Closed-loop TMS for the Core Clinical Features of Methamphetamine Use Disorder

The goal of this clinical trial is to evaluate whether closed-loop transcranial magnetic stimulation (TMS) targeting left-dorsolateral prefrontal cortex (l-DLPFC) can improve core clinical symptoms in individuals with methamphetamine use disorder (MUD), such as cue-reactivity and impaired inhibitory control. The main questions it aims to answer are: Can closed-loop TMS targeting l-DLPFC significantly reduce cue-reactivity, as measured by a Visual Analog Scale (VAS) and cue-reactivity task, compared to a conventional treatment protocol and random TMS ? Does closed-loop stimulation targeting l-DLPFC enhance cognitive control, assessed by performance on the Stop Signal Task (SST), more effectively than the other stimulation modes? Researchers will compare closed-loop, conventional, and random TMS conditions targeting l-DLPFC to determine whether closed-loop yields superior symptom improvement. Participants will: Be randomly assigned to one of the three stimulation groups (closed-loop, conventional and random) according to a pre-generated random number table, and receive the corresponding stimulation session targeting l-DLPFC. Undergo cue-reactivity assessment using VAS and cue-reactivity task, and complete the SST before and after each stimulation session.

Inclusion Criteria: * Aged 18 years old or older, with at least 9 years of education (junior high school or above) or able to fully understand the task. * Meets Meets Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) for mild/severe amphetamine-type substance use disorder. * History of amphetamine-type substance use for no less than 1 year, with use at least once per week. Exclusion Criteria: * Presence of any organic disease, or diagnosis of any other psychiatric disorder according to DSM-5 (e.g., bipolar disorder, major depression disorder). * Contraindications to TMS, as assessed by the Transcranial Magnetic Stimulation Adult Safety Screen (TASS). * Inability to complete assessments, treatment procedures, or follow-up due to cognitive or behavioral limitations.