Repetitive transcranial magnetic stimulation in alcohol dependence

• Verfasst von: Harel, Maayan [VerfasserIn]
• Verfasst von: Perini, Irene [VerfasserIn]
• Verfasst von: Kämpe, Robin [VerfasserIn]
• Verfasst von: Alyagon, Uri [VerfasserIn]
• Verfasst von: Shalev, Hadar [VerfasserIn]
• Verfasst von: Besser, Itay [VerfasserIn]
• Verfasst von: Sommer, Wolfgang H. [VerfasserIn]
• Verfasst von: Heilig, Markus [VerfasserIn]
• Verfasst von: Zangen, Abraham [VerfasserIn]
• Titel: Repetitive transcranial magnetic stimulation in alcohol dependence
• Titelzusatz: a randomized, double-blind, sham-controlled proof-of-concept trial targeting the medial prefrontal and anterior cingulate cortices : archival report
• Verf.angabe: Maayan Harel, Irene Perini, Robin Kämpe, Uri Alyagon, Hadar Shalev, Itay Besser, Wolfgang H. Sommer, Markus Heilig, and Abraham Zangen
• E-Jahr: 2022
• Jahr: 15 June 2022
• Umfang: 9 S.
• Illustrationen: Illustrationen, graphische Darstellungen
• Fussnoten: Online verfügbar: 6 December 2021, Artikelversion: 30 May 2022 ; Gesehen am 23.01.2024
• Titel Quelle: Enthalten in: Biological psychiatry
• Ort Quelle: Amsterdam [u.a.] : Elsevier Science, 1985
• Jahr Quelle: 2022
• Band/Heft Quelle: 91(2022), 12 vom: Juni, Seite 1061-1069
• ISSN Quelle: 1873-2402
• DOI: doi:10.1016/j.biopsych.2021.11.020
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: ACC
• Sach-SW: Alcohol use disorder
• Sach-SW: Deep rTMS
• Sach-SW: fMRI
• Sach-SW: H7 coil
• Sach-SW: mPFC
• K10plus-PPN: 1878671839

Abstract

Background - Alcohol addiction is associated with a high disease burden, and treatment options are limited. In a proof-of-concept study, we used deep repetitive transcranial magnetic stimulation (dTMS) to target circuitry associated with the pathophysiology of alcohol addiction. We evaluated clinical outcomes and explored associated neural signatures using functional magnetic resonance imaging. - Methods - This was a double-blind, randomized, sham-controlled trial. A total of 51 recently abstinent treatment-seeking patients with alcohol use disorder (moderate to severe) were randomized to sham or active dTMS, using an H7 coil targeting midline frontocortical areas, including the medial prefrontal and anterior cingulate cortices. Treatment included 15 sessions over 3 weeks, followed by five sessions over 3 months of follow-up. Each session delivered 100 trains of 30 pulses at 10 Hz. The primary predefined outcome was reduction in percentage of heavy drinking days, obtained using timeline follow-back interviews. Secondary analyses included self-reports of craving, ethyl glucuronide in urine, and brain imaging measures. - Results - Both craving after treatment and percentage of heavy drinking days during follow-up were significantly lower in the active versus sham control group (percentage of heavy drinking days = 2.9 ± 0.8% vs. 10.6 ± 1.9%, p = .037). Active dTMS was associated with decreased resting-state functional connectivity of the dorsal anterior cingulate cortex with the caudate nucleus and decreased connectivity of the medial prefrontal cortex to the subgenual anterior cingulate cortex. - Conclusions - We provide initial proof-of-concept for dTMS targeting midline frontocortical structures as a treatment for alcohol addiction. These data strongly support a rationale for a full-scale confirmatory multicenter trial. Therapeutic benefits of dTMS appear to be associated with persistent changes in brain network activity.