International Network of tES/TMS Trials for Addiction Medicine- INTAM

The International Network of TMS/tES trials for Addiction Medicine (INTAM) was formed in response to the need for a more standardized approach to non-invasive brain stimulation research in substance use disorders (SUDs). The variability in methods and outcome measures across trials has made it difficult to reproduce results and interpret findings, slowing down progress in the field.

INTAM is a VICONS (virtual collaborative network in science) which is an international collaborative group of investigators with expertise in neuromodulation and addiction research. The leadership core consists of 14 experts in the field (steering committee), and the group has grown to over 80 members from research centers and labs across the globe. The aim of INTAM is to provide a framework for future research and propose guidelines for best practices in non-invasive brain stimulation SUD research.

INTAM has already made significant progress toward achieving these goals. The group has held webinars and joint meetings and published a consensus paper with over 70 authors from 17 different countries proposing guidelines for best practices in non-invasive brain stimulation SUD research (INTAM first consensus paper). These guidelines aim to bridge current knowledge gaps and accelerate progress in the field.

INTAM has also collaborated with other organizations, such as the NYC Neuromodulation Conference, and has published a guideline on the impact of COVID-19 on brain stimulation labs/studies/researchers across the world (COVID-19 guideline).

By bringing together experts in the field and providing a standardized approach to research, INTAM aims to accelerate the translation of basic neuroscience findings into advanced neuromodulation tools for clinical practice, ultimately improving outcomes for individuals with SUDs.

INTAM has held a series of six webinars focused on different aspects of non-invasive brain stimulation for substance use disorders. These webinars were led by experts in the field and provided an opportunity for participants to learn about the latest research and developments in the field.

The topics covered in the webinars included:

1. Introduction to non-invasive brain stimulation for addiction medicine
2. Imaging techniques for understanding the mechanisms of non-invasive brain stimulation
3. Optimizing non-invasive brain stimulation protocols for substance use disorders
4. Clinical trials and regulatory issues in non-invasive brain stimulation
5. Long-term effects and ethical considerations of non-invasive brain stimulation for substance use disorders

All of these webinars were recorded and are available for viewing on the INTAM YouTube channel. These recordings provide a valuable resource for researchers, clinicians, and anyone interested in learning more about non-invasive brain stimulation for substance use disorders.

PAST WEBINARS:

• INTAM 1st webinar: International Network of tES/TMS Trials for Addiction Medicine. LINK
• INTAM 2nd webinar: January 24th 2019  LINK
• INTAM 3rd webinar: April 11th 2019 “How to deal with trials with negative results” LINK
• INTAM 4th webinar: February 4th 2021“How to combine brain stimulation with neuroimaging: Concurrent tES-fMRI”: LINK 
• INTAM 5th webinar: September 15th 2020 “Guidelines and experiences for tES/TMS clinical services and research through the COVID-19 pandemic” LINK

INTAM organizes multiple meetings annually in parallel to the major relevant scientific meetings including but not limited to CPDD, SOBP, OHBM and ACNP. To be informed about the upcoming meetings, please join the INTAM WhatsApp group through this link (https://chat.whatsapp.com/G13VLRLc5td8a27FWtcsH8 ).

As an example, INTAM has held two joint meetings in parallel with other conferences to promote collaboration and knowledge sharing across the field. The first joint meeting was held in August 2018 in parallel to the New York City Neuromodulation Meeting. The second joint meeting was held in February 2019 in parallel to the 3rd International Brain Stimulation Conference in Vancouver.

During these joint meetings, INTAM members had the opportunity to discuss current gaps in knowledge and to propose strategies for addressing these gaps. These meetings provided a valuable forum for researchers and clinicians working in the field of non-invasive brain stimulation for substance use disorders to share their ideas and findings, to network with colleagues, and to learn about the latest advances in the field.

The joint meetings were also an opportunity for INTAM members to present their work to a wider audience and to raise awareness about the importance of non-invasive brain stimulation for substance use disorders. By collaborating with other conferences, INTAM was able to reach a broader audience and to build partnerships with other organizations working in related fields.

Overall, the joint meetings were an important step forward for the field of non-invasive brain stimulation for substance use disorders, and they helped to establish INTAM as a key player in this area of research.

The consensus paper proposed guidelines for best practices in non-invasive brain stimulation for substance use disorder (SUD) research. The first paper was published in Neuroscience and Biobehavioral Reviews in 2019 and was authored by more than 70 experts from 17 different countries around the world.

The consensus proposed in the paper is designed to address the challenges facing the field of non-invasive brain stimulation for SUD research, such as the variability in methods and outcome measures across different trials, small sample sizes, lack of rigorous control conditions, and insufficient blinding.

The paper outlines several key recommendations, including the need for larger sample sizes, the use of rigorous control conditions, and the use of standardized outcome measures. The paper also emphasizes the importance of transparency in reporting methods and results, and the need for independent replication of findings.

The publication of this consensus paper was an important milestone for the field of non-invasive brain stimulation for SUD research, as it provided a framework for future research and established a set of best practices that could help to ensure the reliability and reproducibility of research findings. The paper has been cited nearly 40 times in less than a year, demonstrating its impact and influence on the field.

The second INTAM consensus paper is under process. If you have a significant contribution to the published body of evidence, You are welcome to contact INTAM email address and nominate yourself to contribute as one of the authors (intam2018@gmail.com).

INTAM is interested in contributing to the global efforts for transparent and open science with developing guidelines, technical reports, consensus statements and shared protocols.

As an example, INTAM organized a panel on the topic of "COVID-19 and brain stimulation labs/studies/researchers across the world: Sharing experiences, difficulties, and best practices" during the NYC Neuromodulation 2020 conference. The panel was chaired by Hamed Ekhtiari and Marom Bikson and included twelve speakers from different countries.

The panel discussed the impact of the COVID-19 pandemic on brain stimulation labs, studies, and researchers around the world. They identified the challenges posed by the pandemic, such as disruptions to research activities, the need for remote data collection, and the impact on funding and collaborations.

The panel also discussed the best practices that could help researchers navigate these challenges, such as using remote data collection methods, adapting study designs, and collaborating with other labs to share resources and expertise.

Following the panel, the chairs and several colleagues collaborated on a document outlining the best practices discussed during the panel. The resulting guideline is a 68-page document authored by 42 experts and was published in Brain Stimulation. The guideline provides practical recommendations for researchers on how to conduct brain stimulation research during the pandemic, while also addressing the ethical and safety considerations that arise during this time., Here, you can find the published paper.

INTAM also had a fruitful collaboration with the International Network of tES fMRI (INTF) and published a comprehensive checklist to guide researchers in running concurrent tES-fMRI trials. This collaboration represents INTAM's commitment to collaborating with other networks and organizations to advance the field of non-invasive brain stimulation for substance use disorders.

The checklist titled "A checklist for assessing the methodological quality of concurrent tES-fMRI studies (ContES checklist): a consensus study and statement" published in the journal of Nature Protocols in 2021 presents a consensus-based checklist for evaluating the methodological quality of concurrent transcranial electrical stimulation-functional magnetic resonance imaging (tES-fMRI) studies. The checklist includes ten items covering various aspects of study design, execution, and reporting, and is intended to improve the rigor and transparency of tES-fMRI research. The authors emphasize the importance of using the ContES checklist to enhance the credibility and reproducibility of tES-fMRI findings and suggest its adoption as a standard tool for peer reviewers and researchers in the field.

Here, you can find the published paper.