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外2018 Xianju Zhou CCY-I
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Contents lists available at ScienceDirect Psychiatry Research journal homepage: www.elsevier.com/locate/psychres High-frequency repetitive transcranial magnetic stimulation of the left dorsolateral prefrontal cortex restores attention bias to negative information in methamphetamine addicts Ling Zhanga, Xinyu Caob, Qiongdan Lianga, Xiang Lia, Jiemin Yanga, Jiajin Yuana, a The Laboratory for Affect Cognition and Regulation, Key Laboratory of Cognition and Personality of Ministry of Education, Faculty of Psychology, Southwest University, Chongqing,400715, China b Da Lian Shan Institute of Addiction Rehabilitation, Nanjing, China A R T I C L E I N F O Keywords: Emotional attention Inhibitory control Negative bias Methamphetamine A B S T R A C T Methamphetamine (hereafter, meth) addiction results in various emotional problems linked to structural im- pairments in the prefrontal cortex (PFC). In this paper, we investigated whether high-frequency (10 Hz) re- petitive transcranial magnetic stimulation (rTMS) of the left dorsolateral PFC (DLPFC) can improve emotional attention. Thirty-one meth addicts were randomly assigned to a 10 Hz or sham rTMS group; additionally, 31 healthy participants were enrolled, who were required to respond as correctly and quickly as possible to a yellow arrow embedded in an image depicting emotional content (neutral, fear, sadness, or disgust). Results showed that the healthy participants responded more rapidly to negative compared to neutral stimuli, while meth ad- dicts responded indiscriminately to stimuli representing disgust, fear, and neutral content. The randomization check showed no significant differences in the pretest of emotional attention measures between the 10 Hz and sham groups. However, 10 Hz rTMS yielded faster response to negative pictures than to neutral pictures, which was similar to the performance of healthy participants but Sham not. However, this attention bias effect per- sisted in the 10 Hz group 2 weeks later. These results demonstrate that high-frequency rTMS of the left DLPFC can improve the emotional attention of meth addicts. 1. Introduction Methamphetamine (hereafter, meth) addiction causes various social and health problems worldwide. It is related to various negative effects, including physical aggression (Payer et al., 2011; Sommers and Baskin, 2006; Stretesky, 2009) and a high level of emotional problems, parti- cularly depression (Darke, 2008; Glasner-Edwards et al., 2009), fear, and anxiety (Hellem, 2016; Zweben et al., 2004). Studies have reported that meth addicts have difficulty in emotional processing, involving emotional perception (Song et al., 2011), recognition (Henry et al., 2009; Kim et al., 2011a) and regulation (Uhlmann et al., 2016). These emotional deficits are not simply a result of meth use, but are also risk factors for drug craving or relapse (Baker et al., 2004). An intervention concerning the emotional attention of meth addicts may assist in avoiding relapses related to emotional problems. Deficits in emotional processing are closely associated with those in emotional attention. As emotional attention occurs in the early stage of emotional processing, it is an important component of emotional ex- perience (Thompson et al., 2011). Emotional stimulation can only be effectively processed with sufficient attention (Lavie, 2010; Yates et al., 2010). In particular, attention to negative stimuli is important for sur- vival. It allows individuals to identify and respond to threat more ra- pidly to avoid danger (Cacioppo and Gardner, 1998). Several studies indicate that meth use causes an attention deficit in cognitive task ex- periments (Kalechstein et al., 2003; Ezzatpanah et al., 2014). Similarly, these deficits may also exist at the attentional stage of emotional pro- cessing. Clinical observations show that meth addicts often appear distracted. They have difficulty in focusing (Salo et al., 2002) and show reduced responses to affective stimuli even after prolonged abstinence (Henry et al., 2009; Kim et al., 2011a; Payer et al., 2008; Yin et al., 2012). Song et al. (2011) suggest that the emotional awareness of threatening scenes could be compromised in meth addicts. Indifference to negative information may predispose meth addicts to insensitivity toward important biological or social cues, thus leading to interpersonal problems, danger avoidance deficits, and even mental illness. The deficits in emotional attention in meth addicts are likely linked to the dorsolateral prefrontal cortex (DLPFC), particularly a hypoacti- vation of the left DLPFC. It has been shown that the DLPFC subserves https://doi.org/10.1016/j.psychres.2018.04.039 Received 15 August 2017; Received in revised form 6 April 2018; Accepted 11 April 2018 Corresponding author. E-mail address: yuanjiaj@swu.edu.cn (J. Yuan). Psychiatry Research 265 (2018) 151–160 Available online 21 April 2018 0165-1781/ 2018 Elsevier B.V. All rights reserved. T

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