Repetitive transcranial magnetic stimulation of the dorsolateral prefrontal cortex reduces nicotine cue craving

Xingbao Li, Karen J Hartwell, Max Owens, Todd Lematty, Jeffrey J Borckardt, Colleen A Hanlon, Kathleen T Brady, Mark S George, Xingbao Li, Karen J Hartwell, Max Owens, Todd Lematty, Jeffrey J Borckardt, Colleen A Hanlon, Kathleen T Brady, Mark S George

Abstract

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.

Trial registration: ClinicalTrials.gov NCT01690130.

Conflict of interest statement

Financial disclosures

All other authors report no biomedical financial interests or potential conflicts of interest.

Copyright © 2013 Society of Biological Psychiatry. All rights reserved.

Figures

Figure 1
Figure 1
Diagram showing the stimulation and assessments that were performed during this study
Figure 2
Figure 2
Effects of rTMS of DLPFC on subjective nicotine craving provoked by smoking cue. ((Mean ± SEM) (*n = 14, t = 2.692, p = 0.018)) Note, DLPFC = dorsal lateral prefrontal cortex, Note, * p < 0.05
Figure 3
Figure 3
Comparison of the smoking cue-induced craving rating to the neutral cue-induced craving rating between sham and real rTMS. (Mean ± SEM; Y axis = 100*(smoking cue craving rating – neutral control cue craving rating)/neutral control cue craving rating). Factorial 2 × 2 factorial ANOVA revealed a significant main treatment (sham vs real TMS) effect (F=5.17, df = 1, 52, p = 0.027). Post hoc t-test showed that rTMS of the DLPFC significantly reduced subjectively rated craving difference (smoking cue versus neutral control) (12.5 ±10.4 vs. −9.1±10.4; t = 2.07, df = 28, p = 0.049). Note, * p < 0.05
Figure 4
Figure 4
Association between the rTMS effect of cue craving and level of nicotine dependence. A. Correlation between effects of rTMS and FTND score (n=14, r = 0.575, p = 0.031); B. correlation between effects of rTMS and cigarette-day (n =14, r = 0.566, p = 0.035) Note, FTND = Fagerstrom Test for Nicotine Dependence

Source: PubMed

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