Transcranial Magnetic Stimulation as an Interventional Tool for Addiction

Steele, Vaughn R.

doi:10.3389/fnins.2020.592343

Cited by 10 publications

(7 citation statements)

References 33 publications

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“…These preferences may align more with newer alternative treatments that include various forms of neuromodulation. Two types of non-invasive neuromodulation to investigate in athletes with addiction include transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) [ 45 , 47 ]. TMS is a brain stimulation technique targeting the dorsolateral prefrontal cortex (DLPFC) where a metal coil is positioned against the scalp to generate rapidly alternating magnetic fields that then pass through the skull and depolarize neurons in the particular area.…”

Section: Where Do We Go From Here?mentioning

confidence: 99%

Substance Use and Addiction in Athletes: The Case for Neuromodulation and Beyond

Dougherty

Baron

2022

IJERPH

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Substance use, misuse and use disorders continue to be major problems in society as a whole and athletes are certainly not exempt. Substance use has surrounded sports since ancient times and the pressures associated with competition sometimes can increase the likelihood of use and subsequent misuse. The addiction field as a whole has very few answers to how to prevent and secondarily treat substance use disorders and the treatments overall do not necessarily agree with the role of being an athlete. With concerns for side effects that may affect performance coupled with organizational rules and high rates of recidivism in the general population, newer treatments must be investigated. Prevention strategies must continue to be improved and more systems need to be in place to find and treat any underlying causes leading to these behaviors. This review attempts to highlight some of the data regarding the field of substance misuse and addiction in the athletic population as well as explore possible future directions for treatment including Neuromodulation methods and Ketamine. There is a need for more rigorous, high-quality studies to look at addiction as a whole and in particular how to approach this vulnerable subset of the population.

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Section: Where Do We Go From Here?mentioning

confidence: 99%

Substance Use and Addiction in Athletes: The Case for Neuromodulation and Beyond

Dougherty

Baron

2022

IJERPH

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“…SUDs have been linked to abnormal function in brain networks related to reward, stress, and self-control ( Koob and Volkow, 2016 ; Uhl et al, 2019 ; Ceceli et al, 2022 ). As highlighted in several prominent review articles non-invasive brain stimulation has shown promise as an intervention for addiction ( Feil and Zangen, 2010 ; Gorelick et al, 2014 ; Yavari et al, 2016 ; Dunlop et al, 2017 ; Coles et al, 2018 ; Hanlon et al, 2018 ; Ekhtiari et al, 2019 ; Steele, 2020a , b ). As such, there is substantial interest in using TMS to probe function in brain regions thought to underly facets of SUD, but challenges exist.…”

Section: Introductionmentioning

confidence: 99%

Combining noninvasive brain stimulation with behavioral pharmacology methods to study mechanisms of substance use disorder

Wesley

Lile

2023

Front. Neurosci.

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Psychotropic drugs and transcranial magnetic stimulation (TMS) are effective for treating certain psychiatric conditions. Drugs and TMS have also been used as tools to explore the relationship between brain function and behavior in humans. Combining centrally acting drugs and TMS has proven useful for characterizing the neural basis of movement. This combined intervention approach also holds promise for improving our understanding of the mechanisms underlying disordered behavior associated with psychiatric conditions, including addiction, though challenges exist. For example, altered neocortical function has been implicated in substance use disorder, but the relationship between acute neuromodulation of neocortex with TMS and direct effects on addiction-related behaviors is not well established. We propose that the combination of human behavioral pharmacology methods with TMS can be leveraged to help establish these links. This perspective article describes an ongoing study that combines the administration of delta-9-tetrahydrocannabinol (THC), the main psychoactive compound in cannabis, with neuroimaging-guided TMS in individuals with problematic cannabis use. The study examines the impact of the left dorsolateral prefrontal cortex (DLPFC) stimulation on cognitive outcomes impacted by THC intoxication, including the subjective response to THC and the impairing effects of THC on behavioral performance. A framework for integrating TMS with human behavioral pharmacology methods, along with key details of the study design, are presented. We also discuss challenges, alternatives, and future directions.

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“…Noninvasive brain stimulation interventions, such as repetitive transcranial magnetic stimulation (rTMS), are increasingly used to target dysregulated brain reward circuitry in individuals who have substance use disorders (SUDs) and in those who are prone to overeating [14,[38][39][40][41][42][43][44]. rTMS exerts its neuromodulatory influence via electromagnetic coils that generate repetitive magnetic impulses to induce small electrical currents within a focal area in the superficial brain tissue below the scalp directly under the rTMS coil [43].…”

Section: Introductionmentioning

confidence: 99%

Transcranial Magnetic Stimulation for Reducing the Relative Reinforcing Value of Food in Adult Patients With Obesity Pursuing Metabolic and Bariatric Surgery: Protocol for a Pilot, Within-Participants, Sham-Controlled Trial

Bond,

Papasavas,

Raynor

et al. 2023

JMIR Res Protoc

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Background Metabolic and bariatric surgery (MBS) is the most effective and durable obesity treatment. However, there is heterogeneity in weight outcomes, which is partially attributed to variability in appetite and eating regulation. Patients with a strong desire to eat in response to the reward of palatable foods are more likely to overeat and experience suboptimal outcomes. This subgroup, classified as at risk, may benefit from repetitive transcranial magnetic stimulation (rTMS), a noninvasive brain stimulation technique that shows promise for reducing cravings and consumption of addictive drugs and food; no study has evaluated how rTMS affects the reinforcing value of food and brain reward processing in the context of MBS. Objective The goal of the Transcranial Magnetic Stimulation to Reduce the Relative Reinforcing Value of Food (RESTRAIN) study is to perform an initial rTMS test on the relative reinforcing value (RRV) of food (the reinforcing value of palatable food compared with money) among adult patients who are pursuing MBS and report high food reinforcement. Using a within-participants sham-controlled crossover design, we will compare the active and sham rTMS conditions on pre- to posttest changes in the RRV of food (primary objective) and the neural modulation of reward, measured via electroencephalography (EEG; secondary objective). We hypothesize that participants will show larger decreases in food reinforcement and increases in brain reward processing after active versus sham rTMS. Methods Participants (n=10) will attend 2 study sessions separated by a washout period. They will be randomized to active rTMS on 1 day and sham rTMS on the other day using a counterbalanced schedule. For both sessions, participants will arrive fasted in the morning and consume a standardized breakfast before being assessed on the RRV of food and reward tasks via EEG before and after rTMS of the left dorsolateral prefrontal cortex. Results Recruitment and data collection began in December 2022. As of October 2023, overall, 52 patients have been screened; 36 (69%) screened eligible, and 17 (47%) were enrolled. Of these 17 patients, 3 (18%) were excluded before rTMS, 5 (29%) withdrew, 4 (24%) are in the process of completing the protocol, and 5 (29%) completed the protocol. Conclusions The RESTRAIN study is the first to test whether rTMS can target neural reward circuits to reduce behavioral (RRV) and neural (EEG) measures of food reward in patients who are pursuing MBS. If successful, the results would provide a rationale for a fully powered trial to examine whether rTMS-related changes in food reinforcement translate into healthier eating patterns and improved MBS outcomes. If the results do not support our hypotheses, we will continue this line of research to evaluate whether additional rTMS sessions and pulses as well as different stimulation locations produce clinically meaningful changes in food reinforcement. Trial Registration ClinicalTrials.gov NCT05522803; https://clinicaltrials.gov/study/NCT05522803 International Registered Report Identifier (IRRID) DERR1-10.2196/50714

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Transcranial Magnetic Stimulation as an Interventional Tool for Addiction

Cited by 10 publications

References 33 publications

Substance Use and Addiction in Athletes: The Case for Neuromodulation and Beyond

Substance Use and Addiction in Athletes: The Case for Neuromodulation and Beyond

Combining noninvasive brain stimulation with behavioral pharmacology methods to study mechanisms of substance use disorder

Transcranial Magnetic Stimulation for Reducing the Relative Reinforcing Value of Food in Adult Patients With Obesity Pursuing Metabolic and Bariatric Surgery: Protocol for a Pilot, Within-Participants, Sham-Controlled Trial

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