Transcranial Magnetic Stimulation Treatment for Smoking Cessation: An Introduction for Primary Care Clinicians

Young, Jonathan R.; Galla, Jeffrey T.; Appelbaum, Lawrence G.

doi:10.1016/j.amjmed.2021.06.037

Cited by 11 publications

(8 citation statements)

References 21 publications

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“…Brain stimulation is currently viewed as a promising therapy for smoking cessation [81,82] and studies targeting the insula have demonstrated mixed success in affecting smoking-related variables, such as craving and withdrawal [13,16]. TMS has received clearance by the U.S. Food and Drug Administration for smoking cessation [83], and while several studies have shown encouraging results, including one indicating that high-frequency deep TMS to the insula and prefrontal cortex reduces nicotine dependence [84], others have shown weak or no effects [13,45]. By highlighting the relevance of insular subregional RSFC patterns, which are weaker in strength in those who have greater nicotine dependence, this work provides additional relevant targets for future stimulation studies.…”

Section: Discussionmentioning

confidence: 99%

Nicotine dependence and insula subregions: functional connectivity and cue-induced activation

Ghahremani

Pochon

Diaz

et al. 2023

Neuropsychopharmacol.

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Nicotine dependence is a major predictor of relapse in people with Tobacco Use Disorder (TUD). Accordingly, therapies that reduce nicotine dependence may promote sustained abstinence from smoking. The insular cortex has been identified as a promising target in brain-based therapies for TUD, and has three major sub-regions (ventral anterior, dorsal anterior, and posterior) that serve distinct functional networks. How these subregions and associated networks contribute to nicotine dependence is not well understood, and therefore was the focus of this study. Sixty individuals (28 women; 18–45 years old), who smoked cigarettes daily, rated their level of nicotine dependence (on the Fagerström Test for Nicotine Dependence) and, after abstaining from smoking overnight (~12 h), underwent functional magnetic resonance imaging (fMRI) in a resting state. A subset of these participants (N = 48) also completing a cue-induced craving task during fMRI. Correlations between nicotine dependence and resting-state functional connectivity (RSFC) and cue-induced activation of the major insular sub-regions were evaluated. Nicotine dependence was negatively correlated with connectivity of the left and right dorsal, and left ventral anterior insula with regions within the superior parietal lobule (SPL), including the left precuneus. No relationship between posterior insula connectivity and nicotine dependence was found. Cue-induced activation in the left dorsal anterior insula was positively associated with nicotine dependence and negatively associated with RSFC of the same region with SPL, suggesting that craving-related responsivity in this subregion was greater among participants who were more dependent. These results may inform therapeutic approaches, such as brain stimulation, which may elicit differential clinical outcomes (e.g., dependence, craving) depending on the insular subnetwork that is targeted.

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Section: Discussionmentioning

confidence: 99%

Nicotine dependence and insula subregions: functional connectivity and cue-induced activation

Ghahremani

Pochon

Diaz

et al. 2023

Neuropsychopharmacol.

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“…Extensive research supports the clinical efficacy of TMS for psychiatric disorders, most commonly for major depressive disorder (MDD), after FDA approval in 2008 ( 81 ). Since 2008, TMS has received FDA clearance for the obsessive-compulsive disorder (OCD) and smoking cessation ( 87 , 88 ). Researchers have aimed to expand TMS indications for comorbidities associated with MDD, such as OCD, bipolar disorder, PTSD, and substance use disorder ( 83 , 84 ).…”

Section: Research Gaps: Advancing Treatment For Audmentioning

confidence: 99%

Targeting the Salience Network: A Mini-Review on a Novel Neuromodulation Approach for Treating Alcohol Use Disorder

et al. 2022

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Alcohol use disorder (AUD) continues to be challenging to treat despite the best available interventions, with two-thirds of individuals going on to relapse by 1 year after treatment. Recent advances in the brain-based conceptual framework of addiction have allowed the field to pivot into a neuromodulation approach to intervention for these devastative disorders. Small trials of repetitive transcranial magnetic stimulation (rTMS) have used protocols developed for other psychiatric conditions and applied them to those with addiction with modest efficacy. Recent evidence suggests that a TMS approach focused on modulating the salience network (SN), a circuit at the crossroads of large-scale networks associated with AUD, may be a fruitful therapeutic strategy. The anterior insula or dorsal anterior cingulate cortex may be particularly effective stimulation sites given emerging evidence of their roles in processes associated with relapse.

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“…Generally, dTMS follows the same parameters as rTMS, with the difference being that dTMS is less precise in hitting its target. The FDA recently approved dTMS in conjunction with symptom provocation as a treatment for OCD in 2018 ( Roth et al, 2021 ) and for smoking cessation in 2020 ( Young et al, 2021 ). DTMS has also been employed in the treatment of PTSD ( Isserles et al, 2021 ) and has evidence of successful use in interventions to target both cortical and subcortical structures ( Beynel et al, 2021 ; Roth et al, 2021 ).…”

Section: Neuroscience-informed Interventions: Brain Stimulationmentioning

confidence: 99%

The neurobiology of misophonia and implications for novel, neuroscience-driven interventions

et al. 2022

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Decreased tolerance in response to specific every-day sounds (misophonia) is a serious, debilitating disorder that is gaining rapid recognition within the mental health community. Emerging research findings suggest that misophonia may have a unique neural signature. Specifically, when examining responses to misophonic trigger sounds, differences emerge at a physiological and neural level from potentially overlapping psychopathologies. While these findings are preliminary and in need of replication, they support the hypothesis that misophonia is a unique disorder. In this theoretical paper, we begin by reviewing the candidate networks that may be at play in this complex disorder (e.g., regulatory, sensory, and auditory). We then summarize current neuroimaging findings in misophonia and present areas of overlap and divergence from other mental health disorders that are hypothesized to co-occur with misophonia (e.g., obsessive compulsive disorder). Future studies needed to further our understanding of the neuroscience of misophonia will also be discussed. Next, we introduce the potential of neurostimulation as a tool to treat neural dysfunction in misophonia. We describe how neurostimulation research has led to novel interventions in psychiatric disorders, targeting regions that may also be relevant to misophonia. The paper is concluded by presenting several options for how neurostimulation interventions for misophonia could be crafted.

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Transcranial Magnetic Stimulation Treatment for Smoking Cessation: An Introduction for Primary Care Clinicians

Cited by 11 publications

References 21 publications

Nicotine dependence and insula subregions: functional connectivity and cue-induced activation

Nicotine dependence and insula subregions: functional connectivity and cue-induced activation

Targeting the Salience Network: A Mini-Review on a Novel Neuromodulation Approach for Treating Alcohol Use Disorder

The neurobiology of misophonia and implications for novel, neuroscience-driven interventions

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