Medial Prefrontal Cortex Theta Burst Stimulation Improves Treatment Outcomes in Alcohol Use Disorder: A Double-Blind, Sham-Controlled Neuroimaging Study

McCalley, Daniel M.; Kaur, Navneet; Wolf, Julia P; Contreras, Ingrid E.; Book, Sarah W.; Smith, Joshua P.; Hanlon, Colleen A.

doi:10.1016/j.bpsgos.2022.03.002

Cited by 20 publications

(23 citation statements)

References 56 publications

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“…New therapeutic modalities, such as non-invasive applications of brain stimulation, like transcranial magnetic stimulation (TMS) are already being investigated in humans to treat AUD. Current approaches for TMS aimed at treating AUD have provided mixed results ( Perini et al, 2020 ; McCalley et al, 2022 ; Tang et al, 2021 ). The anatomical location of the anterior parts of the insular cortex in humans are also easily accessible by non-invasive approaches and targeted therapies to this brain region may help advance new non-abstinence-based therapeutic approaches to aid those individuals’ seeking treatment for AUD ( Ekhtiari et al, 2019 ).…”

Section: Resultsmentioning

confidence: 99%

The role of anterior insular cortex inputs to dorsolateral striatum in binge alcohol drinking

Haggerty

Muñoz

Pennington

et al. 2022

eLife

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How does binge drinking alcohol change synaptic function, and do these changes maintain binge consumption? The anterior insular cortex (AIC) and dorsolateral striatum (DLS) are brain regions implicated in alcohol use disorder. In male, but not female mice, we found that binge drinking alcohol produced glutamatergic synaptic adaptations selective to AIC inputs within the DLS. Photoexciting AIC→DLS circuitry in male mice during binge drinking decreased alcohol, but not water consumption and altered alcohol drinking mechanics. Further, drinking mechanics alone from drinking session data predicted alcohol-related circuit changes. AIC→DLS manipulation did not alter operant, valence, or anxiety-related behaviors. These findings suggest that alcohol-mediated changes at AIC inputs govern behavioral sequences that maintain binge drinking and may serve as a circuit-based biomarker for the development of alcohol use disorder.

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Section: Resultsmentioning

confidence: 99%

The role of anterior insular cortex inputs to dorsolateral striatum in binge alcohol drinking

Haggerty

Muñoz

Pennington

et al. 2022

eLife

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“…Crucially, rTMS protocols can be preferentially used as a priming (before the task) or as a consolidator (after the task) [ 122 ] due to the noise and somatosensory discomfort elicited during stimulation. Therefore, several authors addressed this point by administering cue-inducing tasks or stimuli as a primer to activate and engage the brain network and then delivering stimulation (typically through inhibitory protocols) [ 167 , 168 ]. Conversely, tDCS is easier to combine with concurrent treatments, as was performed in one of the works included in the present systematic review [ 98 ].…”

Section: Discussionmentioning

confidence: 99%

Betting on Non-Invasive Brain Stimulation to Treat Gambling Disorder: A Systematic Review and Meta-Analysis

et al. 2023

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Gambling disorder (GD) is a behavioral addiction that severely impacts individuals’ functioning, leading to high socioeconomic costs. Non-invasive brain stimulation (NiBS) has received attention for treating psychiatric and neurological conditions in recent decades, but there is no recommendation for its use for GD. Therefore, this study aimed to systematically review and analyze the available literature to determine the effectiveness of NiBS in treating GD. Following the PRISMA guidelines, we screened four electronic databases up to July 2022 and selected relevant English-written original articles. We included ten papers in the systematic review and seven in the meta-analysis. As only two studies employed a sham-controlled design, the pre–post standardized mean change (SMCC) was computed as effect size only for real stimulation. The results showed a significant effect of NiBS in reducing craving scores (SMCC = −0.69; 95% CI = [−1.2, −0.2], p = 0.010). Moreover, considering the GD’s frequent comorbidity with mood disorders, we ran an exploratory analysis of the effects of NiBS on depressive symptoms, which showed significant decreases in post-treatment scores (SMCC = −0.71; 95% CI = [−1.1, −0.3], p < 0.001). These results provide initial evidence for developing NiBS as a feasible therapy for GD symptoms but further comprehensive research is needed to validate these findings. The limitations of the available literature are critically discussed.

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“…(a) Fixed Fp2 approach: in the first set of simulations, EEG 10-10 system Fp2 electrode was selected to target the right frontopolar with fixed standard orientation (y direction toward AF8) across the population in a one-size-fits-all manner (inspired by [27], [50]), (b) Fixed Fp1 approach: in the second set of simulations, EEG 10-10 system Fp1 electrode was selected to target the left frontopolar with fixed standard orientation (y direction towards AF7) across the population in a one-size-fits-all manner (inspired by [16], [18], [19]). These two approaches were commonly used for targeting the frontopolar area in previous TMS studies for SUDs [16], [18], [18], [24], [51]. (c) Optimized approach: optimization was performed at three levels: (1) location, (2) orientation, and (3) intensity.…”

Section: Construction Of Head Modelsmentioning

confidence: 99%

Optimizing Individual Targeting of Fronto-Amygdala Network with Transcranial Magnetic Stimulation (TMS): Biophysical, Physiological and Behavioral Variations in People with Methamphetamine Use Disorder

Soleimani

Conelea

Kuplicki

et al. 2023

Preprint

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Background: Prior research on drug addiction has linked the frontopolar cortex and amygdala coupling to drug cue reactivity/craving. However, one-size-fits-all approaches for transcranial magnetic stimulation (TMS) over frontopolar-amygdala have led to inconsistent results. Objective: Here, we (1) defined individualized TMS target location based on functional connectivity of the amygdala-frontopolar circuit while people were exposed to drug-related cues, (2) optimized coil orientation for maximum electric field (EF) perpendicular to the individualized target, and (3) harmonized EF strength in targeted brain regions across a population. Method: MRI data were collected from 60 participants with methamphetamine use disorders (MUDs). and examined the variability in TMS target location based on task-based connectivity between the frontopolar cortex and amygdala. using psychophysiological interaction (PPI) analysis. EF simulations were calculated for fixed vs. optimized coil location (Fp1/Fp2 vs. individualized maximal PPI), orientation (AF7/AF8 vs. optimization algorithm), and stimulation intensity (constant vs. adjusted intensity across the population). Results: Left medial amygdala with the highest (0.31 +- 0.29) fMRI drug cue reactivity was selected as the subcortical seed region. The location of the voxel with the most positive amygdala-frontopolar PPI connectivity in each participant was considered as the individualized TMS target (MNI coordinates: [12.6,64.23,-0.8] +- [13.64,3.50,11.01]). Individualized frontopolar-amygdala connectivity showed a significant correlation with VAS craving scores after cue exposure (R=0.27, p=0.03). Averaged EF strength in a sphere with r=5mm around the individualized target location was significantly higher in the optimized (0.99 +- 0.21V/m) compared to the fixed approach (Fp1:0.56 +- 0.22V/m, Fp2:0.78 +- 0.25V/m) with large effect sizes (Fp1:p=1.1e-13,Hedges g=1.5, Fp2:p=1.7e-5,Hedges g=1.26). Adjustment factor to have identical 1V/m EF strength in a 5mm sphere around the individualized targets ranged from 0.72-to-2.3 (1.07 +- 0.29). Conclusion: Our results show that optimizing coil orientation and stimulation intensity based on individualized TMS targets led to stronger harmonized electric fields in the targeted brain regions compared to a one-size-fits-all method that hopefully helps to refine future TMS therapy for MUDs.

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Medial Prefrontal Cortex Theta Burst Stimulation Improves Treatment Outcomes in Alcohol Use Disorder: A Double-Blind, Sham-Controlled Neuroimaging Study

Cited by 20 publications

References 56 publications

The role of anterior insular cortex inputs to dorsolateral striatum in binge alcohol drinking

The role of anterior insular cortex inputs to dorsolateral striatum in binge alcohol drinking

Betting on Non-Invasive Brain Stimulation to Treat Gambling Disorder: A Systematic Review and Meta-Analysis

Optimizing Individual Targeting of Fronto-Amygdala Network with Transcranial Magnetic Stimulation (TMS): Biophysical, Physiological and Behavioral Variations in People with Methamphetamine Use Disorder

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