Two weeks of image-guided left dorsolateral prefrontal cortex repetitive transcranial magnetic stimulation improves smoking cessation: A double-blind, sham-controlled, randomized clinical trial

Brain Stimulation

Karen J. Hartwell¹  Scott Henderson²  Kathleen T. Brady³  Mark S. George⁴  Bashar W. Badran⁵  Xingbao Li⁵ 

[1] Center for Biomedical Imaging, Medical University of South Carolina, Charleston, SC, 29425, USA;Corresponding author. Brain Stimulation Division, Department of Psychiatry, Medical University of South Carolina, 67 President St. 502N, Charleston, SC, 29425, USA.;Ralph H. Johnson VA Medical Center, Charleston, SC, 29401, USA;Center for Biomedical Imaging, Medical University of South Carolina, Charleston, SC, 29425, USA;Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, 29425, USA;

关键词: Addiction;    Nicotine;    Smoking cessation;    Image-guided TMS;    DLPFC;   

DOI  :  

来源: DOAJ

【 摘 要 】

Background: Previous studies have found that repetitive transcranial magnetic stimulation (rTMS) to the left dorsal lateral prefrontal cortex (LDLPFC) transiently reduces smoking craving, decreases cigarette consumption, and increases abstinence rates. Objective: We investigated whether 10 daily MRI-guided rTMS sessions over two weeks to the LDLPFC paired with craving cues could reduce cigarette consumption and induce smoking cessation. Methods: We enrolled 42 treatment-seeking nicotine-dependent smokers (≥10 cigarettes per day) in a randomized, double-blind, sham-controlled trial. Participants received 10 daily sessions over 2 weeks of either active or sham MRI-guided rTMS (10Hz, 3000 pulses each session) to the LDLPFC concurrently with video smoking cues. The primary outcome was a reduction in biochemically confirmed cigarette consumption with a secondary outcome of abstinence on the target quit date. We also recorded cue-induced craving and withdrawal symptoms. Results: Compared to sham (n = 17), participants receiving active rTMS (n = 21) smoked significantly fewer cigarettes per day during the 2-week treatment (mean [SD], 13.73[9.18] vs. 11.06[9.29], P < .005) and at 1-month follow-up (12.78[9.53] vs. 7.93[7.24], P < .001). Active rTMS participants were also more likely to quit by their target quit rate (23.81%vs. 0%, OR 11.67, 90% CL, 0.96–141.32, x2 = 4.66, P = .031). Furthermore, rTMS significantly reduced mean craving throughout the treatments and at follow-up (29.93[13.12] vs. 25.01[14.45], P < .001). Interestingly across the active treatment sample, more lateral coil location was associated with more success in quitting (−43.43[0.40] vs. −41.79[2.24], P < .013). Conclusions: Daily MRI-guided rTMS to the LDLPFC for 10 days reduces cigarette consumption and cued craving for up to one month and also increases the likelihood of smoking cessation. Trial registration: ClinicalTrials.gov identifier: NCT02401672.

【 授权许可】

Unknown