The positive effects of high-frequency right dorsolateral prefrontal cortex repetitive transcranial magnetic stimulation on memory, correlated with increases in brain metabolites detected by proton magnetic resonance spectroscopy in recently detoxified alcohol-dependent patients

Figures & data

Figure 1 Change in memory function assessed by HVLT-R and BVMT-R after high-frequency right dorsolateral prefrontal cortex rTMS in recently detoxified alcohol-dependent patients.

Notes: Both groups showed improved memory after rTMS from baseline. The experimental group had significantly greater improvement than the control group in HVLT-R (*P=0.003, Cohen’s d=1.15) and BVMT-R (**P<0.001, Cohen’s d=3.56) scores.
Abbreviations: rTMS, repetitive transcranial magnetic stimulation; HVLT-R, Hopkins Verbal Learning Test-Revised; BVMT-R, Brief Visuospatial Memory Test-Revised.

Table 1 The changes of brain metabolites after treatment

Variables	Experimental group (n=18)	Control group (n=20)	P-value
Left brain
NAA
Pretreatment	55 (51–61)	50 (46–56)	0.032
Posttreatment	57 (49–62)	52 (49–55)	0.065
Change	3 (−3 to 6)	2 (−1 to 3)	0.527
Change (%)	5.5 (−5.8 to 9.7)	3.8 (−1.9 to 6.8)	0.804
Cho
Pretreatment	52 (42–55)	47 (44–51)	0.285
Posttreatment	54 (50–63)	49 (44–53)	0.005
Change	7 (3–12)	2 (−3 to 4)	0.004
Change (%)	12.5 (5.5–25.9)	3.3 (−5.7 to 8.0)	0.004
Cr
Pretreatment	45 (43–48)	43 (41–46)	0.090
Posttreatment	41 (39–43)	43 (39–44)	0.371
Change	−5 (−6 to −1)	−3 (−3 to 1)	0.017
Change (%)	−8.8 (−13.9 to −2.4)	−5.3 (−7.5 to 1.2)	0.021
NAA/Cr
Pretreatment	1.2 (1.2–1.3)	1.2 (1.1–1.3)	0.292
Posttreatment	1.4 (1.1–1.6)	1.3 (1.2–1.3)	0.077
Change	0.2 (0.1–0.3)	0.1 (0–0.1)	0.017
Change (%)	16.3 (8.3–26.7)	5.7 (1.4–12.1)	0.023
Cho/Cr
Pretreatment	1.1 (0.9–1.3)	1.1 (1.0–1.1)	0.930
Posttreatment	1.4 (1.2–1.5)	1.1 (1.1–1.2)	0.001
Change	0.3 (0.1–0.4)	0.1 (0–0.1)	0.003
Change (%)	26.7 (4.6–40.6)	6.1 (−1.4 to 12.8)	0.005
Right brain
NAA
Pretreatment	54 (49–56)	52 (47–55)	0.333
Posttreatment	60 (57–65)	54 (47–58)	0.000
Change	7 (4–13)	3 (−2 to 4)	0.001
Change (%)	11.8 (7.8–27.7)	4.5 (−3.2 to 8.3)	0.002
Cho
Pretreatment	49 (42–52)	49 (42–53)	0.736
Posttreatment	58 (53–64)	48 (46–55)	0.004
Change	10 (6–13)	4 (1.0 to 6)	0.001
Change (%)	22.9 (9.5–30.8)	7.8 (0.7–13.0)	0.003
Cr
Pretreatment	46 (43–49)	45 (42–48)	0.340
Posttreatment	43 (40–45)	44 (43–46)	0.268
Change	−4 (−6 to 1)	0 (−3 to 2)	0.077
Change (%)	−8.7 (−10.7 to 2.4)	−1.1 (−6.6 to 3.3)	0.047
NAA/Cr
Pretreatment	1.2 (1.0–1.2)	1.1 (1.0–1.2)	0.988
Posttreatment	1.4 (1.2–1.6)	1.2 (1.1–1.3)	0.002
Change	0.3 (0.1–0.4)	0.1 (0–0.1)	0.001
Change (%)	28.7 (6.4–40.1)	6.5 (−1.5 to 10.1)	0.001
Cho/Cr
Pretreatment	1.0 (1.0–1.1)	1.1 (0.9–1.2)	0.599
Posttreatment	1.4 (1.2–1.5)	1.1 (1.0–1.2)	0.001
Change	0.3 (0.2–0.5)	0.1 (0–0.2)	<0.001
Change (%)	29.3 (14.6–45.6)	6.8 (−0.2 to 14.5)	<0.001

Note: Data are presented as median (interquartile range).

Abbreviations: NAA, N-acetyl aspartic acid; Cho, choline compound; Cr, creatine compound.

Table 2 Correlations between the percentage changes of memory function and the percentage change of brain metabolites by Spearman’s rank correlation coefficient

Variables	HVLT-R	BVMT-R
Left brain
NAA	0.045	0.138
Cho	−0.027	0.354*
Cr	−0.127	−0.254
NAA/Cr	0.274	0.324*
Cho/Cr	0.062	0.340*
Right brain
NAA	0.345*	0.561*
Cho	0.254	0.352*
Cr	−0.311	−0.352*
NAA/Cr	0.392*	0.532*
Cho/Cr	0.405*	0.461*

Note:

* P<0.05.

Abbreviations: HVLT-R, Hopkins Verbal Learning Test-Revised; BVMT-R, Brief Visuospatial Memory Test-Revised; NAA, N-acetyl aspartic acid; Cho, choline compound; Cr, creatine compound.