TY - JOUR
T1 - Left frontal pole theta burst stimulation decreases orbitofrontal and insula activity in cocaine users and alcohol users
AU - Hanlon, Colleen A.
AU - Dowdle, Logan T.
AU - Correia, Brittany
AU - Mithoefer, Oliver
AU - Kearney-Ramos, Tonisha
AU - Lench, Daniel
AU - Griffin, Millie
AU - Anton, Raymond F.
AU - George, Mark S.
N1 - Funding Information:
This work was supported by R01DA0036617 (Hanlon), T32DA007288 (McGinty), P50 DA015369 (Kalivas), P50 AA010761 (Becker), K05 AA017435 (Anton). Additional assistance was given by the South Carolina Translational Research Institute UL1 TR000062.
PY - 2017/9/1
Y1 - 2017/9/1
N2 - Background Preclinical research has demonstrated a causal relationship between medial prefrontal cortex activity and cocaine self-administration. As a step towards translating those data to a neural circuit-based intervention for patients, this study sought to determine if continuous theta burst stimulation (cTBS) to the left frontal pole (FP), would attenuate frontal-striatal activity in two substance-dependent populations. Methods Forty-nine substance dependent individuals (25 cocaine, 24 alcohol) completed a single-blind, sham-controlled, crossover study wherein they received 6 trains of real or sham cTBS (110% resting motor threshold, FP1) each visit. Baseline evoked BOLD signal was measured immediately before and after real and sham cTBS (interleaved TMS/BOLD imaging: single pulses to left FP; scalp-to-cortex distance covariate, FWE correction p < 0.05) Results Among cocaine users, real cTBS significantly decreased evoked BOLD signal in the caudate, accumbens, anterior cingulate, orbitofrontal (OFC) and parietal cortex relative to sham cTBS. Among alcohol users, real cTBS significantly decreased evoked BOLD signal in left OFC, insula, and lateral sensorimotor cortex. There was no significant difference between the groups. Conclusions These data suggest that 6 trains of left FP cTBS delivered in a single day decreases TMS-evoked BOLD signal in the OFC and several cortical nodes which regulate salience and are typically activated by drug cues. The reliability of this pattern across cocaine- and alcohol-dependent individuals suggests that cTBS may be an effective tool to dampen neural circuits typically engaged by salient drug cues. Multiday studies are required to determine it this has a sustainable effect on the brain or drug use behavior.
AB - Background Preclinical research has demonstrated a causal relationship between medial prefrontal cortex activity and cocaine self-administration. As a step towards translating those data to a neural circuit-based intervention for patients, this study sought to determine if continuous theta burst stimulation (cTBS) to the left frontal pole (FP), would attenuate frontal-striatal activity in two substance-dependent populations. Methods Forty-nine substance dependent individuals (25 cocaine, 24 alcohol) completed a single-blind, sham-controlled, crossover study wherein they received 6 trains of real or sham cTBS (110% resting motor threshold, FP1) each visit. Baseline evoked BOLD signal was measured immediately before and after real and sham cTBS (interleaved TMS/BOLD imaging: single pulses to left FP; scalp-to-cortex distance covariate, FWE correction p < 0.05) Results Among cocaine users, real cTBS significantly decreased evoked BOLD signal in the caudate, accumbens, anterior cingulate, orbitofrontal (OFC) and parietal cortex relative to sham cTBS. Among alcohol users, real cTBS significantly decreased evoked BOLD signal in left OFC, insula, and lateral sensorimotor cortex. There was no significant difference between the groups. Conclusions These data suggest that 6 trains of left FP cTBS delivered in a single day decreases TMS-evoked BOLD signal in the OFC and several cortical nodes which regulate salience and are typically activated by drug cues. The reliability of this pattern across cocaine- and alcohol-dependent individuals suggests that cTBS may be an effective tool to dampen neural circuits typically engaged by salient drug cues. Multiday studies are required to determine it this has a sustainable effect on the brain or drug use behavior.
KW - Functional MRI
KW - Mesolimbic
KW - Neuromodulation
KW - Orbitofrontal
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U2 - 10.1016/j.drugalcdep.2017.03.039
DO - 10.1016/j.drugalcdep.2017.03.039
M3 - Article
C2 - 28686990
AN - SCOPUS:85030472451
SN - 0376-8716
VL - 178
SP - 310
EP - 317
JO - Drug and alcohol dependence
JF - Drug and alcohol dependence
ER -