Background: Repetitive transcranial magnetic stimulation (rTMS) can noninvasively stimulate the brain and transiently amplify or block behaviors mediated through a region. We hypothesized that a single high-frequency rTMS session over the left dorsolateral prefrontal cortex (DLPFC) would reduce cue craving for cigarettes compared with a sham TMS session.
Methods: Sixteen non-treatment-seeking, nicotine-dependent participants were randomized to receive either real high-frequency rTMS (10 Hz, 100% resting motor threshold, 5-sec on, 10-sec off for 15 min; 3000 pulses) or active sham (eSham) TMS over the DLPFC in two visits with 1 week between visits. The participants received cue exposure before and after rTMS and rated their craving after each block of cue presentation.
Results: Stimulation of the left DLFPC with real, but not sham, rTMS reduced craving significantly from baseline (64.1±5.9 vs. 45.7±6.4, t = 2.69, p = .018). When compared with neutral cue craving, the effect of real TMS on cue craving was significantly greater than the effect of sham TMS (12.5±10.4 vs. -9.1±10.4; t = 2.07, p = .049). More decreases in subjective craving induced by TMS correlated positively with higher Fagerström Test for Nicotine Dependence score (r = .58, p = .031) and more cigarettes smoked per day (r = .57, p = .035).
Conclusions: One session of high-frequency rTMS (10 Hz) of the left DLPFC significantly reduced subjective craving induced by smoking cues in nicotine-dependent participants. Additional studies are needed to explore rTMS as an aid to smoking cessation.
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http://dx.doi.org/10.1016/j.biopsych.2013.01.003 | DOI Listing |
Substance use disorders (SUDs) are a significant public health concern, with over 30% failing available treatment. Severe SUD is characterized by drug-cue reactivity that predicts treatment-failure. We leveraged this pathophysiological feature to personalize deep brain stimulation (DBS) of the nucleus accumbens region (NAc) in an SUD patient.
View Article and Find Full Text PDFBiol Psychiatry
January 2025
Department of Neuroscience, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, USA; Department of Behavioral Medicine and Psychiatry, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, USA. Electronic address:
Background: Opioid use disorder remains a critical healthcare challenge as current therapeutic strategies have limitations resulting in high recurrence and deaths. We evaluated safety and feasibility of focused ultrasound (FUS) neuromodulation to reduce substance cravings and use in severe opioid- and co-occurring substance use disorders.
Methods: This prospective, open-label, single-arm study enrolled 8 participants with severe, primary opioid use disorder with co-occurring substance use.
Addict Biol
January 2025
Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, Minnesota, USA.
The ventromedial prefrontal cortex (VMPFC), located along the medial aspect of the frontal area, plays a critical role in regulating arousal/emotions. Its intricate connections with subcortical structures, including the striatum and amygdala, highlight the VMPFC's importance in the neurocircuitry of addiction. Due to these features, the VMPFC is considered a promising target for transcranial magnetic stimulation (TMS) in substance use disorders (SUD).
View Article and Find Full Text PDFAlcohol Clin Exp Res (Hoboken)
January 2025
Department of Psychiatry, The Yale Stress Center, Yale University School of Medicine, New Haven, Connecticut, USA.
Background: Chronic alcohol consumption in alcohol use disorder (AUD) is associated with autonomic nervous system dysregulation, increasing cardiovascular risk, and high alcohol cravings. Heart rate variability (HRV), a marker of autonomic nervous system responsiveness to stressors, may mediate alcohol's impact on the cardiovascular system. While pregnenolone (PREG) has been shown to normalize heart rate and blood pressure in individuals with AUD, its effects on sympathetic and parasympathetic components of HRV and related alcohol craving are not known.
View Article and Find Full Text PDFExp Clin Psychopharmacol
January 2025
Substance Use and Concurrent Disorders Program, Royal Ottawa Mental Health Centre.
The role of craving in opioid use disorder (OUD) has been well established with respect to heroin but less so with prescription opioids. This pilot study, conducted in 18 treatment-seeking patients with prescription OUD and 18 healthy volunteers, assessed spontaneous (in the moment) and cue-induced craving and their relationship to depression and anxiety. Patients (vs.
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