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Gay A, Jaussent I, Sigaud T, Billard S, Attal J, Seneque M, Galusca B, Van Den Eynde F, Massoubre C, Courtet P, Guillaume S. A Lack of Clinical Effect of High-frequency rTMS to Dorsolateral Prefrontal Cortex on Bulimic Symptoms: A Randomised, Double-blind Trial. EUROPEAN EATING DISORDERS REVIEW 2016; 24:474-481. [DOI: 10.1002/erv.2475] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 07/12/2016] [Accepted: 08/11/2016] [Indexed: 11/06/2022]
Affiliation(s)
- Aurelia Gay
- University Department of Psychiatry and Addictology, North Hospital; CHU St-Etienne; St Etienne France
- TAPE Laboratory, EA7423; Jean Monnet University; Saint Etienne France
| | | | - Torrance Sigaud
- University Department of Psychiatry and Addictology, North Hospital; CHU St-Etienne; St Etienne France
- TAPE Laboratory, EA7423; Jean Monnet University; Saint Etienne France
| | - Stephane Billard
- University Department of Psychiatry and Addictology, North Hospital; CHU St-Etienne; St Etienne France
| | - Jerome Attal
- Inserm U1061; University of Montpellier; Montpellier France
- University Department of Adult Psychiatry; CHRU Montpellier; Montpellier France
| | - Maude Seneque
- Inserm U1061; University of Montpellier; Montpellier France
- Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital; CHRU Montpellier; Montpellier France
| | - Bogdan Galusca
- TAPE Laboratory, EA7423; Jean Monnet University; Saint Etienne France
| | - Frederique Van Den Eynde
- Eating Disorders Program, Department of Psychiatry, Douglas Hospital; McGill University; Montreal Canada
| | - Catherine Massoubre
- University Department of Psychiatry and Addictology, North Hospital; CHU St-Etienne; St Etienne France
- TAPE Laboratory, EA7423; Jean Monnet University; Saint Etienne France
| | - Philippe Courtet
- Inserm U1061; University of Montpellier; Montpellier France
- Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital; CHRU Montpellier; Montpellier France
| | - Sebastien Guillaume
- Inserm U1061; University of Montpellier; Montpellier France
- Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital; CHRU Montpellier; Montpellier France
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152
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Yang LZ, Yang Z, Zhang X. Non-invasive Brain Stimulation for the Treatment of Nicotine Addiction: Potential and Challenges. Neurosci Bull 2016; 32:550-556. [PMID: 27590484 DOI: 10.1007/s12264-016-0056-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 07/03/2016] [Indexed: 12/19/2022] Open
Abstract
Tobacco consumption is one of the leading causes of preventable death worldwide. However, it is difficult to give up smoking by relying on the help of traditional treatments only. Recent years have witnessed emerging positive evidence that non-invasive brain stimulation (NIBS), such as transcranial magnetic stimulation and transcranial direct-current stimulation, can reduce smoking-related behaviors. Although their potential has been implied by advances in research, several methodological issues restrict the clinical application of NIBS to treating nicotine dependence. In this review, we critically evaluate related studies and give suggestions for future research and applications to meet these challenges.
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Affiliation(s)
- Li-Zhuang Yang
- Chinese Academy of Sciences Key Laboratory of Brain Function and Disease and School of Life Sciences, University of Science and Technology of China, Hefei, 230027, China
| | - Zhiyu Yang
- Chinese Academy of Sciences Key Laboratory of Brain Function and Disease and School of Life Sciences, University of Science and Technology of China, Hefei, 230027, China
| | - Xiaochu Zhang
- Chinese Academy of Sciences Key Laboratory of Brain Function and Disease and School of Life Sciences, University of Science and Technology of China, Hefei, 230027, China. .,School of Humanities and Social Science, University of Science and Technology of China, Hefei, 230027, China. .,Center for Biomedical Engineering, University of Science and Technology of China, Hefei, 230027, China. .,Center of Medical Physics and Technology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, 230031, China.
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153
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Ljubisavljevic M, Maxood K, Bjekic J, Oommen J, Nagelkerke N. Long-Term Effects of Repeated Prefrontal Cortex Transcranial Direct Current Stimulation (tDCS) on Food Craving in Normal and Overweight Young Adults. Brain Stimul 2016; 9:826-833. [PMID: 27498606 DOI: 10.1016/j.brs.2016.07.002] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2015] [Revised: 06/28/2016] [Accepted: 07/09/2016] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND The dorsolateral prefrontal cortex (DLPFC) plays an important role in the regulation of food intake. Several previous studies demonstrated that a single session of transcranial direct current stimulation (tDCS) of the DLPFC reduces food craving and caloric intake. OBJECTIVES We hypothesized that repeated tDCS of the right DLPFC cortex may exert long-term changes in food craving in young, healthy adults and that these changes may differ between normal and overweight subjects. METHODS Thirty healthy individuals who reported frequent food cravings without a prior history of eating disorders were initially recruited. Subjects were randomized into an ACTIVE group who received 5 days of real tDCS (20 minutes, anode right-cathode left montage, 2 mA with current density kept at 0.06 mA/cm2, 1 min ramp-up/ramp-down), and a SHAM group, who received one day of real tDCS, on the first day (same parameters), followed by 4 days of sham tDCS. Food craving intensity was examined by Food Craving Questionnaires State and Trait and Food Craving Inventory before, during, (5-days) and one month (30-days) after tDCS. RESULTS Single session of tDCS significantly reduced the intensity of current food craving (FCQ-S). Five days of active tDCS significantly reduced habitual experiences of food craving (FCQ-T), when compared to baseline pre-stimulation levels. Furthermore, both current (FCQ-S) and habitual craving (FCQ-T) were significantly reduced 30 days after active tDCS, while sham tDCS, i.e. a single tDCS session did not have significant effects. Also, active tDCS significantly decreased craving for fast food and sweets, and to a lesser degree for fat, while it did not have significant effects on craving for carbohydrates (FCI). There were no significant differences between individual FCQ-T subscales (craving dimensions) after 5 or 30 days of either sham or active tDCS. Changes in craving were not significantly associated with the initial weight, or with weight changes 30 days after the stimulation in the subjects. CONCLUSIONS The results confirm earlier findings that single session of tDCS has immediate effects in reducing food craving. They also show that repeated tDCS over the right DLPFC may increase the duration of its effects, which may be present 30 days after the stimulation. These results support further investigation of the use of tDCS in obesity.
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Affiliation(s)
- M Ljubisavljevic
- Department of Physiology, College of Medicine and Health Sciences, UAE University, PO Box 17666, Al Ain, United Arab Emirates.
| | - K Maxood
- Department of Physiology, College of Medicine and Health Sciences, UAE University, PO Box 17666, Al Ain, United Arab Emirates
| | - J Bjekic
- Department of Neurophysiology, Institute for Medical Research, University of Belgrade, PO Box 124, Belgrade, Serbia
| | - J Oommen
- Department of Physiology, College of Medicine and Health Sciences, UAE University, PO Box 17666, Al Ain, United Arab Emirates
| | - N Nagelkerke
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, College of Medicine, Queen Elizabeth Central Hospital, Malawi; Institute of Public Health, College of Medicine and Health Sciences, PO Box 17666, UAE University, Al Ain, United Arab Emirates
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154
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Shariatirad S, Vaziri A, Hassani-Abharian P, Sharifi Fardshad M, Molavi N, Fitzgerald PB. Cumulative and booster effects of tdcs sessions on drug cravings, lapse, and cognitive impairment in methamphetamine use disorder: A case study report. Am J Addict 2016; 25:264-6. [PMID: 27219624 DOI: 10.1111/ajad.12373] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 03/15/2016] [Accepted: 03/15/2016] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Transcranial Direct Current Stimulation (tDCS) is a non-invasive brain stimulation method, which shows promising therapeutic effects in controlling drug cravings. METHODS In this study, we present cumulative and booster effects of tDCS sessions on methamphetamine cravings, lapse, and cognitive impairment in a methamphetamine dependent subject. RESULTS Our study shows cumulative effects of continuous anodal tDCS sessions on right dorsolateral prefrontal cortex (DLPFC) could reduce drug cravings and their consequences. DISCUSSION AND CONCLUSIONS Moreover, booster tDCS treatments might be helpful in controlling psychological stress and drug cravings. (Am J Addict 2016;25:264-266).
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Affiliation(s)
- Schwann Shariatirad
- Students Research Center of International Campus, Tehran University of Medical Sciences, Tehran, Iran.,Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Alaleh Vaziri
- Students Research Center of International Campus, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mona Sharifi Fardshad
- Department of General Psychology, Karaj Branch, Islamic Azad University, Karaj, Iran
| | - Nader Molavi
- Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.,Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Paul B Fitzgerald
- Monash Alfred Psychiatry Research Centre, Monash University Central Clinical School and the Alfred, Melbourne, Australia
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155
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Trojak B, Soudry-Faure A, Abello N, Carpentier M, Jonval L, Allard C, Sabsevari F, Blaise E, Ponavoy E, Bonin B, Meille V, Chauvet-Gelinier JC. Efficacy of transcranial direct current stimulation (tDCS) in reducing consumption in patients with alcohol use disorders: study protocol for a randomized controlled trial. Trials 2016; 17:250. [PMID: 27188795 PMCID: PMC4869375 DOI: 10.1186/s13063-016-1363-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Accepted: 04/24/2016] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Approximately 15 million persons in the European Union and 10 million persons in the USA are alcohol-dependent. The global burden of disease and injury attributable to alcohol is considerable: worldwide, approximately one in 25 deaths in 2004 was caused by alcohol. At the same time, alcohol use disorders remain seriously undertreated. In this context, alternative or adjunctive therapies such as brain stimulation may play a prominent role. The early results of studies using transcranial direct current stimulation found that stimulations delivered to the dorsolateral prefrontal cortex result in a significant reduction of craving and an improvement of the decision-making processes in various additive disorders. We, therefore, hypothesize that transcranial direct current stimulation can lead to a decrease in alcohol consumption in patients suffering from alcohol use disorders. METHODS/DESIGN We report the protocol of a randomized, double-blind, placebo-controlled, parallel-group trial, to evaluate the efficacy of transcranial direct current stimulation on alcohol reduction in patients with an alcohol use disorder. The study will be conducted in 14 centers in France and Monaco. Altogether, 340 subjects over 18 years of age and diagnosed with an alcohol use disorder will be randomized to receive five consecutive twice-daily sessions of either active or placebo transcranial direct current stimulation. One session consists in delivering a current flow continuously (anode F4; cathode F3) twice for 13 minutes, with treatments separated by a rest interval of 20 min. Efficacy will be evaluated using the change from baseline (alcohol consumption during the 4 weeks before randomization) to 24 weeks in the total alcohol consumption and number of heavy drinking days. Secondary outcome measures will include alcohol craving, clinical and biological improvements, and the effects on mood and quality of life, as well as cognitive and safety assessments, and, for smokers, an assessment of the effects of transcranial direct current stimulation on tobacco consumption. DISCUSSION Several studies have reported a beneficial effect of transcranial direct current stimulation on substance use disorders by reducing craving, impulsivity, and risk-taking behavior, and suggest that transcranial direct current stimulation may be a promising treatment in addiction. However, to date, no studies have included sufficiently large samples and sufficient follow-up to confirm the hypothesis. Results from this large randomized controlled trial will give a better overview of the therapeutic potential of transcranial direct current stimulation in alcohol use disorders. TRIAL REGISTRATION Clinical Trials Gov, NCT02505126 (registration date: July 15 2015).
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Affiliation(s)
- Benoit Trojak
- Department of Psychiatry and Addictology, University Hospital of Dijon, 21079, Dijon Cedex, France.
| | - Agnès Soudry-Faure
- Unité de Soutien Méthodologique, DRCI, University Hospital of Dijon, 21079, Dijon Cedex, France
| | - Nicolas Abello
- Direction of Clinical Research, University Hospital of Dijon, 21079, Dijon Cedex, France
| | - Maud Carpentier
- Direction of Clinical Research, University Hospital of Dijon, 21079, Dijon Cedex, France
| | - Lysiane Jonval
- Direction of Clinical Research, University Hospital of Dijon, 21079, Dijon Cedex, France
| | - Coralie Allard
- Department of Psychiatry and Addictology, University Hospital of Dijon, 21079, Dijon Cedex, France.,Direction of Clinical Research, University Hospital of Dijon, 21079, Dijon Cedex, France
| | - Foroogh Sabsevari
- Department of Psychiatry and Addictology, University Hospital of Dijon, 21079, Dijon Cedex, France
| | - Emilie Blaise
- Department of Psychiatry and Addictology, University Hospital of Dijon, 21079, Dijon Cedex, France
| | - Eddy Ponavoy
- Department of Psychiatry and Addictology, University Hospital of Dijon, 21079, Dijon Cedex, France
| | - Bernard Bonin
- Department of Psychiatry and Addictology, University Hospital of Dijon, 21079, Dijon Cedex, France
| | - Vincent Meille
- Department of Psychiatry and Addictology, University Hospital of Dijon, 21079, Dijon Cedex, France
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156
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Nakamura-Palacios EM, Lopes IBC, Souza RA, Klauss J, Batista EK, Conti CL, Moscon JA, de Souza RSM. Ventral medial prefrontal cortex (vmPFC) as a target of the dorsolateral prefrontal modulation by transcranial direct current stimulation (tDCS) in drug addiction. J Neural Transm (Vienna) 2016; 123:1179-94. [DOI: 10.1007/s00702-016-1559-9] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 04/19/2016] [Indexed: 12/25/2022]
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157
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Hall PA. Executive-Control Processes in High-Calorie Food Consumption. CURRENT DIRECTIONS IN PSYCHOLOGICAL SCIENCE 2016. [DOI: 10.1177/0963721415625049] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Human beings have reliable preferences for energy-rich foods; these preferences are present at birth and possibly innate. Relatively recent changes in our day-to-day living context have rendered such foods commonly encountered, nearly effortless to procure, and frequently brought to mind. Theoretical, conceptual, and empirical perspectives from the field of social neuroscience support the hypothesis that the increase in the prevalence of overweight and obesity in first- and second-world countries may be a function of these dynamics coupled with our highly evolved but ultimately imperfect capacities for self-control. This review describes the significance of executive-control systems for explaining the occurrence of nonhomeostatic forms of dietary behavior—that is, those aspects of calorie ingestion that are not for the purpose of replacing calories burned. I focus specifically on experimental findings—including those from cortical-stimulation studies—that collectively support a causal role for executive-control systems in modulating cravings for and consumption of high-calorie foods.
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Affiliation(s)
- Peter A. Hall
- Faculty of Applied Health Sciences, University of Waterloo
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158
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Wietschorke K, Lippold J, Jacob C, Polak T, Herrmann MJ. Transcranial direct current stimulation of the prefrontal cortex reduces cue-reactivity in alcohol-dependent patients. J Neural Transm (Vienna) 2016; 123:1173-8. [PMID: 27038632 DOI: 10.1007/s00702-016-1541-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 03/20/2016] [Indexed: 12/21/2022]
Abstract
Alcohol craving has been shown to be an important factor for relapses in alcohol-dependent patients. Furthermore, brain activity in reward-related areas in response to alcohol-related cues is positively related to the amount of post-relapse alcohol consumption. On the other hand, it has been shown that cue-exposure based extinction training (CET) leads to larger decrease of striatal and left dorsolateral prefrontal cortex (dLPFC) cue-induced activation compared to standard clinical day-care treatment, but the effect sizes are relatively small. The question of this study was, whether it is possible to change cue-reactivity and subjective craving by applying bilateral prefrontal transcranial direct current stimulation (tDCS). We stimulated 30 detoxified alcohol-dependent patients (50 % with a sham and 50 % with left cathodal/right anodal stimulation) and presented emotional as well as alcohol-related pictures. We measured the emotional startle modulation and found significantly increased startle amplitudes in the verum stimulation condition for alcohol-related cues, indicating a more negative processing of this cues in alcohol-dependent patients after verum tDCS stimulation. Additionally we found tendencies for stronger reduction in subjective craving in verum-stimulated patients. Therefore our study underscores the positive value of DCS in reducing craving and might help to improve the understanding and therapy of alcohol dependence.
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Affiliation(s)
- Katharina Wietschorke
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Clinic Würzburg, University of Würzburg, Füchsleinstr. 15, 97080, Würzburg, Germany
| | - Julian Lippold
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Clinic Würzburg, University of Würzburg, Füchsleinstr. 15, 97080, Würzburg, Germany
| | - Christian Jacob
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Clinic Würzburg, University of Würzburg, Füchsleinstr. 15, 97080, Würzburg, Germany
| | - Thomas Polak
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Clinic Würzburg, University of Würzburg, Füchsleinstr. 15, 97080, Würzburg, Germany
| | - Martin J Herrmann
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Clinic Würzburg, University of Würzburg, Füchsleinstr. 15, 97080, Würzburg, Germany.
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159
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McClelland J, Kekic M, Bozhilova N, Nestler S, Dew T, Van den Eynde F, David AS, Rubia K, Campbell IC, Schmidt U. A Randomised Controlled Trial of Neuronavigated Repetitive Transcranial Magnetic Stimulation (rTMS) in Anorexia Nervosa. PLoS One 2016; 11:e0148606. [PMID: 27008620 PMCID: PMC4805273 DOI: 10.1371/journal.pone.0148606] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 01/19/2016] [Indexed: 12/22/2022] Open
Abstract
Background Anorexia nervosa (AN) is associated with morbid fear of fatness, extreme food restriction and altered self-regulation. Neuroimaging data implicate fronto-striatal circuitry, including the dorsolateral prefrontal cortex (DLPFC). Methods In this double-blind parallel group study, we investigated the effects of one session of sham-controlled high-frequency repetitive transcranial magnetic stimulation (rTMS) to the left DLPFC (l-DLPFC) in 60 individuals with AN. A food exposure task was administered before and after the procedure to elicit AN-related symptoms. Outcomes The primary outcome measure was ‘core AN symptoms’, a variable which combined several subjective AN-related experiences. The effects of rTMS on other measures of psychopathology (e.g. mood), temporal discounting (TD; intertemporal choice behaviour) and on salivary cortisol concentrations were also investigated. Safety, tolerability and acceptability were assessed. Results Fourty-nine participants completed the study. Whilst there were no interaction effects of rTMS on core AN symptoms, there was a trend for group differences (p = 0.056): after controlling for pre-rTMS scores, individuals who received real rTMS had reduced symptoms post-rTMS and at 24-hour follow-up, relative to those who received sham stimulation. Other psychopathology was not altered differentially following real/sham rTMS. In relation to TD, there was an interaction trend (p = 0.060): real versus sham rTMS resulted in reduced rates of TD (more reflective choice behaviour). Salivary cortisol concentrations were unchanged by stimulation. rTMS was safe, well–tolerated and was considered an acceptable intervention. Conclusions This study provides modest evidence that rTMS to the l-DLPFC transiently reduces core symptoms of AN and encourages prudent decision making. Importantly, individuals with AN considered rTMS to be a viable treatment option. These findings require replication in multiple-session studies to evaluate therapeutic efficacy. Trial Registration www.Controlled-Trials.comISRCTN22851337
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Affiliation(s)
- Jessica McClelland
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- * E-mail:
| | - Maria Kekic
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Natali Bozhilova
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Steffen Nestler
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Tracy Dew
- Department of Clinical Biochemistry, King’s College Hospital, London, United Kingdom
| | - Frederique Van den Eynde
- Neuromodulation Research Clinic, Douglas Mental Health University Institute, Montréal, Québec, Canada
| | - Anthony S. David
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Katya Rubia
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Iain C. Campbell
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Ulrike Schmidt
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
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160
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Falcone M, Bernardo L, Ashare RL, Hamilton R, Faseyitan O, McKee SA, Loughead J, Lerman C. Transcranial Direct Current Brain Stimulation Increases Ability to Resist Smoking. Brain Stimul 2016; 9:191-6. [PMID: 26572280 PMCID: PMC4789149 DOI: 10.1016/j.brs.2015.10.004] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 08/28/2015] [Accepted: 10/15/2015] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND The ability to exert self-control over temptation is a fundamental component of smoking behavior change. Transcranial direct current stimulation (tDCS) of the dorsolateral prefrontal cortex (DLPFC) has been shown to modulate cognitive control circuits. Although prior studies show that stimulation reduces cigarette craving and self-reported smoking, effects on ability to resist smoking have not been investigated directly. OBJECTIVES We assessed effects of a single 20-minute session of 1.0 mA anodal stimulation over the left DLPFC with cathodal stimulation over the right supra-orbital area (vs. sham stimulation) on ability to resist smoking in a validated smoking lapse paradigm. METHODS Twenty-five participants completed two tDCS sessions (active and sham stimulation) in a within-subject, double-blind, randomized and counterbalanced order with a 2-week washout period. Following overnight abstinence, participants received tDCS in the presence of smoking related cues; they had the option to smoke at any time or receive $1 for every 5 minutes they abstained. After 50 minutes, they participated in a 1 hour ad libitum smoking session. Primary and secondary outcomes were time to first cigarette and cigarette consumption, respectively. RESULTS In multiple regression models, active tDCS (compared to sham) significantly increased latency to smoke (p = 0.02) and decreased the total number of cigarettes smoked (p = 0.014) during the session. CONCLUSION These findings suggest that acute anodal stimulation over the left DLPFC (with cathodal stimulation over the right supra-orbital area) can improve ability to resist smoking, supporting the therapeutic potential of tDCS for smoking cessation treatment.
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Affiliation(s)
- Mary Falcone
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA.
| | - Leah Bernardo
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Rebecca L Ashare
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Roy Hamilton
- Laboratory for Cognition and Neural Stimulation, University of Pennsylvania, Philadelphia, PA, USA
| | - Olufunsho Faseyitan
- Laboratory for Cognition and Neural Stimulation, University of Pennsylvania, Philadelphia, PA, USA
| | - Sherry A McKee
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - James Loughead
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Caryn Lerman
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
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161
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Morein-Zamir S, Robbins TW. Fronto-striatal circuits in response-inhibition: Relevance to addiction. Brain Res 2015; 1628:117-29. [PMID: 25218611 PMCID: PMC4686018 DOI: 10.1016/j.brainres.2014.09.012] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Revised: 08/28/2014] [Accepted: 09/03/2014] [Indexed: 12/29/2022]
Abstract
Disruptions to inhibitory control are believed to contribute to multiple aspects of drug abuse, from preexisting vulnerability in at-risk individuals, through escalation to dependence, to promotion of relapse in chronic users. Paradigms investigating the suppression of actions have been investigated in animal and human research on drug addiction. Rodent research has focused largely on impulsive behaviors, often gauged by premature responding, as a viable model highlighting the relevant role of dopamine and other neurotransmitters primarily in the striatum. Human research on action inhibition in stimulant dependence has highlighted impaired performance and largely prefrontal cortical abnormalities as part of a broader pattern of cognitive abnormalities. Animal and human research implicate inhibitory difficulties mediated by fronto-striatal circuitry both preceding and as a result of excessive stimulus use. In this regard, response-inhibition has proven a useful cognitive function to gauge the integrity of fronto-striatal systems and their role in contributing to impulsive and compulsive features of drug dependence.
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Affiliation(s)
- Sharon Morein-Zamir
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge CB2 3EB, UK; Department of Psychology, University of Cambridge, Cambridge CB2 0SZ, UK.
| | - Trevor W Robbins
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge CB2 3EB, UK; Department of Psychology, University of Cambridge, Cambridge CB2 0SZ, UK
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162
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Hone-Blanchet A, Ciraulo DA, Pascual-Leone A, Fecteau S. Noninvasive brain stimulation to suppress craving in substance use disorders: Review of human evidence and methodological considerations for future work. Neurosci Biobehav Rev 2015; 59:184-200. [PMID: 26449761 PMCID: PMC5365234 DOI: 10.1016/j.neubiorev.2015.10.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Revised: 09/10/2015] [Accepted: 10/01/2015] [Indexed: 12/19/2022]
Abstract
Substance use disorders (SUDs) can be viewed as a pathology of neuroadaptation. The pharmacological overstimulation of neural mechanisms of reward, motivated learning and memory leads to drug-seeking behavior. A critical characteristic of SUDs is the appearance of craving, the motivated desire and urge to use, which is a main focus of current pharmacological and behavioral therapies. Recent proof-of-concept studies have tested the effects of noninvasive brain stimulation on craving. Although its mechanisms of action are not fully understood, this approach shows interesting potential in tuning down craving and possibly consumption of diverse substances. This article reviews available results on the use of repetitive transcranial magnetic stimulation (rTMS) and transcranial electrical stimulation (tES) in SUDs, specifically tobacco, alcohol and psychostimulant use disorders. We discuss several important factors that need to be addressed in future works to improve clinical assessment and effects of noninvasive brain stimulation in SUDs. Factors discussed include brain stimulation devices and parameters, study designs, brain states and subjects' characteristics.
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Affiliation(s)
- Antoine Hone-Blanchet
- Laboratory of Canada Research Chair in Cognitive Neuroplasticity, Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale, Centre de Recherche de l'Institut Universitaire en Santé Mentale de Québec, Faculté de Médecine, Université Laval, Québec, QC, Canada
| | - Domenic A Ciraulo
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Alvaro Pascual-Leone
- Berenson-Allen Center for Noninvasive Brain Stimulation and Division of Translational Cognitive Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Shirley Fecteau
- Laboratory of Canada Research Chair in Cognitive Neuroplasticity, Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale, Centre de Recherche de l'Institut Universitaire en Santé Mentale de Québec, Faculté de Médecine, Université Laval, Québec, QC, Canada; Berenson-Allen Center for Noninvasive Brain Stimulation and Division of Translational Cognitive Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
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163
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Jansen JM, van Wingen G, van den Brink W, Goudriaan AE. Resting state connectivity in alcohol dependent patients and the effect of repetitive transcranial magnetic stimulation. Eur Neuropsychopharmacol 2015; 25:2230-9. [PMID: 26481907 DOI: 10.1016/j.euroneuro.2015.09.019] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 07/13/2015] [Accepted: 09/28/2015] [Indexed: 01/15/2023]
Abstract
Alcohol dependence is thought to result from an overactive neural motivation system and a deficient cognitive control system, and rebalancing these systems may mitigate excessive alcohol use. This study examines the differences in functional connectivity of the fronto-parietal cognitive control network (FPn) and the motivational network (striatum and orbitofrontal cortex) between alcohol dependent patients (ADPs) and healthy controls (HCs), and the effect of repetitive transcranial magnetic stimulation (rTMS) on these networks. This randomized controlled trial included 38 ADPs and 37 HCs, matched on age, gender and education. Participants were randomly assigned to sham or right dorsolateral prefrontal cortex (dlPFC) stimulation with rTMS. A 3T resting state functional Magnetic Resonance Imaging (fMRI) scan was acquired before and after active or sham 10Hz rTMS. Group differences of within and between network connectivity and the effect of rTMS on network connectivity was assessed using independent component analysis. Results showed higher connectivity within the left FPn (p=0.012) and the left fronto-striatal motivational network (p=0.03) in ADPs versus HCs, and a further increase in connectivity within the left FPn after active stimulation in ADPs. ADPs also showed higher connectivity between the left and the right FPns (p=0.025), and this higher connectivity was related to fewer alcohol related problems (r=0.30, p=0.06). The results show higher within and between network connectivity in ADPs and a further increase in fronto-parietal connectivity after right dlPFC rTMS in ADPs, suggesting that frontal rTMS may have a beneficial influence on cognitive control and may result in lower relapse rates.
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Affiliation(s)
- Jochem M Jansen
- Academic Medical Centre (AMC), Department of Psychiatry, University of Amsterdam, Amsterdam, The Netherlands; Amsterdam Institute for Addiction Research, University of Amsterdam, Amsterdam, The Netherlands.
| | - Guido van Wingen
- Academic Medical Centre (AMC), Department of Psychiatry, University of Amsterdam, Amsterdam, The Netherlands.
| | - Wim van den Brink
- Academic Medical Centre (AMC), Department of Psychiatry, University of Amsterdam, Amsterdam, The Netherlands; Amsterdam Institute for Addiction Research, University of Amsterdam, Amsterdam, The Netherlands.
| | - Anna E Goudriaan
- Academic Medical Centre (AMC), Department of Psychiatry, University of Amsterdam, Amsterdam, The Netherlands; Amsterdam Institute for Addiction Research, University of Amsterdam, Amsterdam, The Netherlands; Arkin Mental Health, Amsterdam, The Netherlands.
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164
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Fadardi JS, Cox WM, Rahmani A. Neuroscience of attentional processes for addiction medicine: from brain mechanisms to practical considerations. PROGRESS IN BRAIN RESEARCH 2015; 223:77-89. [PMID: 26806772 DOI: 10.1016/bs.pbr.2015.08.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The present chapter first argues how having a goal for procuring alcohol or other substances leads to the development of a time-binding, dynamic, and goal oriented motivational state termed current concern, as the origin of substance-related attentional bias. Next, it discusses the importance of attentional bias in the development, continuation of, and relapsing to substance abuse. It further proceeds with a review of selective evidence from cognitive psychology that helps account for making decisions about using an addictive substance or refraining from using it. A discussion on the various brain loci that are involved in attentional bias and other kinds of cue reactivity is followed by presenting findings from neurocognitive research. Finally, from an interdisciplinary perspective, the chapter presents new trends and ideas that can be applied to addiction-related cognitive measurement and training.
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Affiliation(s)
- Javad Salehi Fadardi
- Ferdowsi University of Mashhad, Mashhad, Iran; Bangor University, Bangor, UK; Addiction Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran.
| | | | - Arash Rahmani
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
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165
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Repetitive Transcranial Magnetic Stimulation (rTMS) Treatment in Enduring Anorexia Nervosa: A Case Series. EUROPEAN EATING DISORDERS REVIEW 2015; 24:157-63. [DOI: 10.1002/erv.2414] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Revised: 10/06/2015] [Accepted: 10/07/2015] [Indexed: 11/07/2022]
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166
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Sutoh C, Koga Y, Kimura H, Kanahara N, Numata N, Hirano Y, Matsuzawa D, Iyo M, Nakazato M, Shimizu E. Repetitive Transcranial Magnetic Stimulation Changes Cerebral Oxygenation on the Left Dorsolateral Prefrontal Cortex in Bulimia Nervosa: A Near-Infrared Spectroscopy Pilot Study. EUROPEAN EATING DISORDERS REVIEW 2015; 24:83-8. [DOI: 10.1002/erv.2413] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 09/09/2015] [Accepted: 09/23/2015] [Indexed: 12/11/2022]
Affiliation(s)
- Chihiro Sutoh
- Department of Cognitive Behavioral Physiology, Graduate School of Medicine; Chiba University; Chiba Japan
| | - Yasuko Koga
- Department of Cognitive Behavioral Physiology, Graduate School of Medicine; Chiba University; Chiba Japan
- Research Center for Child Mental Development; Chiba University; Chiba Japan
| | - Hiroshi Kimura
- Department of Psychiatry, Graduate School of Medicine; Chiba University; Chiba Japan
| | - Nobuhisa Kanahara
- Department of Psychiatry, Graduate School of Medicine; Chiba University; Chiba Japan
- Division of Medical Treatment and Rehabilitation, Center for Forensic Mental Health; Chiba University; Chiba Japan
| | - Noriko Numata
- Department of Cognitive Behavioral Physiology, Graduate School of Medicine; Chiba University; Chiba Japan
| | - Yoshiyuki Hirano
- Research Center for Child Mental Development; Chiba University; Chiba Japan
| | - Daisuke Matsuzawa
- Department of Cognitive Behavioral Physiology, Graduate School of Medicine; Chiba University; Chiba Japan
- Research Center for Child Mental Development; Chiba University; Chiba Japan
| | - Masaomi Iyo
- Department of Psychiatry, Graduate School of Medicine; Chiba University; Chiba Japan
- Division of Medical Treatment and Rehabilitation, Center for Forensic Mental Health; Chiba University; Chiba Japan
| | - Michiko Nakazato
- Research Center for Child Mental Development; Chiba University; Chiba Japan
- Department of Psychiatry, Graduate School of Medicine; Chiba University; Chiba Japan
| | - Eiji Shimizu
- Department of Cognitive Behavioral Physiology, Graduate School of Medicine; Chiba University; Chiba Japan
- Research Center for Child Mental Development; Chiba University; Chiba Japan
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167
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Sauvaget A, Trojak B, Bulteau S, Jiménez-Murcia S, Fernández-Aranda F, Wolz I, Menchón JM, Achab S, Vanelle JM, Grall-Bronnec M. Transcranial direct current stimulation (tDCS) in behavioral and food addiction: a systematic review of efficacy, technical, and methodological issues. Front Neurosci 2015; 9:349. [PMID: 26500478 PMCID: PMC4598576 DOI: 10.3389/fnins.2015.00349] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 09/14/2015] [Indexed: 01/29/2023] Open
Abstract
Objectives: Behavioral addictions (BA) are complex disorders for which pharmacological and psychotherapeutic treatments have shown their limits. Non-invasive brain stimulation, among which transcranial direct current stimulation (tDCS), has opened up new perspectives in addiction treatment. The purpose of this work is to conduct a critical and systematic review of tDCS efficacy, and of technical and methodological considerations in the field of BA. Methods: A bibliographic search has been conducted on the Medline and ScienceDirect databases until December 2014, based on the following selection criteria: clinical studies on tDCS and BA (namely eating disorders, compulsive buying, Internet addiction, pathological gambling, sexual addiction, sports addiction, video games addiction). Study selection, data analysis, and reporting were conducted according to the PRISMA guidelines. Results: Out of 402 potential articles, seven studies were selected. So far focusing essentially on abnormal eating, these studies suggest that tDCS (right prefrontal anode/left prefrontal cathode) reduces food craving induced by visual stimuli. Conclusions: Despite methodological and technical differences between studies, the results are promising. So far, only few studies of tDCS in BA have been conducted. New research is recommended on the use of tDCS in BA, other than eating disorders.
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Affiliation(s)
- Anne Sauvaget
- Addictology and Liaison Psychiatry Department, Nantes University Hospital Nantes, France ; Clinical Investigation Unit 18-BALANCED "BehaviorAL AddictioNs and ComplEx Mood Disorders", University Hospital of Nantes Nantes, France ; Department of Psychiatry, University Hospital of Bellvitge-IDIBELL Barcelona, Spain
| | - Benoît Trojak
- Department of Psychiatry and Addictology, University Hospital of Dijon Dijon, France ; Behavioral Addictions Program, NANT New Addictions New Treatments, Addiction Division, Department of Mental Health and Psychiatry, University Hospital of Geneva Geneva, Switzerland
| | - Samuel Bulteau
- Addictology and Liaison Psychiatry Department, Nantes University Hospital Nantes, France ; Clinical Investigation Unit 18-BALANCED "BehaviorAL AddictioNs and ComplEx Mood Disorders", University Hospital of Nantes Nantes, France
| | - Susana Jiménez-Murcia
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL Barcelona, Spain ; CIBER Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos III Barcelona, Spain
| | - Fernando Fernández-Aranda
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL Barcelona, Spain ; CIBER Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos III Barcelona, Spain
| | - Ines Wolz
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL Barcelona, Spain ; CIBER Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos III Barcelona, Spain
| | - José M Menchón
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL Barcelona, Spain ; CIBER Salud Mental, Instituto de Salud Carlos III Barcelona, Spain
| | - Sophia Achab
- Behavioral Addictions Program, NANT New Addictions New Treatments, Addiction Division, Department of Mental Health and Psychiatry, University Hospital of Geneva Geneva, Switzerland
| | - Jean-Marie Vanelle
- Addictology and Liaison Psychiatry Department, Nantes University Hospital Nantes, France ; Clinical Investigation Unit 18-BALANCED "BehaviorAL AddictioNs and ComplEx Mood Disorders", University Hospital of Nantes Nantes, France
| | - Marie Grall-Bronnec
- Addictology and Liaison Psychiatry Department, Nantes University Hospital Nantes, France ; Clinical Investigation Unit 18-BALANCED "BehaviorAL AddictioNs and ComplEx Mood Disorders", University Hospital of Nantes Nantes, France ; EA 4275 "Biostatistics, Clinical Research and Subjective Measures in Health Sciences", University of Nantes Nantes, France
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169
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The Impact of Accelerated Right Prefrontal High-Frequency Repetitive Transcranial Magnetic Stimulation (rTMS) on Cue-Reactivity: An fMRI Study on Craving in Recently Detoxified Alcohol-Dependent Patients. PLoS One 2015; 10:e0136182. [PMID: 26295336 PMCID: PMC4546410 DOI: 10.1371/journal.pone.0136182] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Accepted: 07/30/2015] [Indexed: 11/19/2022] Open
Abstract
In alcohol-dependent patients craving is a difficult-to-treat phenomenon. It has been suggested that high-frequency (HF) repetitive transcranial magnetic stimulation (rTMS) may have beneficial effects. However, exactly how this application exerts its effect on the underlying craving neurocircuit is currently unclear. In an effort to induce alcohol craving and to maximize detection of HF-rTMS effects to cue-induced alcohol craving, patients were exposed to a block and event-related alcohol cue-reactivity paradigm while being scanned with fMRI. Hence, we assessed the effect of right dorsolateral prefrontal cortex (DLPFC) stimulation on cue-induced and general alcohol craving, and the related craving neurocircuit. Twenty-six recently detoxified alcohol-dependent patients were included. First, we evaluated the impact of one sham-controlled stimulation session. Second, we examined the effect of accelerated right DLPFC HF-rTMS treatment: here patients received 15 sessions in an open label accelerated design, spread over 4 consecutive days. General craving significantly decreased after 15 active HF-rTMS sessions. However, cue-induced alcohol craving was not altered. Our brain imaging results did not show that the cue-exposure affected the underlying craving neurocircuit after both one and fifteen active HF-rTMS sessions. Yet, brain activation changes after one and 15 HF-rTMS sessions, respectively, were observed in regions associated with the extended reward system and the default mode network, but only during the presentation of the event-related paradigm. Our findings indicate that accelerated HF-rTMS applied to the right DLPFC does not manifestly affect the craving neurocircuit during an alcohol-related cue-exposure, but instead it may influence the attentional network.
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170
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Grall-Bronnec M, Sauvaget A. The use of repetitive transcranial magnetic stimulation for modulating craving and addictive behaviours: a critical literature review of efficacy, technical and methodological considerations. Neurosci Biobehav Rev 2015; 47:592-613. [PMID: 25454360 DOI: 10.1016/j.neubiorev.2014.10.013] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Revised: 09/25/2014] [Accepted: 10/15/2014] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Repetitive transcranial magnetic stimulation (rTMS) is a potential therapeutic intervention for the treatment of addiction. This critical review aims to summarise the recent developments with respect to the efficacy of rTMS for all types of addiction and related disorders (including eating disorders), and concentrates on the associated methodological and technical issues. METHODS The bibliographic search consisted of a computerised screening of the Medline and ScienceDirect databases up to December 2013. Criteria for inclusion were the target problem was an addiction, a related disorder, or craving; the intervention was performed using rTMS; and the study was a clinical trial. RESULTS Of the potential 638 articles, 18 met the criteria for inclusion. Most of these (11 of the 18) supported the efficacy of rTMS, especially in the short term. In most cases, the main assessment criterion was the measurement of craving using a Visual Analogue Scale. DISCUSSION The results are discussed with respect to the study limitations and, in particular, the many methodological and technical discrepancies that were identified. Key recommendations are provided.
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Trojak B, Meille V, Achab S, Lalanne L, Poquet H, Ponavoy E, Blaise E, Bonin B, Chauvet-Gelinier JC. Transcranial Magnetic Stimulation Combined With Nicotine Replacement Therapy for Smoking Cessation: A Randomized Controlled Trial. Brain Stimul 2015; 8:1168-74. [PMID: 26590478 DOI: 10.1016/j.brs.2015.06.004] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Revised: 05/06/2015] [Accepted: 06/07/2015] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Further evidence suggests that repetitive Transcranial Magnetic Stimulation (rTMS) is an effective method to reduce tobacco craving among smokers. HYPOTHESIS As relapse is common within a few days after smoking cessation, we hypothesized that combining the anti-craving effects of rTMS with Nicotine replacement therapy (NRT) to attenuate withdrawal symptoms could increase abstinence rates in smokers with severe nicotine dependence who quit smoking. METHODS Thirty-seven smokers who failed to quit with the usual treatments were randomly assigned to two treatment groups to receive either active (n = 18) or sham (n = 19) 1-Hz rTMS of the right dorsolateral prefrontal cortex. The day after quitting smoking, each patient combined NRT (21-mg patch) with active or sham rTMS (10 sessions) for 2 weeks. Cessation support was then continued with NRT alone using lower-dose patches. Abstinence rates and self-report craving scales were used to assess the therapeutic results during the combined treatment and for up to 12 weeks after quitting. RESULTS At the end of the combined treatment, there were significantly more abstinent participants in the active rTMS group (n = 16) than in the sham rTMS group (n = 9) (P = 0.027). The craving scales analysis revealed that active rTMS (P = 0.011) but not sham rTMS (P = 0.116) led to a significant decrease in the compulsive factor. However, no lasting rTMS effect was found. CONCLUSIONS 1-Hz rTMS combined with NRT improved the success rate of abstinence in smokers during tobacco cessation. The stimulation-induced reduction in compulsivity may explain this result.
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Affiliation(s)
- Benoit Trojak
- Department of Psychiatry and Addictology, University Hospital of Dijon, 21079 Dijon, France; EA 4452, LPPM, University of Burgundy, 21000 Dijon, France.
| | - Vincent Meille
- Department of Psychiatry and Addictology, University Hospital of Dijon, 21079 Dijon, France
| | - Sophia Achab
- Addiction Division, Department of Mental Health and Psychiatry, University Hospitals of Geneva, 1202 Geneva, Switzerland
| | - Laurence Lalanne
- Department of Psychiatry, Strasbourg University Hospital, 67091 Strasbourg, France; INSERM U 1114, FMTS, Strasbourg University Hospital, 67091 Strasbourg, France
| | - Hélène Poquet
- Department of Psychiatry and Addictology, University Hospital of Dijon, 21079 Dijon, France
| | - Eddy Ponavoy
- Department of Psychiatry and Addictology, University Hospital of Dijon, 21079 Dijon, France
| | - Emilie Blaise
- Department of Psychiatry and Addictology, University Hospital of Dijon, 21079 Dijon, France
| | - Bernard Bonin
- Department of Psychiatry and Addictology, University Hospital of Dijon, 21079 Dijon, France; EA 4452, LPPM, University of Burgundy, 21000 Dijon, France
| | - Jean-Christophe Chauvet-Gelinier
- Department of Psychiatry and Addictology, University Hospital of Dijon, 21079 Dijon, France; EA 4452, LPPM, University of Burgundy, 21000 Dijon, France
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Batista EK, Klauss J, Fregni F, Nitsche MA, Nakamura-Palacios EM. A Randomized Placebo-Controlled Trial of Targeted Prefrontal Cortex Modulation with Bilateral tDCS in Patients with Crack-Cocaine Dependence. Int J Neuropsychopharmacol 2015; 18:pyv066. [PMID: 26065432 PMCID: PMC4675977 DOI: 10.1093/ijnp/pyv066] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 06/03/2015] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Transcranial direct current stimulation over the dorsolateral prefrontal cortex has been shown to be clinically useful in the treatment of drug addiction. METHODS We conducted a double-blind randomized clinical trial aiming to assess the effects of bilateral dorsolateral prefrontal cortex transcranial direct current stimulation (left cathodal/right anodal) on crack-cocaine addiction. We defined craving as the primary outcome, and other clinical measurements, including depressive and anxiety symptoms, and quality of life, as secondary outcomes. Seventeen male crack-cocaine users (mean age 30.4 ± 9.8 SD) were randomized to receive 5 sessions of active transcranial direct current stimulation (2 mA, 35 cm(2), for 20 minutes), every other day, and 19 males (mean age 30.3 ± 8.4 SD) to receive sham-transcranial direct current stimulation (placebo) as control group. RESULTS Craving scores were significantly reduced in the transcranial direct current stimulation group after treatment when compared with sham-transcranial direct current stimulation (P = .028) and baseline values (P = .003), and decreased linearly over 4 weeks (before, during, and after treatment) in the transcranial direct current stimulation group only (P = .047). Changes of anxiety scores towards increase in the sham-transcranial direct current stimulation and decrease in the transcranial direct current stimulation group (P = .03), and of the overall perception of quality of life (P = .031) and of health (P = .048) towards decrease in the sham-transcranial direct current stimulation group and increase in the transcranial direct current stimulation group differed significantly between groups. CONCLUSIONS Repetitive bilateral transcranial direct current stimulation over the dorsolateral prefrontal cortex reduced craving for crack-cocaine use, decreased anxiety, and improved quality of life. We hypothesize that transcranial direct current stimulation effects may be associated with increased prefrontal processing and regulation of craving behavior.
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Affiliation(s)
| | | | | | | | - Ester Miyuki Nakamura-Palacios
- Laboratory of Cognitive Sciences and Neuropsychopharmacology, Program of Post-Graduation in Physiological Sciences, Federal University of Espírito Santo, Vitória-ES, Brazil (Dr Batista, Ms Klauss, and Dr Palacios); Spaulding Neuromodulation Center, Department of Physical Medicine & Rehabilitation, Massachusetts General Hospital, Spaulding Neuromodulation Center, Harvard Medical School, Boston, MA (Dr Fregni); Berenson-Allen Center for Non-invasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (Dr Fregni); Laboratory of Neuroplasticity, University Medical Center, Department of Clinical Neurophysiology, Georg-August-University, Göttingen, Germany (Dr Nitsche); Leibniz Research Centre for Working Environment and Human Resources, Dortmund, Germany (Dr Nitsche); Department of Neurology, University Medical Hospital Bergmannsheil, Bochum, Germany (Dr Nitsche).
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173
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Hall PA, Fong GT. Temporal self-regulation theory: a neurobiologically informed model for physical activity behavior. Front Hum Neurosci 2015; 9:117. [PMID: 25859196 PMCID: PMC4373277 DOI: 10.3389/fnhum.2015.00117] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 02/16/2015] [Indexed: 11/18/2022] Open
Abstract
Dominant explanatory models for physical activity behavior are limited by the exclusion of several important components, including temporal dynamics, ecological forces, and neurobiological factors. The latter may be a critical omission, given the relevance of several aspects of cognitive function for the self-regulatory processes that are likely required for consistent implementation of physical activity behavior in everyday life. This narrative review introduces temporal self-regulation theory (TST; Hall and Fong, 2007, 2013) as a new explanatory model for physical activity behavior. Important features of the model include consideration of the default status of the physical activity behavior, as well as the disproportionate influence of temporally proximal behavioral contingencies. Most importantly, the TST model proposes positive feedback loops linking executive function (EF) and the performance of physical activity behavior. Specifically, those with relatively stronger executive control (and optimized brain structures supporting it, such as the dorsolateral prefrontal cortex (PFC)) are able to implement physical activity with more consistency than others, which in turn serves to strengthen the executive control network itself. The TST model has the potential to explain everyday variants of incidental physical activity, sport-related excellence via capacity for deliberate practice, and variability in the propensity to schedule and implement exercise routines.
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Affiliation(s)
- Peter A Hall
- Faculty of Applied Health Sciences, University of Waterloo Waterloo, ON, Canada
| | - Geoffrey T Fong
- Department of Psychology, University of Waterloo Waterloo, ON, Canada
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174
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Fregni F, Nitsche MA, Loo CK, Brunoni AR, Marangolo P, Leite J, Carvalho S, Bolognini N, Caumo W, Paik NJ, Simis M, Ueda K, Ekhitari H, Luu P, Tucker DM, Tyler WJ, Brunelin J, Datta A, Juan CH, Venkatasubramanian G, Boggio PS, Bikson M. Regulatory Considerations for the Clinical and Research Use of Transcranial Direct Current Stimulation (tDCS): review and recommendations from an expert panel. CLINICAL RESEARCH AND REGULATORY AFFAIRS 2015; 32:22-35. [PMID: 25983531 PMCID: PMC4431691 DOI: 10.3109/10601333.2015.980944] [Citation(s) in RCA: 174] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The field of transcranial electrical stimulation (tES) has experienced significant growth in the past 15 years. One of the tES techniques leading this increased interest is transcranial direct current stimulation (tDCS). Significant research efforts have been devoted to determining the clinical potential of tDCS in humans. Despite the promising results obtained with tDCS in basic and clinical neuroscience, further progress has been impeded by a lack of clarity on international regulatory pathways. We therefore convened a group of research and clinician experts on tDCS to review the research and clinical use of tDCS. In this report, we review the regulatory status of tDCS, and we summarize the results according to research, off-label and compassionate use of tDCS in the following countries: Australia, Brazil, France, Germany, India, Iran, Italy, Portugal, South Korea, Taiwan and United States. Research use, off label treatment and compassionate use of tDCS are employed in most of the countries reviewed in this study. It is critical that a global or local effort is organized to pursue definite evidence to either approve and regulate or restrict the use of tDCS in clinical practice on the basis of adequate randomized controlled treatment trials.
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Affiliation(s)
- F Fregni
- Spaulding Neuromodulation Center, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - M A Nitsche
- Department of Clinical Neurophysiology, Georg-August-University, Göttingen, Germany
| | - C K Loo
- School of Psychiatry & The Black Dog Institute, University of New South Wales, Sydney, Australia
| | - A R Brunoni
- Service of Interdisciplinary Neuromodulation, Department and Institute of Psychiatry, University of São Paulo, São Paulo, Brazil and Division of Neurology, Santa Casa Medicak School, Sao Paulo, Brazil
| | - P Marangolo
- Department of Experimental and Clinical Medicine, University Politecnica delle Marche, Ancona, and IRCCS Fondazione Santa Lucia, Roma, Italy
| | - J Leite
- Spaulding Neuromodulation Center, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA ; Neuropsychophysiology Laboratory, CIPsi, School of Psychology (EPsi), University of Minho, Campus de Gualtar, Braga, Portugal
| | - S Carvalho
- Spaulding Neuromodulation Center, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA ; Neuropsychophysiology Laboratory, CIPsi, School of Psychology (EPsi), University of Minho, Campus de Gualtar, Braga, Portugal
| | - N Bolognini
- Department of Psychology, University of Milano Bicocca, and Laboratory of Neuropsychology, IRCC Instituto Auxologico Italiano, Milano, Italy
| | - W Caumo
- Laboratory of Pain & Neuromodulation at Hospital de Clínicas de Porto Alegre at UFRGS
| | - N J Paik
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoul, South Korea
| | - M Simis
- Service of Interdisciplinary Neuromodulation, Department and Institute of Psychiatry, University of São Paulo, São Paulo, Brazil and Division of Neurology, Santa Casa Medicak School, Sao Paulo, Brazil
| | - K Ueda
- National Cardiovascular Center, Osaka, Japan
| | - H Ekhitari
- Translational Neuroscience Program, Institute for Cognitive Science Studies, Tehran, Iran ; Neurocognitive Laboratory, Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
| | - P Luu
- Electrical Geodesics, Inc., and University of Oregon, Eugene, Oregon, USA
| | - D M Tucker
- Electrical Geodesics, Inc., and University of Oregon, Eugene, Oregon, USA
| | - W J Tyler
- Virginia Tech Carilion Research Institute, Department of Psychiatry and Behavioral Medicine, Virginia Tech Carilion School of Medicine, and School of Biomedical Engineering and Sciences, Virginia Tech, Roanoke, VA USA
| | - J Brunelin
- EA 4615, Centre Hospitalier le Vinatier, Université de Lyon, F-69003, Université Claude Bernard Lyon I, Bron, France
| | - A Datta
- Department of Biomedical Engineering, Neural Engineering Laboratory, The City College of the City University of New York New York, NY, USA
| | - C H Juan
- Institute of Cognitive Neuroscience, National Central University, Taiwan
| | - G Venkatasubramanian
- Translational Psychiatry Laboratory, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - P S Boggio
- Social and Cognitive Neuroscience Laboratory and Developmental Disorders Program, Center for Healthy and Biological Sciences, Mackenzie Presbyterian University, Sao Paulo, Brazil
| | - M Bikson
- Department of Biomedical Engineering, Neural Engineering Laboratory, The City College of the City University of New York New York, NY, USA
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Interest of targeting either cortical area Brodmann 9 or 46 in rTMS treatment for depression: A preliminary randomized study. Clin Neurophysiol 2014; 125:2384-9. [DOI: 10.1016/j.clinph.2014.04.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Revised: 03/03/2014] [Accepted: 04/04/2014] [Indexed: 11/22/2022]
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177
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Potenza MN, Grilo CM. How Relevant is Food Craving to Obesity and Its Treatment? Front Psychiatry 2014; 5:164. [PMID: 25477827 PMCID: PMC4237037 DOI: 10.3389/fpsyt.2014.00164] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 11/06/2014] [Indexed: 01/26/2023] Open
Affiliation(s)
- Marc N. Potenza
- Departments of Psychiatry, Neurobiology and Child Study Center, Yale University School of Medicine, New Haven, CT, USA
| | - Carlos M. Grilo
- Department of Psychiatry and Psychology, Yale University, New Haven, CT, USA
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Hall PA, Marteau TM. Executive function in the context of chronic disease prevention: theory, research and practice. Prev Med 2014; 68:44-50. [PMID: 25042899 DOI: 10.1016/j.ypmed.2014.07.008] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2014] [Revised: 06/07/2014] [Accepted: 07/09/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To provide an overview of the nature, organization and measurement of executive function, and describe its significance for preventive medicine theory, research and practice. METHOD A conceptual and narrative review linking the operation of executive control systems to health behavior performance and health outcomes, within the context of chronic illness prevention. RESULTS Stronger executive function is linked with more consistent performance of a variety of health protective behaviors, less performance of health risk behaviors, and greater longevity in the existing observational research literature. These effects are not fully explained by demographic factors such as education, income and socioeconomic status, but may in some cases interact with them, or mediate their effects on other outcomes. Experimental manipulations of executive control suggest that the effect of executive function is causal, particularly in relation to the modulation of appetitive craving responses that may compete with healthy behaviors (or facilitate unhealthy behaviors). CONCLUSION Executive function is a potentially important variable in explanatory frameworks for health behavior and health outcomes. The size of effect and its endurance remain uncertain, though the causal status of its influence on some behaviors is becoming increasingly clear. Additional understanding of the relation between executive control and demand imposed by ecological context is an important frontier for research on changing behavior to prevent disease, and may be an explanatory factor in social patterning of these same conditions.
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Affiliation(s)
- Peter A Hall
- Faculty of Applied Health Sciences, University of Waterloo, Canada.
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179
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Hebebrand J, Albayrak Ö, Adan R, Antel J, Dieguez C, de Jong J, Leng G, Menzies J, Mercer JG, Murphy M, van der Plasse G, Dickson SL. “Eating addiction”, rather than “food addiction”, better captures addictive-like eating behavior. Neurosci Biobehav Rev 2014; 47:295-306. [DOI: 10.1016/j.neubiorev.2014.08.016] [Citation(s) in RCA: 244] [Impact Index Per Article: 24.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 08/25/2014] [Accepted: 08/28/2014] [Indexed: 01/18/2023]
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Guillaume S. tDCS dans le traitement des addictions : quelles perspectives ? Eur Psychiatry 2014. [DOI: 10.1016/j.eurpsy.2014.09.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Les troubles addictifs sont des troubles complexes où les traitements actuellement efficaces restent peu nombreux. Dans ce contexte, la tDCS de part son action neuromodulatrice, sa simplicité d’utilisation et sa faible innocuité pourrait être une option valable à la fois pour mieux comprendre la physiopathologie de ces troubles que comme traitement potentiel. Les comportements addictifs sont marqués par un ensemble de symptômes cognitifs, comportementaux et physiologiques faisant qu’un individu continue à consommer en dépit des conséquences négatives auquel il s’expose. Parmi ces caractéristiques, le craving est particulièrement impliqué dans le maintien des consommations. La neurobiologie du craving implique les régions préfrontales. Cela en fait une cible de choix pour la tDCS. Des études tDCS versus une stimulation placEbo ciblant le cortex préfrontal ont montré une diminution du craving. Ces résultats ont été retrouvé dans une série d’addiction allant du tabac à la methamphetamine en passant par l’alcool et la nourriture. Dans certaines études, cette diminution du craving était associée cliniquement à une diminution des consommations de nourriture ou de cigarettes.Une autre cible d’action potentielle pourrait être neurocognitive. Les addictions sont marquées par des altérations de la prise de décision, une hypersensibilité à la récompense et une impulsivité importante. Des études très préliminaires chez des sujet dépendants au tabac et au cannabis suggèrent qu’un programme de tDCS ciblant le cortex préfrontal dorsolatéral améliore ces fonctions neuropsychologiques et ainsi indirectement le pronostic de l’addiction. Les données actuelles ne permettent cependant pas de préciser si il existe un maintien à long terme des effets observés. L’intérêt clinique et les paramètres optimaux d’utilisation doivent également être mieux définis. Néanmoins ces premières données suggèrent que la tDCS pourrait permettre le développement de nouvelles approches thérapeutiques dans des troubles où les prises en charge actuelles sont perfectibles.
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Abstract
Neuromodulation techniques in obsessive-compulsive disorder (OCD) involve electroconvulsive therapy (ECT), transcranial direct current stimulation (tDCS), transcranial magnetic stimulation (TMS), and deep brain stimulation (DBS). This article reviews the available literature on the efficacy and applicability of these techniques in OCD. ECT is used for the treatment of comorbid depression or psychosis. One case report on tDCS showed no effects in OCD. Low-frequency TMS provides significant but mostly transient improvement of obsessive-compulsive symptoms. DBS shows a response rate of 60% in open and sham-controlled studies. In OCD, it can be concluded that DBS, although more invasive, is the most efficacious technique.
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Affiliation(s)
- Melisse Bais
- Department of Psychiatry, Academic Medical Center, Meibergdreef 5, Amsterdam 1105 AZ, The Netherlands
| | - Martijn Figee
- Department of Psychiatry, Academic Medical Center, Meibergdreef 5, Amsterdam 1105 AZ, The Netherlands
| | - Damiaan Denys
- Department of Psychiatry, Academic Medical Center, Meibergdreef 5, Amsterdam 1105 AZ, The Netherlands; Neuromodulation & Behavior group, Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Meibergdreef 47, Amsterdam 1105 BA, The Netherlands.
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The effects of continuous theta burst stimulation to the left dorsolateral prefrontal cortex on executive function, food cravings, and snack food consumption. Psychosom Med 2014; 76:503-11. [PMID: 25215552 DOI: 10.1097/psy.0000000000000090] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Prior research has demonstrated that executive function (EF) strength is positively associated with dietary self-control. As such, the differential operation of the brain centers underlying EFs (i.e., dorsolateral prefrontal cortex [DLPFC]) may explain controlled aspects of dietary self-control. The present study was designed to examine the causal relationship between DLPFC function and two aspects of dietary self-control: visceral cravings and actual consumptive behaviors. METHODS The research was conducted using a within-participant design. A sample of 21 healthy female young adults aged 19 to 26 years (mean [M; standard deviation] = 21.10 [1.86] years) received both active and sham continuous theta burst stimulation (cTBS) to the left DLPFC. Before and after each session, subjective food cravings were assessed using the Food Craving Questionnaire-State. After each stimulation session, participants competed three measures of EF (Stroop, Go/No-Go, and Stop-Signal) and a bogus taste test. RESULTS Participants reported larger increases in snack food cravings after active stimulation (M = 9.98% change, standard error [SE] = 0.45) than after sham stimulation (M = -3.46, SE = 0.39, p = .012) on the reinforcement anticipation dimension of Food Craving Questionnaire-State. Likewise, participants consumed significantly more snack foods after active stimulation (M = 70.62 grams, SE = 5.17) than after sham stimulation (M = 61.33, SE = 3.56, p = .006). Finally, performance on the Stroop task was reduced more after active (M = 71.56 milliseconds, SE = 25.18) than after sham stimulation (M = 20.16, SE = 13.32, p = .033); reduction in Stroop performance mediated the effect of active stimulation on increased appetitive food consumption. CONCLUSION These results support the contention that EF strength, as modulated by DLPFC activity, is causally associated with effective dietary self-control.
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183
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Gorelick DA, Zangen A, George MS. Transcranial magnetic stimulation in the treatment of substance addiction. Ann N Y Acad Sci 2014; 1327:79-93. [PMID: 25069523 DOI: 10.1111/nyas.12479] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Transcranial magnetic stimulation (TMS) is a noninvasive method of brain stimulation used to treat a variety of neuropsychiatric disorders, but is still in the early stages of study as addiction treatment. We identified 19 human studies using repetitive TMS (rTMS) to manipulate drug craving or use, which exposed a total of 316 adults to active rTMS. Nine studies involved tobacco, six alcohol, three cocaine, and one methamphetamine. The majority of studies targeted high-frequency (5-20 Hz; expected to stimulate neuronal activity) rTMS pulses to the dorsolateral prefrontal cortex. Only five studies were controlled clinical trials: two of four nicotine trials found decreased cigarette smoking; the cocaine trial found decreased cocaine use. Many aspects of optimal treatment remain unknown, including rTMS parameters, duration of treatment, relationship to cue-induced craving, and concomitant treatment. The mechanisms of rTMS potential therapeutic action in treating addictions are poorly understood, but may involve increased dopamine and glutamate function in corticomesolimbic brain circuits and modulation of neural activity in brain circuits that mediate cognitive processes relevant to addiction, such as response inhibition, selective attention, and reactivity to drug-associated cues. rTMS treatment of addiction must be considered experimental at this time, but appears to have a promising future.
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Affiliation(s)
- David A Gorelick
- Chemistry and Drug Metabolism Section, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, Maryland; Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland
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184
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Kekic M, McClelland J, Campbell I, Nestler S, Rubia K, David AS, Schmidt U. The effects of prefrontal cortex transcranial direct current stimulation (tDCS) on food craving and temporal discounting in women with frequent food cravings. Appetite 2014; 78:55-62. [DOI: 10.1016/j.appet.2014.03.010] [Citation(s) in RCA: 122] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Revised: 03/04/2014] [Accepted: 03/09/2014] [Indexed: 01/07/2023]
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185
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Fecteau S, Agosta S, Hone-Blanchet A, Fregni F, Boggio P, Ciraulo D, Pascual-Leone A. Modulation of smoking and decision-making behaviors with transcranial direct current stimulation in tobacco smokers: a preliminary study. Drug Alcohol Depend 2014; 140:78-84. [PMID: 24814566 PMCID: PMC4242508 DOI: 10.1016/j.drugalcdep.2014.03.036] [Citation(s) in RCA: 115] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Revised: 03/24/2014] [Accepted: 03/28/2014] [Indexed: 01/12/2023]
Abstract
BACKGROUND Most tobacco smokers who wish to quit fail to reach their goal. One important, insufficiently emphasized aspect of addiction relates to the decision-making system, often characterized by dysfunctional cognitive control and a powerful drive for reward. Recent proof-of-principle studies indicate that transcranial direct current stimulation (tDCS) over the dorsolateral prefrontal cortex (DLPFC) can transiently modulate processes involved in decision-making, and reduce substance intake and craving for various addictions. We previously proposed that this beneficial effect of stimulation for reducing addictive behaviors is in part mediated by more reflective decision-making. The goal of this study was to test whether nicotine intake and decision-making behaviors are modulated by tDCS over the DLPFC in tobacco smokers who wished to quit smoking. METHODS Subjects received two five-day tDCS regimens (active or sham). Stimulation was delivered over the right DLPFC at a 2 mA during 30 min. Nicotine cravings, cigarette consumption and decision-making were assessed before and after each session. RESULTS Main findings include a significant decrease in the number of cigarettes smoked when participants received active as compared to sham stimulation. This effect lasted up to four days after the end of the stimulation regimen. In regards to decision-making, smokers rejected more often offers of cigarettes, but not offers of money, after they received active as compared to sham stimulation at the Ultimatum Game. No significant change was observed at the Risk Task with cigarettes or money as rewards. CONCLUSION Overall, these findings suggest that tDCS over the DLPFC may be beneficial for smoking reduction and induce reward sensitive effects.
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Affiliation(s)
- Shirley Fecteau
- Laboratory of Canada Research Chair in Cognitive Neuroscience, Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale, Centre de Recherche l'Institut Universitaire en Santé Mentale de Québec, Medical School, Laval University, Québec, QC, Canada; Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
| | - Sara Agosta
- Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Center for Neuroscience and Cognitive Systems@UniTn, Italian Institute of Technology, Rovereto, Italy
| | - Antoine Hone-Blanchet
- Laboratory of Canada Research Chair in Cognitive Neuroscience, Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale, Centre de Recherche l'Institut Universitaire en Santé Mentale de Québec, Medical School, Laval University, Québec, QC, Canada
| | - Felipe Fregni
- Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Laboratory of Neuromodulation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, USA
| | - Paulo Boggio
- Núcleo de Neurociências, Centro de Ciências Biológicas e da Saúde, Universidade Presbiteriana Mackenzie, São Paulo, SP, Brazil
| | - Domenic Ciraulo
- Boston University School of Medicine, Boston Medical Center, Boston, MA, USA
| | - Alvaro Pascual-Leone
- Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Institut Guttmann de Neurorehabilitació, Universitat Autónoma, Barcelona, Spain
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186
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Lefaucheur JP, André-Obadia N, Antal A, Ayache SS, Baeken C, Benninger DH, Cantello RM, Cincotta M, de Carvalho M, De Ridder D, Devanne H, Di Lazzaro V, Filipović SR, Hummel FC, Jääskeläinen SK, Kimiskidis VK, Koch G, Langguth B, Nyffeler T, Oliviero A, Padberg F, Poulet E, Rossi S, Rossini PM, Rothwell JC, Schönfeldt-Lecuona C, Siebner HR, Slotema CW, Stagg CJ, Valls-Sole J, Ziemann U, Paulus W, Garcia-Larrea L. Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS). Clin Neurophysiol 2014; 125:2150-2206. [PMID: 25034472 DOI: 10.1016/j.clinph.2014.05.021] [Citation(s) in RCA: 1251] [Impact Index Per Article: 125.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Revised: 05/09/2014] [Accepted: 05/13/2014] [Indexed: 12/11/2022]
Abstract
A group of European experts was commissioned to establish guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS) from evidence published up until March 2014, regarding pain, movement disorders, stroke, amyotrophic lateral sclerosis, multiple sclerosis, epilepsy, consciousness disorders, tinnitus, depression, anxiety disorders, obsessive-compulsive disorder, schizophrenia, craving/addiction, and conversion. Despite unavoidable inhomogeneities, there is a sufficient body of evidence to accept with level A (definite efficacy) the analgesic effect of high-frequency (HF) rTMS of the primary motor cortex (M1) contralateral to the pain and the antidepressant effect of HF-rTMS of the left dorsolateral prefrontal cortex (DLPFC). A Level B recommendation (probable efficacy) is proposed for the antidepressant effect of low-frequency (LF) rTMS of the right DLPFC, HF-rTMS of the left DLPFC for the negative symptoms of schizophrenia, and LF-rTMS of contralesional M1 in chronic motor stroke. The effects of rTMS in a number of indications reach level C (possible efficacy), including LF-rTMS of the left temporoparietal cortex in tinnitus and auditory hallucinations. It remains to determine how to optimize rTMS protocols and techniques to give them relevance in routine clinical practice. In addition, professionals carrying out rTMS protocols should undergo rigorous training to ensure the quality of the technical realization, guarantee the proper care of patients, and maximize the chances of success. Under these conditions, the therapeutic use of rTMS should be able to develop in the coming years.
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Affiliation(s)
- Jean-Pascal Lefaucheur
- Department of Physiology, Henri Mondor Hospital, Assistance Publique - Hôpitaux de Paris, Créteil, France; EA 4391, Nerve Excitability and Therapeutic Team, Faculty of Medicine, Paris Est Créteil University, Créteil, France.
| | - Nathalie André-Obadia
- Neurophysiology and Epilepsy Unit, Pierre Wertheimer Neurological Hospital, Hospices Civils de Lyon, Bron, France; Inserm U 1028, NeuroPain Team, Neuroscience Research Center of Lyon (CRNL), Lyon-1 University, Bron, France
| | - Andrea Antal
- Department of Clinical Neurophysiology, Georg-August University, Göttingen, Germany
| | - Samar S Ayache
- Department of Physiology, Henri Mondor Hospital, Assistance Publique - Hôpitaux de Paris, Créteil, France; EA 4391, Nerve Excitability and Therapeutic Team, Faculty of Medicine, Paris Est Créteil University, Créteil, France
| | - Chris Baeken
- Department of Psychiatry and Medical Psychology, Ghent Experimental Psychiatry (GHEP) Lab, Ghent University, Ghent, Belgium; Department of Psychiatry, University Hospital (UZBrussel), Brussels, Belgium
| | - David H Benninger
- Neurology Service, Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Roberto M Cantello
- Department of Translational Medicine, Section of Neurology, University of Piemonte Orientale "A. Avogadro", Novara, Italy
| | | | - Mamede de Carvalho
- Institute of Physiology, Institute of Molecular Medicine, Faculty of Medicine, University of Lisbon, Portugal
| | - Dirk De Ridder
- Brai(2)n, Tinnitus Research Initiative Clinic Antwerp, Belgium; Department of Neurosurgery, University Hospital Antwerp, Belgium
| | - Hervé Devanne
- Department of Clinical Neurophysiology, Lille University Hospital, Lille, France; ULCO, Lille-Nord de France University, Lille, France
| | - Vincenzo Di Lazzaro
- Department of Neurosciences, Institute of Neurology, Campus Bio-Medico University, Rome, Italy
| | - Saša R Filipović
- Department of Neurophysiology, Institute for Medical Research, University of Belgrade, Beograd, Serbia
| | - Friedhelm C Hummel
- Brain Imaging and Neurostimulation (BINS) Laboratory, Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Satu K Jääskeläinen
- Department of Clinical Neurophysiology, Turku University Hospital, University of Turku, Turku, Finland
| | - Vasilios K Kimiskidis
- Laboratory of Clinical Neurophysiology, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Giacomo Koch
- Non-Invasive Brain Stimulation Unit, Neurologia Clinica e Comportamentale, Fondazione Santa Lucia IRCCS, Rome, Italy
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Thomas Nyffeler
- Perception and Eye Movement Laboratory, Department of Neurology, University Hospital, Inselspital, University of Bern, Bern, Switzerland
| | - Antonio Oliviero
- FENNSI Group, Hospital Nacional de Parapléjicos, SESCAM, Toledo, Spain
| | - Frank Padberg
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University, Munich, Germany
| | - Emmanuel Poulet
- Department of Emergency Psychiatry, CHU Lyon, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France; EAM 4615, Lyon-1 University, Bron, France
| | - Simone Rossi
- Brain Investigation & Neuromodulation Lab, Unit of Neurology and Clinical Neurophysiology, Department of Neuroscience, University of Siena, Siena, Italy
| | - Paolo Maria Rossini
- Brain Connectivity Laboratory, IRCCS San Raffaele Pisana, Rome, Italy; Institute of Neurology, Catholic University, Rome, Italy
| | - John C Rothwell
- Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, University College London, London, United Kingdom
| | | | - Hartwig R Siebner
- Department of Neurology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark; Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | | | - Charlotte J Stagg
- Oxford Centre for Functional MRI of the Brain (FMRIB), Department of Clinical Neurosciences, University of Oxford, United Kingdom
| | - Josep Valls-Sole
- EMG Unit, Neurology Service, Hospital Clinic, Department of Medicine, University of Barcelona, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Ulf Ziemann
- Department of Neurology & Stroke, and Hertie Institute for Clinical Brain Research, Eberhard Karls University, Tübingen, Germany
| | - Walter Paulus
- Department of Clinical Neurophysiology, Georg-August University, Göttingen, Germany
| | - Luis Garcia-Larrea
- Inserm U 1028, NeuroPain Team, Neuroscience Research Center of Lyon (CRNL), Lyon-1 University, Bron, France; Pain Unit, Pierre Wertheimer Neurological Hospital, Hospices Civils de Lyon, Bron, France
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187
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Goudriaan AE, Yücel M, van Holst RJ. Getting a grip on problem gambling: what can neuroscience tell us? Front Behav Neurosci 2014; 8:141. [PMID: 24904328 PMCID: PMC4033022 DOI: 10.3389/fnbeh.2014.00141] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2013] [Accepted: 04/08/2014] [Indexed: 01/27/2023] Open
Abstract
In problem gamblers, diminished cognitive control and increased impulsivity is present compared to healthy controls. Moreover, impulsivity has been found to be a vulnerability marker for the development of pathological gambling (PG) and problem gambling (PrG) and to be a predictor of relapse. In this review, the most recent findings on functioning of the brain circuitry relating to impulsivity and cognitive control in PG and PrG are discussed. Diminished functioning of several prefrontal areas and of the anterior cingulate cortex (ACC) indicate that cognitive-control related brain circuitry functions are diminished in PG and PrG compared to healthy controls. From the available cue reactivity studies on PG and PrG, increased responsiveness towards gambling stimuli in fronto-striatal reward circuitry and brain areas related to attentional processing is present compared to healthy controls. At this point it is unresolved whether PG is associated with hyper- or hypo-activity in the reward circuitry in response to monetary cues. More research is needed to elucidate the complex interactions for reward responsivity in different stages of gambling and across different types of reward. Conflicting findings from basic neuroscience studies are integrated in the context of recent neurobiological addiction models. Neuroscience studies on the interface between cognitive control and motivational processing are discussed in light of current addiction theories. Clinical implications: We suggest that innovation in PG therapy should focus on improvement of dysfunctional cognitive control and/or motivational functions. The implementation of novel treatment methods like neuromodulation, cognitive training and pharmacological interventions as add-on therapies to standard treatment in PG and PrG, in combination with the study of their effects on brain-behavior mechanisms could prove an important clinical step forward towards personalizing and improving treatment results in PG.
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Affiliation(s)
- Anna E Goudriaan
- Department of Psychiatry and Amsterdam Institute for Addiction Research, Academic Medical Center, University of Amsterdam Amsterdam, Netherlands
| | - Murat Yücel
- Monash Clinical and Imaging Neuroscience (MCIN) Laboratory, Monash Biomedical Imaging and School of Psychological Sciences, Monash University Monash, VIC, Australia
| | - Ruth J van Holst
- Department of Psychiatry and Amsterdam Institute for Addiction Research, Academic Medical Center, University of Amsterdam Amsterdam, Netherlands ; Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Nijmegen, Netherlands
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188
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Davis C, Levitan RD, Kaplan AS, Kennedy JL, Carter JC. Food cravings, appetite, and snack-food consumption in response to a psychomotor stimulant drug: the moderating effect of "food-addiction". Front Psychol 2014; 5:403. [PMID: 24847301 PMCID: PMC4021123 DOI: 10.3389/fpsyg.2014.00403] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Accepted: 04/16/2014] [Indexed: 01/02/2023] Open
Abstract
There is mounting evidence that many highly processed foods have addictive properties, and that some cases of compulsive overeating resemble an addiction disorder. While support for the Yale Food Addiction Scale (YFAS) as a valid diagnostic tool has been impressive and continues to increase, to date, no research has examined the food-addiction construct in response to an actual food stimulus, and in relation to direct measures of appetite and food consumption. As part of a larger community-based study of overeating in healthy adults who were predominately overweight and obese (aged 25-50 years), 136 participants completed the YFAS, of whom 23 met the diagnostic criteria for food-addiction. They took part in a 2-day, double-blind, cross-over, single-dose drug challenge using a psychomotor stimulant (methylphenidate) and placebo. Participants were first assessed on ratings of appetite and food cravings after holding and tasting their favorite snack food, after which they were able to eat all or part of the snack, as they wished. Three separate repeated-measures analysis-of-variance procedures were carried out, each with two between-subjects factors (Diagnosis: food-addiction vs. non-food addiction) and (Sex: male vs. female) and 1 within-subjects factor (Days: drug vs. placebo). As anticipated, for all three dependent variables, there was a significant main effect for Days with a response decrease from placebo to the drug condition. With respect to food cravings and appetite ratings, results indicated that the food addiction group had significantly higher scores on both variables. For food consumption, there was a significant Days × Diagnosis interaction whereby the food-addiction group showed no food-intake suppression across days compared to the non-food-addiction group who demonstrated a significant decrease in snack-food consumption with methylphenidate. The finding that the food-addiction group was resistant to the food-intake suppression typically induced by a dopamine agonist supports evidence of dopamine signaling-strength differences in individuals with compulsive overeating compared to those without this disorder. This represents the first demonstration that individuals defined by their food-addiction status have a unique pattern of food-intake following a pharmacologic challenge with such agents.
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Affiliation(s)
- Caroline Davis
- Kinesiology and Health Science, York UniversityToronto, ON, Canada
| | | | | | | | - Jacqueline C. Carter
- Department of Psychology, Memorial University of NewfoundlandSt. John’s, NL, Canada
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Hall PA. Re-establishing momentum in theory development: a commentary on Sniehotta, Presseau and Araújo-Soares. Health Psychol Rev 2014. [PMID: 26209207 DOI: 10.1080/17437199.2014.896080] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Peter A Hall
- a Faculty of Applied Health Sciences , University of Waterloo , Waterloo , ON N2L 3G1 , Canada
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190
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Dieler AC, Dresler T, Joachim K, Deckert J, Herrmann MJ, Fallgatter AJ. Can intermittent theta burst stimulation as add-on to psychotherapy improve nicotine abstinence? Results from a pilot study. Eur Addict Res 2014; 20:248-53. [PMID: 24924851 DOI: 10.1159/000357941] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2013] [Accepted: 12/12/2013] [Indexed: 11/19/2022]
Abstract
Smoking is among the leading causes of mortality worldwide. Discontinuing smoking can increase life expectancy to the presmoking level. Unaided attempts are often ineffective, strengthening the necessity of cognitive-behavioral therapy (CBT), nicotine replacement or pharmacotherapy. Still, relapse rates are high. Recently, a modulation of nicotine craving, which predicts relapse, through transcranial magnetic stimulation to the prefrontal cortex was shown. In a pilot study, we investigated whether 4 sessions of intermittent theta burst stimulation (iTBS) as add-on treatment to CBT reduces nicotine craving and improves long-term abstinence (at 3, 6 and 12 months). Smokers were randomly assigned to a treatment (n = 38) or a sham group (n = 36). Although we did not find reduced craving, we could show higher abstinence rates in the treatment group at 3 months. At 6 and 12 months abstinence rates did not differ significantly. Results at 12 months, however, have to be interpreted cautiously due to significant differences in the dropout rates between the two groups at this time point. We provide first evidence for a beneficial effect of additional iTBS on intermediate nicotine abstinence; however, the low number of iTBS sessions might have prevented longer effects. More lasting effects might be achieved by iTBS maintenance sessions in analogy to the treatment of depression.
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Affiliation(s)
- Alica C Dieler
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, Ludwig Maximilians University Munich, Munich, Germany
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191
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Konova AB, Moeller SJ, Goldstein RZ. Common and distinct neural targets of treatment: changing brain function in substance addiction. Neurosci Biobehav Rev 2013; 37:2806-17. [PMID: 24140399 PMCID: PMC3859814 DOI: 10.1016/j.neubiorev.2013.10.002] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Revised: 09/17/2013] [Accepted: 10/08/2013] [Indexed: 01/28/2023]
Abstract
Neuroimaging offers an opportunity to examine the neurobiological effects of therapeutic interventions for human drug addiction. Using activation likelihood estimation, the aim of the current meta-analysis was to quantitatively summarize functional neuroimaging studies of pharmacological and cognitive-based interventions for drug addiction, with an emphasis on their common and distinct neural targets. More exploratory analyses also contrasted subgroups of studies based on specific study and sample characteristics. The ventral striatum, a region implicated in reward, motivation, and craving, and the inferior frontal gyrus and orbitofrontal cortex, regions involved in inhibitory control and goal-directed behavior, were identified as common targets of pharmacological and cognitive-based interventions; these regions were observed when the analysis was limited to only studies that used established or efficacious interventions, and across imaging paradigms and types of addictions. Consistent with theoretical models, cognitive-based interventions were additionally more likely to activate the anterior cingulate cortex, middle frontal gyrus, and precuneus, implicated in self-referential processing, cognitive control, and attention. These results suggest that therapeutic interventions for addiction may target the brain structures that are altered across addictions and identify potential neurobiological mechanisms by which the tandem use of pharmacological and cognitive-based interventions may yield synergistic or complementary effects. These findings could inform the selection of novel functional targets in future treatment development for this difficult-to-treat disorder.
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Affiliation(s)
- Anna B. Konova
- Departments of Psychiatry & Neuroscience, Icahn School of Medicine at Mount Sinai, 1470 Madison Ave., New York, NY 10029
- Department of Psychology, Stony Brook University, Stony Brook, NY 11794
| | - Scott J. Moeller
- Departments of Psychiatry & Neuroscience, Icahn School of Medicine at Mount Sinai, 1470 Madison Ave., New York, NY 10029
| | - Rita Z. Goldstein
- Departments of Psychiatry & Neuroscience, Icahn School of Medicine at Mount Sinai, 1470 Madison Ave., New York, NY 10029
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