Clinical and Neurophysiological Evaluation of qEEG-Guided Transcranial Magnetic Stimulation (TMS) Therapy in Methamphetamine Dependence: A Case Series Report at the National Narcotics Board Rehabilitation Center of the Republic of Indonesia

This presentation will be featured at Indonesia 2025, on the 18.09.2025.

Authors:

Elvina Sahusilawane - National Narcotics Board Rehabilitation Center

Adre Mayza, Maharani - NeurorestorationNeuroengineering Working Group of the Indonesian Neurological Association

Abstract: 

Background

Methamphetamine dependence is a national problem with variable therapeutic success rates. Innovative approaches such as neuromodulation are required to enhance rehabilitation effectiveness. Transcranial Magnetic Stimulation (TMS) is a non-invasive brain stimulation technique that can modulate the neural circuits involved in addiction. Personalization of the therapeutic target using Quantitative Electroencephalography (qEEG) is expected to yield more optimal results by targeting specific areas of dysfunction in each individual.

Objective

This case report aims to demonstrate the neurophysiological (qEEG) changes and clinical presentation following the administration of 10 personalized TMS therapy sessions to clients with methamphetamine dependence undergoing rehabilitation at the National Narcotics Board Rehabilitation Center.

Methods

This case study analyzed eleven clients undergoing a rehabilitation program. Each client underwent an initial qEEG assessment to observe brainwave patterns to determine the TMS stimulation target location corresponding to the apparent clinical presentation. The intervention consisted of 10 consecutive daily TMS therapy sessions using the Continuous Theta Burst Stimulation (cTBS) and/or Intermittent Theta Burst Stimulation (iTBS) protocols. Efficacy was evaluated by comparing pre- and post-TMS therapy data, assessing qEEG results and clinical presentation obtained through interviews and measurements from the GAD-7, PHQ-9, and PSQI instruments.

Results

After 10 therapy sessions, 9 out of 11 clients (81.8%) experienced significant improvement in clinical symptoms, accompanied by objective improvements in the qEEG findings. One client (9.1%) showed clinical improvement, but no significant changes were found in their qEEG results. Meanwhile, another client (9.1%), who did not report specific clinical complaints from the outset, also showed no change in the post-therapy qEEG findings. Instrument measurements showed that for anxiety (GAD-7), 10 clients improved; for depression (PHQ-9), 7 clients improved; and for sleep quality (PSQI), 9 clients showed improvement.

Conclusion

qEEG-guided TMS therapy shows great potential as an effective and measurable adjunctive therapeutic modality in the rehabilitation program for methamphetamine dependence. This approach indicates that improvements at the neurophysiological level also influence clinical improvement. These preliminary results support the further development of qEEG-guided neuromodulation therapy for the management of methamphetamine dependence.