Elevated ad libitum alcohol consumption following continuous theta burst stimulation to the left-dorsolateral prefrontal cortex is partially mediated by changes in craving

Abstract

Previous research indicates that following alcohol intoxication, activity in prefrontal cortices is reduced, linking to changes in associated cognitive processes, such as inhibitory control, attentional bias (AB), and craving. While these changes have been implicated in alcohol consumption behaviour, it has yet to be fully illuminated how these frontal regions and cognitive processes interact to govern alcohol consumption behaviour. The current preregistered study applied continuous theta burst transcranial magnetic stimulation (cTBS) to examine directly these relationships while removing the wider pharmacological effects of alcohol. A mixed design was implemented, with cTBS stimulation to right and left dorsolateral prefrontal cortex (DLPFC), the medial orbital frontal cortex (mOFC) and Vertex, with measures of inhibitory control, AB, and craving taken both pre- and post-stimulation. Ad libitum consumption was measured using a bogus taste task. Results suggest that rDLPFC stimulation impaired inhibitory control but did not significantly increase ad libitum consumption. However, lDLPFC stimulation heightened craving and increased consumption, with findings indicating that changes in craving partially mediated the relationship between cTBS stimulation of prefrontal regions and ad libitum consumption. Medial OFC stimulation and AB findings were inconclusive. Overall, results implicate the left DLPFC in the regulation of craving, which appears to be a prepotent cognitive mechanism by which alcohol consumption is driven and maintained.

The ad-libitum taste test as measure of momentary alcohol use in the laboratory: an investigation of construct validity and confounding factors

“…The taste ratings are intended to conceal the genuine purpose of the taste test, which is to assess the amount of alcohol consumed during the test session (Jones et al 2016 ). The taste test has been used to investigate a number of potential influences on alcohol consumption, including alcohol cues (Colby et al 2004 ; Jones et al 2013 ; Van Dyke and Fillmore 2015 ), impulse control (Jones et al 2011 ; Christiansen et al 2012 ), stress (Thomas et al 2011 ; Bacon and Thomas 2013 ; McGrath et al 2016 ), coping motives (Thomas et al 2014 ), and social influences (Quigley and Collins 1999 ), and it has been used to establish initial proof of concept for novel interventions (Field and Eastwood 2005 ; Bowley et al 2013 ; McNeill et al 2022 ).…”