indicating that SERPINA3 is correlated with alcohol dependence. However, SERPINA3 may not be a potential predictive marker of relapse with patients in alcohol dependence.
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Affiliation(s)
- Bo Zhang
- Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Gang Wang
- Department of Substance Dependence, Wuhan Mental Health Center, Wuhan, China
| | | | - Jian Nan Zhu
- The Third People's Hospital of Huai'an, Huai'an, China
| | - Yong Xue
- The Third People's Hospital of Huai'an, Huai'an, China
| | - Jian Hu
- Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, China
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