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They exhibited reduced RMT and AMT (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), indicating increased excitability, with no significant differences in MEP-A (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.083). CSP onset latency was prolonged at 150% RMT (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.042), suggesting impaired inhibition. Excitability thresholds correlated negatively with methamphetamine dose, while addiction duration was linked to CSP changes and obsessive-compulsive symptoms. Lower thresholds also correlated with greater interpersonal sensitivity and addiction severity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Increased cortical excitability and decreased inhibitory control are linked to METH usage, and these factors may be underlying psychiatric symptoms. TMS-derived indices show potential as biomarkers for neurophysiological monitoring and targeted interventions in methamphetamine use disorder.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00213-025-06996-4","type":"journal-article","created":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T04:52:55Z","timestamp":1768798375000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Heightened excitability and impaired Inhibition in methamphetamine users: a pilot study of neurophysiological correlates of psychological symptoms"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5679-9833","authenticated-orcid":false,"given":"Eman M.","family":"Khedr","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasser","family":"Elserogy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdelrahman","family":"Goda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Fawzy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,19]]},"reference":[{"key":"6996_CR1","doi-asserted-by":"publisher","first-page":"16","DOI":"10.2466\/03.09.PR0.110.1.16-24","volume":"110","author":"AM Abdel-Khalek","year":"2012","unstructured":"Abdel-Khalek AM (2012) Convergent validity of the Arabic scale of mental health. 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The study was prospectively registered at ClinicalTrials.gov under registration number NCT06066164. The research design adheres to the ethical principles outlined in the Declaration of Helsinki of 1964. Informed written consent was obtained from all patients or their relatives, as well as from the controls, before the commencement of the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval and consent to participate"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}