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Sallie SN, Sonkusare S, Mandali A, Casero V, Cui H, Guzman NV, Allison M, Voon V. Cortical paired associative stimulation shows impaired plasticity of inhibition networks as a function of chronic alcohol use. Psychol Med 2024; 54:698-709. [PMID: 37712403 DOI: 10.1017/s0033291723002374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
BACKGROUND Response inhibition - or the ability to withhold a suboptimal response - relies on the efficacy of fronto-striatal networks, and is impaired in neuropsychiatric disorders including addiction. Cortical paired associative stimulation (cPAS) is a form of transcranial magnetic stimulation (TMS) which can strengthen neuronal connections via spike-timing-dependent plasticity mechanisms. Here, we used cPAS targeting the fronto-striatal inhibitory network to modulate performance on a response inhibition measure in chronic alcohol use. METHODS Fifty-five participants (20 patients with a formal alcohol use disorder (AUD) diagnosis (26-74 years, 6[30%] females) and 20 matched healthy controls (HCs) (27-73 years, 6[30%] females) within a larger sample of 35 HCs (23-84 years, 11[31.4%] females) underwent two randomized sessions of cPAS 1-week apart: right inferior frontal cortex stimulation preceding right presupplementary motor area stimulation by either 4 ms (excitation condition) or 100 ms (control condition), and were subsequently administered the Stop Signal Task (SST) in both sessions. RESULTS HCs showed decreased stop signal reaction time in the excitation condition (t(19) = -3.01, p = 0.007, [CIs]:-35.6 to -6.42); this facilitatory effect was not observed for AUD (F(1,31) = 9.57, p = 0.004, CIs: -68.64 to -14.11). Individually, rates of SST improvement were substantially higher for healthy (72%) relative to AUD (13.6%) groups (OR: 2.33, p = 0.006, CIs:-3.34 to -0.55). CONCLUSION In line with previous findings, cPAS improved response inhibition in healthy adults by strengthening the fronto-striatal network through putative long-term potentiation-like plasticity mechanisms. Furthermore, we identified a possible marker of impaired cortical excitability, and, thus, diminished capacity for cPAS-induced neuroplasticity in AUD with direct implications to a disorder-relevant cognitive process.
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Affiliation(s)
- Samantha N Sallie
- Department of Psychiatry, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Saurabh Sonkusare
- Department of Psychiatry, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Alekhya Mandali
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, OX3 9DU, UK
- MRC Brain Network Dynamics Unit, University of Oxford, Oxford, OX13TH, UK
| | - Violeta Casero
- Department of Psychiatry, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Hailun Cui
- Department of Psychiatry, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Natalie V Guzman
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Michael Allison
- Liver Unit, Department of Medicine, Cambridge NIHR Biomedical Research Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, CB2 0QQ, UK
| | - Valerie Voon
- Department of Psychiatry, University of Cambridge, Cambridge, CB2 0QQ, UK
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
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Tang VM, Ibrahim C, Rodak T, Goud R, Blumberger DM, Voineskos D, Le Foll B. Managing substance use in patients receiving therapeutic repetitive transcranial magnetic stimulation: A scoping review. Neurosci Biobehav Rev 2023; 155:105477. [PMID: 38007879 DOI: 10.1016/j.neubiorev.2023.105477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 11/16/2023] [Accepted: 11/18/2023] [Indexed: 11/28/2023]
Abstract
Repetitive Transcranial Magnetic Stimulation (rTMS) is an invaluable treatment option for neuropsychiatric disorders. Co-occurring recreational and nonmedical substance use can be common in those presenting for rTMS treatment, and it is unknown how it may affect the safety and efficacy of rTMS for the treatment of currently approved neuropsychiatric indications. This scoping review aimed to map the literature on humans receiving rTMS and had a history of any type of substance use. The search identified 274 articles providing information on inclusion/exclusion criteria, withdrawal criteria, safety protocols, type of rTMS and treatment parameters, adverse events and effect on primary outcomes that related to substance use. There are neurophysiological effects of substance use on cortical excitability, although the relevance to clinical rTMS practice is unknown. The current literature supports the safety and feasibility of delivering rTMS to those who have co-occurring neuropsychiatric disorder and substance use. However, specific details on how varying degrees of substance use alters the safety, efficacy, and mechanisms of rTMS remains poorly described.
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Affiliation(s)
- Victor M Tang
- Addictions Division, Centre for Addiction and Mental Health, Canada; Institute for Medical Science, Temerty Faculty of Medicine, University of Toronto, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Canada; Institute of Mental Health Policy Research, Centre for Addiction and Mental Health, Canada.
| | - Christine Ibrahim
- Addictions Division, Centre for Addiction and Mental Health, Canada; Institute for Medical Science, Temerty Faculty of Medicine, University of Toronto, Canada
| | - Terri Rodak
- CAMH Mental Health Sciences Library, Department of Education, Centre for Addiction and Mental Health, Canada
| | - Rachel Goud
- Addictions Division, Centre for Addiction and Mental Health, Canada
| | - Daniel M Blumberger
- Institute for Medical Science, Temerty Faculty of Medicine, University of Toronto, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Canada; Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Canada
| | - Daphne Voineskos
- Institute for Medical Science, Temerty Faculty of Medicine, University of Toronto, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Canada; Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Canada; Poul Hansen Family Centre for Depression, Krembil Research Institute, Toronto Western Hospital, University Health Network, Canada
| | - Bernard Le Foll
- Addictions Division, Centre for Addiction and Mental Health, Canada; Institute for Medical Science, Temerty Faculty of Medicine, University of Toronto, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Canada; Institute of Mental Health Policy Research, Centre for Addiction and Mental Health, Canada; CAMH Mental Health Sciences Library, Department of Education, Centre for Addiction and Mental Health, Canada; Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Canada; Poul Hansen Family Centre for Depression, Krembil Research Institute, Toronto Western Hospital, University Health Network, Canada; Department of Pharmacology and Toxicology, Temerty Faculty of Medicine, University of Toronto, Canada; Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, Canada; Waypoint Research Institute, Waypoint Centre for Mental Health Care, Penetanguishene, Canada
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3
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Dharavath RN, Pina-Leblanc C, Tang VM, Sloan ME, Nikolova YS, Pangarov P, Ruocco AC, Shield K, Voineskos D, Blumberger DM, Boileau I, Bozinoff N, Gerretsen P, Vieira E, Melamed OC, Sibille E, Quilty LC, Prevot TD. GABAergic signaling in alcohol use disorder and withdrawal: pathological involvement and therapeutic potential. Front Neural Circuits 2023; 17:1218737. [PMID: 37929054 PMCID: PMC10623140 DOI: 10.3389/fncir.2023.1218737] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 09/04/2023] [Indexed: 11/07/2023] Open
Abstract
Alcohol is one of the most widely used substances. Alcohol use accounts for 5.1% of the global disease burden, contributes substantially to societal and economic costs, and leads to approximately 3 million global deaths yearly. Alcohol use disorder (AUD) includes various drinking behavior patterns that lead to short-term or long-lasting effects on health. Ethanol, the main psychoactive molecule acting in alcoholic beverages, directly impacts the GABAergic system, contributing to GABAergic dysregulations that vary depending on the intensity and duration of alcohol consumption. A small number of interventions have been developed that target the GABAergic system, but there are promising future therapeutic avenues to explore. This review provides an overview of the impact of alcohol on the GABAergic system, the current interventions available for AUD that target the GABAergic system, and the novel interventions being explored that in the future could be included among first-line therapies for the treatment of AUD.
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Affiliation(s)
| | - Celeste Pina-Leblanc
- Campbell Family Mental Health Research Institute of CAMH, Toronto, ON, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - Victor M. Tang
- Campbell Family Mental Health Research Institute of CAMH, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Addiction Division, CAMH, Toronto, ON, Canada
- Division of Neurosciences and Clinical Translation, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Institute of Mental Health Policy Research, CAMH, Toronto, ON, Canada
| | - Matthew E. Sloan
- Campbell Family Mental Health Research Institute of CAMH, Toronto, ON, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
- Addiction Division, CAMH, Toronto, ON, Canada
- Division of Neurosciences and Clinical Translation, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Department of Psychological Clinical Science, University of Toronto Scarborough, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Institute of Mental Health Policy Research, CAMH, Toronto, ON, Canada
| | - Yuliya S. Nikolova
- Campbell Family Mental Health Research Institute of CAMH, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Peter Pangarov
- Campbell Family Mental Health Research Institute of CAMH, Toronto, ON, Canada
| | - Anthony C. Ruocco
- Campbell Family Mental Health Research Institute of CAMH, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Temerty Centre for Therapeutic Brain Intervention, CAMH, Toronto, ON, Canada
- Department of Psychology, University of Toronto Scarborough, Toronto, ON, Canada
| | - Kevin Shield
- Institute of Mental Health Policy Research, CAMH, Toronto, ON, Canada
| | - Daphne Voineskos
- Campbell Family Mental Health Research Institute of CAMH, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Temerty Centre for Therapeutic Brain Intervention, CAMH, Toronto, ON, Canada
| | - Daniel M. Blumberger
- Campbell Family Mental Health Research Institute of CAMH, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Temerty Centre for Therapeutic Brain Intervention, CAMH, Toronto, ON, Canada
| | - Isabelle Boileau
- Campbell Family Mental Health Research Institute of CAMH, Toronto, ON, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Brain Health Imaging Centre, CAMH, Toronto, ON, Canada
| | - Nikki Bozinoff
- Campbell Family Mental Health Research Institute of CAMH, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Philip Gerretsen
- Campbell Family Mental Health Research Institute of CAMH, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Brain Health Imaging Centre, CAMH, Toronto, ON, Canada
| | - Erica Vieira
- Campbell Family Mental Health Research Institute of CAMH, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Osnat C. Melamed
- Campbell Family Mental Health Research Institute of CAMH, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Etienne Sibille
- Campbell Family Mental Health Research Institute of CAMH, Toronto, ON, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Lena C. Quilty
- Campbell Family Mental Health Research Institute of CAMH, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Thomas D. Prevot
- Campbell Family Mental Health Research Institute of CAMH, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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Hamel R, Demers O, Boileau C, Roy ML, Théoret H, Bernier PM, Lepage JF. The neurobiological markers of acute alcohol's subjective effects in humans. Neuropsychopharmacology 2022; 47:2101-2110. [PMID: 35701548 PMCID: PMC9556716 DOI: 10.1038/s41386-022-01354-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 05/21/2022] [Accepted: 05/24/2022] [Indexed: 12/21/2022]
Abstract
The ingestion of alcohol yields acute biphasic subjective effects: stimulation before sedation. Despite their predictive relevance to the development of alcohol use disorders (AUD), the neurobiological markers accounting for the biphasic effects of alcohol remain poorly understood in humans. Informed by converging lines of evidence, this study tested the hypothesis that alcohol ingestion acutely increases gamma-aminobutyric acid (GABA)-mediated inhibition, which would positively and negatively predict the feeling of stimulation and sedation, respectively. To do so, healthy participants (n = 20) ingested a single dose of 94% ABV alcohol (males: 1.0 ml/kg; females: 0.85 ml/kg) in a randomized placebo-controlled cross-over design. The alcohol's biphasic effects were assessed with the Brief-Biphasic Alcohol Effects Scale, and non-invasive neurobiological markers were measured with transcranial magnetic stimulation, before and every 30 min (up to 120 min) after the complete ingestion of the beverage. Results showed that acute alcohol ingestion selectively increased the duration of the cortical silent period (CSP) as compared to placebo, suggesting that alcohol increases non-specific GABAergic inhibition. Importantly, CSP duration positively and negatively predicted increases in the feeling of stimulation and sedation, respectively, suggesting that stimulation emerges as GABAergic inhibition increases and that sedation emerges as GABAergic inhibition returns to baseline values. Overall, these results suggest that modulations of GABAergic inhibition are central to the acute biphasic subjective effects of alcohol, providing a potential preventive target to curb the progression of at-risk individuals to AUD.
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Affiliation(s)
- Raphael Hamel
- Département de kinanthropologie, Faculté des sciences de l'activité physique, Université de Sherbrooke, Sherbrooke, QC, Canada
- Département de pédiatrie, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Olivier Demers
- Département de pédiatrie, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Camille Boileau
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Marie-Laurence Roy
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Hugo Théoret
- Département de psychologie, Faculté des arts et sciences, Université de Montréal, Montreal, QC, Canada
| | - Pierre-Michel Bernier
- Département de kinanthropologie, Faculté des sciences de l'activité physique, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Jean-Francois Lepage
- Département de pédiatrie, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada.
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke, Sherbrooke, QC, Canada.
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Lanza G, Fisicaro F, Dubbioso R, Ranieri F, Chistyakov AV, Cantone M, Pennisi M, Grasso AA, Bella R, Di Lazzaro V. A comprehensive review of transcranial magnetic stimulation in secondary dementia. Front Aging Neurosci 2022; 14:995000. [PMID: 36225892 PMCID: PMC9549917 DOI: 10.3389/fnagi.2022.995000] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 08/29/2022] [Indexed: 11/13/2022] Open
Abstract
Although primary degenerative diseases are the main cause of dementia, a non-negligible proportion of patients is affected by a secondary and potentially treatable cognitive disorder. Therefore, diagnostic tools able to early identify and monitor them and to predict the response to treatment are needed. Transcranial magnetic stimulation (TMS) is a non-invasive neurophysiological technique capable of evaluating in vivo and in “real time” the motor areas, the cortico-spinal tract, and the neurotransmission pathways in several neurological and neuropsychiatric disorders, including cognitive impairment and dementia. While consistent evidence has been accumulated for Alzheimer’s disease, other degenerative cognitive disorders, and vascular dementia, to date a comprehensive review of TMS studies available in other secondary dementias is lacking. These conditions include, among others, normal-pressure hydrocephalus, multiple sclerosis, celiac disease and other immunologically mediated diseases, as well as a number of inflammatory, infective, metabolic, toxic, nutritional, endocrine, sleep-related, and rare genetic disorders. Overall, we observed that, while in degenerative dementia neurophysiological alterations might mirror specific, and possibly primary, neuropathological changes (and hence be used as early biomarkers), this pathogenic link appears to be weaker for most secondary forms of dementia, in which neurotransmitter dysfunction is more likely related to a systemic or diffuse neural damage. In these cases, therefore, an effort toward the understanding of pathological mechanisms of cognitive impairment should be made, also by investigating the relationship between functional alterations of brain circuits and the specific mechanisms of neuronal damage triggered by the causative disease. Neurophysiologically, although no distinctive TMS pattern can be identified that might be used to predict the occurrence or progression of cognitive decline in a specific condition, some TMS-associated measures of cortical function and plasticity (such as the short-latency afferent inhibition, the short-interval intracortical inhibition, and the cortical silent period) might add useful information in most of secondary dementia, especially in combination with suggestive clinical features and other diagnostic tests. The possibility to detect dysfunctional cortical circuits, to monitor the disease course, to probe the response to treatment, and to design novel neuromodulatory interventions in secondary dementia still represents a gap in the literature that needs to be explored.
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Affiliation(s)
- Giuseppe Lanza
- Department of Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
- Clinical Neurophysiology Research Unit, Oasi Research Institute-IRCCS, Troina, Italy
- *Correspondence: Giuseppe Lanza,
| | - Francesco Fisicaro
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Raffaele Dubbioso
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, Naples, Italy
| | - Federico Ranieri
- Unit of Neurology, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | | | - Mariagiovanna Cantone
- Neurology Unit, Policlinico University Hospital “G. Rodolico – San Marco”, Catania, Italy
- Neurology Unit, Sant’Elia Hospital, ASP Caltanissetta, Caltanissetta, Italy
| | - Manuela Pennisi
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Alfio Antonio Grasso
- Department of Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Rita Bella
- Department of Medical and Surgical Sciences and Advanced Technologies, University of Catania, Catania, Italy
| | - Vincenzo Di Lazzaro
- Unit of Neurology, Neurophysiology and Neurobiology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Rome, Italy
- Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
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Nardone R, Sebastianelli L, Versace V, Ferrazzoli D, Brigo F, Schwenker K, Saltuari L, Trinka E. TMS for the functional evaluation of cannabis effects and for treatment of cannabis addiction: A review. Psychiatry Res 2022; 310:114431. [PMID: 35219263 DOI: 10.1016/j.psychres.2022.114431] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 01/29/2022] [Accepted: 02/03/2022] [Indexed: 11/15/2022]
Abstract
The knowledge about the effects of cannabis on human cortical brain processes is increasing. In this regard, transcranial magnetic stimulation (TMS) enables the evaluation of central nervous system function, including drug effects. Moreover, repetitive TMS (rTMS) has been used therapeutically in several substance use disorders. In this scoping review, we summarize and discuss studies that have employed TMS and rTMS techniques in users of cannabis for recreational purposes. In subjects with a history of persistent cannabis use, TMS studies showed reduced short-interval cortical inhibition (SICI). This observation points more at neurobiological changes of chronic cannabis use than to a direct effect of cannabis on gamma-aminobutyric acid (GABA) A receptors. Moreover, individuals vulnerable to becoming long-term users of cannabis may also have underlying pre-existing abnormalities in SICI. Of note, the use of cannabis is associated with an increased risk of schizophrenia, and the down-regulation of GABAergic function may play a role. Less frequent cannabis use and spontaneous craving were observed following rTMS applied to the dorsolateral prefrontal cortex (DLPFC). There is emerging evidence that the posterior cingulate cortex and the precuneus are potential targets for rTMS intervention in cannabis use disorder. However, larger and randomized trials should corroborate these encouraging findings.
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Affiliation(s)
- Raffaele Nardone
- Department of Neurology, Hospital of Merano (SABES-ASDAA), Merano-Meran, Italy; Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria; Spinal Cord Injury and Tissue Regeneration Center, Salzburg, Austria; Karl Landsteiner Institut für Neurorehabilitation und Raumfahrtneurologie, Salzburg, Austria.
| | - Luca Sebastianelli
- Department of Neurorehabilitation, Hospital of Vipiteno (SABES-ASDAA), Vipiteno-Sterzing, Italy; Research Unit for Neurorehabilitation South Tyrol, Bolzano, Italy
| | - Viviana Versace
- Department of Neurorehabilitation, Hospital of Vipiteno (SABES-ASDAA), Vipiteno-Sterzing, Italy; Research Unit for Neurorehabilitation South Tyrol, Bolzano, Italy
| | - Davide Ferrazzoli
- Department of Neurorehabilitation, Hospital of Vipiteno (SABES-ASDAA), Vipiteno-Sterzing, Italy; Research Unit for Neurorehabilitation South Tyrol, Bolzano, Italy
| | - Francesco Brigo
- Department of Neurology, Hospital of Merano (SABES-ASDAA), Merano-Meran, Italy; Department of Neuroscience, Biomedicine and Movement Science, University of Verona, Italy
| | - Kerstin Schwenker
- Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria; Karl Landsteiner Institut für Neurorehabilitation und Raumfahrtneurologie, Salzburg, Austria
| | - Leopold Saltuari
- Department of Neurorehabilitation, Hospital of Vipiteno (SABES-ASDAA), Vipiteno-Sterzing, Italy; Research Unit for Neurorehabilitation South Tyrol, Bolzano, Italy
| | - Eugen Trinka
- Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria; Karl Landsteiner Institut für Neurorehabilitation und Raumfahrtneurologie, Salzburg, Austria; Centre for Cognitive Neurosciences Salzburg, Salzburg, Austria; UMIT, University for Medical Informatics and Health Technology, Hall in Tirol, Austria
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7
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Transcranial ultrasound stimulation of the human motor cortex. iScience 2021; 24:103429. [PMID: 34901788 PMCID: PMC8637484 DOI: 10.1016/j.isci.2021.103429] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 08/04/2021] [Accepted: 11/09/2021] [Indexed: 12/22/2022] Open
Abstract
It has been 40 years since the report of long-term synaptic plasticity on the rodent brain. Transcranial ultrasound stimulation (TUS) shows advantages in spatial resolution and penetration depth when compared with electrical or magnetic stimulation. The repetitive TUS (rTUS) can induce cortical excitability alteration on animals, and persistent aftereffects were observed. However, the effects of rTUS on synaptic plasticity in humans remain unelucidated. In the current study, we applied a 15-min rTUS protocol to stimulate left primary motor cortex (l-M1) in 24 male healthy participants. The single-pulsed transcranial magnetic stimulation-evoked motor evoked potential and Stop-signal task was applied to measure the rTUS aftereffects. Here, we report that conditioning the human motor cortex using rTUS may produce long-lasting and statistically significant effects on motor cortex excitability as well as motor behavior, without harmful side effects observed. These findings suggest a considerable potential of rTUS in cortical plasticity modulation and clinical intervention for impulsivity-related disorders.
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Taga M, Charalambous CC, Raju S, Lin J, Zhang Y, Stern E, Schambra HM. Corticoreticulospinal tract neurophysiology in an arm and hand muscle in healthy and stroke subjects. J Physiol 2021; 599:3955-3971. [PMID: 34229359 DOI: 10.1113/jp281681] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 06/30/2021] [Indexed: 11/08/2022] Open
Abstract
KEY POINTS The corticoreticulospinal tract (CReST) is a descending motor pathway that reorganizes after corticospinal tract (CST) injury in animals. In humans, the pattern of CReST innervation to upper limb muscles has not been carefully examined in healthy individuals or individuals with CST injury. In the present study, we assessed CReST projections to an arm and hand muscle on the same side of the body in healthy and chronic stoke subjects using transcranial magnetic stimulation. We show that CReST connection strength to the muscles differs between healthy and stroke subjects, with stronger connections to the hand than arm in healthy subjects, and stronger connections to the arm than hand in stroke subjects. These results help us better understand CReST innervation patterns in the upper limb, and may point to its role in normal motor function and motor recovery in humans. ABSTRACT The corticoreticulospinal tract (CReST) is a major descending motor pathway in many animals, but little is known about its innervation patterns in proximal and distal upper extremity muscles in humans. The contralesional CReST furthermore reorganizes after corticospinal tract (CST) injury in animals, but it is less clear whether CReST innervation changes after stroke in humans. We thus examined CReST functional connectivity, connection strength, and modulation in an arm and hand muscle of healthy (n = 15) and chronic stroke (n = 16) subjects. We delivered transcranial magnetic stimulation to the contralesional hemisphere (assigned in healthy subjects) to elicit ipsilateral motor evoked potentials (iMEPs) from the paretic biceps (BIC) and first dorsal interosseous (FDI) muscle. We operationalized CReST functional connectivity as iMEP presence/absence, CReST projection strength as iMEP size and CReST modulation as change in iMEP size by head rotation. We found comparable CReST functional connectivity to the BICs and FDIs in both subject groups. However, the pattern of CReST connection strength to the muscles diverged between groups, with stronger connections to FDIs than BICs in healthy subjects and stronger connections to BICs than FDIs in stroke subjects. Head rotation modulated only FDI iMEPs of healthy subjects. Our findings indicate that the healthy CReST does not have a proximal innervation bias, and its strong FDI connections may have functional relevance to finger individuation. The reversed CReST innervation pattern in stroke subjects confirms its reorganization after CST injury, and its strong BIC connections may indicate upregulation for particular upper extremity muscles or their functional actions.
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Affiliation(s)
- Myriam Taga
- Department of Neurology, School of Medicine, NYU Langone, New York, NY, USA
| | - Charalambos C Charalambous
- Department of Neurology, School of Medicine, NYU Langone, New York, NY, USA.,Department of Basic and Clinical Sciences, University of Nicosia Medical School, Nicosia, Cyprus.,Center for Neuroscience and Integrative Brain Research (CENIBRE), University of Nicosia Medical School, Nicosia, Cyprus
| | - Sharmila Raju
- Department of Neurology, School of Medicine, NYU Langone, New York, NY, USA
| | - Jing Lin
- Department of Neurology, School of Medicine, NYU Langone, New York, NY, USA
| | - Yian Zhang
- Division of Biostatistics, Department of Population Health, School of Medicine, New York University, New York, NY, USA
| | - Elisa Stern
- Department of Neurology, School of Medicine, NYU Langone, New York, NY, USA
| | - Heidi M Schambra
- Department of Neurology, School of Medicine, NYU Langone, New York, NY, USA
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Nicolini C, Fahnestock M, Gibala MJ, Nelson AJ. Understanding the Neurophysiological and Molecular Mechanisms of Exercise-Induced Neuroplasticity in Cortical and Descending Motor Pathways: Where Do We Stand? Neuroscience 2020; 457:259-282. [PMID: 33359477 DOI: 10.1016/j.neuroscience.2020.12.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 12/08/2020] [Accepted: 12/09/2020] [Indexed: 02/07/2023]
Abstract
Exercise is a promising, cost-effective intervention to augment successful aging and neurorehabilitation. Decline of gray and white matter accompanies physiological aging and contributes to motor deficits in older adults. Exercise is believed to reduce atrophy within the motor system and induce neuroplasticity which, in turn, helps preserve motor function during aging and promote re-learning of motor skills, for example after stroke. To fully exploit the benefits of exercise, it is crucial to gain a greater understanding of the neurophysiological and molecular mechanisms underlying exercise-induced brain changes that prime neuroplasticity and thus contribute to postponing, slowing, and ameliorating age- and disease-related impairments in motor function. This knowledge will allow us to develop more effective, personalized exercise protocols that meet individual needs, thereby increasing the utility of exercise strategies in clinical and non-clinical settings. Here, we review findings from studies that investigated neurophysiological and molecular changes associated with acute or long-term exercise in healthy, young adults and in healthy, postmenopausal women.
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Affiliation(s)
- Chiara Nicolini
- Department of Kinesiology, McMaster University, Hamilton, ON L8S 4K1, Canada
| | - Margaret Fahnestock
- Department of Psychiatry & Behavioral Neurosciences, McMaster University, Hamilton, ON L8S 4K1, Canada
| | - Martin J Gibala
- Department of Kinesiology, McMaster University, Hamilton, ON L8S 4K1, Canada
| | - Aimee J Nelson
- Department of Kinesiology, McMaster University, Hamilton, ON L8S 4K1, Canada.
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10
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Turco CV, Arsalan SO, Nelson AJ. The Influence of Recreational Substance Use in TMS Research. Brain Sci 2020; 10:E751. [PMID: 33080965 PMCID: PMC7603156 DOI: 10.3390/brainsci10100751] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 10/13/2020] [Accepted: 10/15/2020] [Indexed: 12/30/2022] Open
Abstract
(1) Background: Transcranial magnetic stimulation (TMS) approaches are widely used to study cortical and corticospinal function. However, responses to TMS are subject to significant intra-and inter-individual variability. Acute and chronic exposure to recreational substances alters the excitability of the sensorimotor system and may contribute to the variability in TMS outcome measures. The increasing prevalence of recreational substance use poses a significant challenge for executing TMS studies, but there is a lack of clarity regarding the influence of these substances on sensorimotor function. (2) Methods: The literature investigating the influence of alcohol, nicotine, caffeine and cannabis on TMS outcome measures of corticospinal, intracortical and interhemispheric excitability was reviewed. (3) Results: Both acute and chronic use of recreational substances modulates TMS measures of excitability. Despite the abundance of research in this field, we identify knowledge gaps that should be addressed in future studies to better understand the influence of these substances on TMS outcomes. (4) Conclusions: This review highlights the need for TMS studies to take into consideration the history of participant substance use and to control for acute substance use prior to testing.
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Affiliation(s)
| | | | - Aimee J. Nelson
- Department of Kinesiology, McMaster University, Hamilton, ON L8S 4L8, Canada; (C.V.T.); (S.O.A.)
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11
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Pellegrini M, Zoghi M, Jaberzadeh S. A Checklist to Reduce Response Variability in Studies Using Transcranial Magnetic Stimulation for Assessment of Corticospinal Excitability: A Systematic Review of the Literature. Brain Connect 2020; 10:53-71. [PMID: 32093486 DOI: 10.1089/brain.2019.0715] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Response variability between individuals (interindividual variability) and within individuals (intraindividual variability) is an important issue in the transcranial magnetic stimulation (TMS) literature. This has raised questions of the validity of TMS to assess changes in corticospinal excitability (CSE) in a predictable and reliable manner. Several participant-specific factors contribute to this observed response variability with a current lack of consensus on the degree each factor contributes. This highlights a need for consistency and structure in reporting study designs and methodologies. Currently, there is no summarized review of the participant-specific factors that can be controlled and may contribute to response variability. This systematic review aimed to develop a checklist of methodological measures taken by previously published research to increase the homogeneity of participant selection criteria, preparation of participants before experimental testing, participant scheduling, and the instructions given to participants throughout experimental testing to minimize their effect on response variability. Seven databases were searched in full. Studies were included if CSE was measured via TMS and included methodological measures to increase the homogeneity of the participants. Eighty-four studies were included. Twenty-three included measures to increase participant selection homogeneity, 21 included measures to increase participant preparation homogeneity, while 61 included measures to increase participant scheduling and instructions during experimental testing homogeneity. These methodological measures were summarized into a user-friendly checklist with considerations, suggestions, and rationale/justification for their inclusion. This may provide the framework for further insights into ways to reduce response variability in TMS research.
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Affiliation(s)
- Michael Pellegrini
- Non-Invasive Brain Stimulation and Neuroplasticity Laboratory, Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Victoria, Australia
| | - Maryam Zoghi
- Department of Rehabilitation, Nutrition and Sport, Discipline of Physiotherapy, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia
| | - Shapour Jaberzadeh
- Non-Invasive Brain Stimulation and Neuroplasticity Laboratory, Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Victoria, Australia
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12
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Mostafavi SA, Khaleghi A, Mohammadi MR. Noninvasive brain stimulation in alcohol craving: A systematic review and meta-analysis. Prog Neuropsychopharmacol Biol Psychiatry 2020; 101:109938. [PMID: 32234509 DOI: 10.1016/j.pnpbp.2020.109938] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 03/17/2020] [Accepted: 03/27/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Alcohol dependence (AD) is characterized by a set of physical and behavioral symptoms, which may include withdrawal, tolerance and craving. Recently, noninvasive brain stimulation (NIBS) methods, namely transcranial direct current stimulation (tDCS) and transcranial magnetic stimulation (TMS), have been investigated as possible new therapeutic approaches for adjusting the pathological neuroplasticity involved in alcohol dependence. Therefore, we conducted a systematic review and meta-analysis on the therapeutic uses of tDCS and rTMS in AD patients. METHODS A systematic search was performed on Scopus, Web of Science, PubMed, Cochrane library and ProQuest. Search terms presented the diagnoses of interest (alcohol dependence, alcohol craving, alcohol use disorders and hazardous drinkers) and the intervention of interest (NIBS, TMS, rTMS, TBS, tDCS, tACS and transcranial). Original articles reporting the use of tDCS or rTMS to treat AD were screened and studied by two researchers independently based on PRISMA guidelines. Next, in the meta-analysis step, random-effects model was utilized to measure the pooled effect size. RESULTS We found 34 eligible studies including 11 tDCS trials and 23 rTMS trials. Three of these studies were case-reports, four were open label trials and the remaining 27 were controlled trials which assessed tDCS/rTMS effects on the three cognitive, behavioral and biological dimensions in AD. The pooled standardized mean differences for the effects of tDCS and rTMS on alcohol cravings were - 0.13 [-0.34, 0.08] and - 0.43 [-1.02, 0.17], respectively. CONCLUSION There is no evidence for a positive effect of tDCS/rTMS on various dimensions of AD. We need more randomized, double blind, sham controlled trials with enough follow-up periods to evaluate the efficacy of tDCS/rTMS for alcohol dependence treatment.
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Affiliation(s)
- Seyed-Ali Mostafavi
- Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Khaleghi
- Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Mohammad Reza Mohammadi
- Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran
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13
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Pellegrini M, Zoghi M, Jaberzadeh S. The effects of transcranial direct current stimulation on corticospinal and cortico-cortical excitability and response variability: Conventional versus high-definition montages. Neurosci Res 2020; 166:12-25. [PMID: 32610058 DOI: 10.1016/j.neures.2020.06.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 06/08/2020] [Accepted: 06/11/2020] [Indexed: 01/19/2023]
Abstract
Response variability following transcranial direct current stimulation (tDCS) highlights need for exploring different tDCS electrode montages. Corticospinal excitability (CSE), cortico-cortical excitability and intra-individual variability was compared following conventional and high-definition (HD) anodal (a-tDCS) and cathodal (c-tDCS) tDCS. Fifteen healthy males attended four sessions at-least one-week apart: conventional a-tDCS, conventional c-tDCS, HD-a-tDCS, HD-c-tDCS. TDCS was administered (1 mA, 10-minutes) over primary motor cortex (M1), via 6 × 4 cm active and 7 × 5 cm return electrodes (conventional tDCS) and 4 × 1 ring-electrodes 3.5 cm apart over M1 (HD-tDCS). For CSE, twenty-five single-pulse transcranial magnetic stimulation (TMS) peak-to-peak motor evoked potentials (MEP) were recorded at baseline, 0-minutes and 30-minutes post-tDCS. Twenty-five paired-pulse MEPs with 3-millisecond (ms) inter-pulse interval (IPI) and twenty-five at 10 ms assessed short-interval intracortical inhibition (SICI) and intracortical facilitation (ICF). MEP standardised z-values standard deviations represented intra-individual variability. No significant changes in CSE from baseline were reported for all four interventions. No significant differences were reported in CSE between conventional and HD a-tDCS, but significant differences between conventional and HD c-tDCS 0-minutes post-tDCS. Conventional tDCS significantly reduced intra-individual variability compared to HD-tDCS for a-tDCS (0-minutes) and c-tDCS (30-minutes). No changes were reported for SICI/ICF. These novel findings of increased intra-individual variability following HD-tDCS, at the current stimulus parameters, highlight need for further nuanced research and refinement to optimise the HD-tDCS dosage-response relationship.
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Affiliation(s)
- Michael Pellegrini
- Non-Invasive Brain Stimulation and Neuroplasticity Laboratory, Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Australia.
| | - Maryam Zoghi
- Department of Rehabilitation, Nutrition and Sport, School of Allied Health, Discipline of Physiotherapy, La Trobe University, Melbourne, Australia
| | - Shapour Jaberzadeh
- Non-Invasive Brain Stimulation and Neuroplasticity Laboratory, Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Australia
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14
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Nardone R, Trinka E, Sebastianelli L, Versace V, Saltuari L. Commentary: Deficient inhibition in alcohol-dependence: let's consider the role of the motor system! Front Neurosci 2019; 13:1237. [PMID: 31798409 PMCID: PMC6874153 DOI: 10.3389/fnins.2019.01237] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 11/01/2019] [Indexed: 11/13/2022] Open
Affiliation(s)
- Raffaele Nardone
- Department of Neurology, Franz Tappeiner Hospital, Merano, Italy.,Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria.,Karl Landsteiner Institut für Neurorehabilitation und Raumfahrtneurologie, Salzburg, Austria
| | - Eugen Trinka
- Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria.,Centre for Cognitive Neurosciences Salzburg, Salzburg, Austria.,University for Medical Informatics and Health Technology, UMIT, Hall in Tirol, Austria
| | - Luca Sebastianelli
- Department of Neurorehabilitation, Hospital of Vipiteno, Vipiteno, Italy.,Research Unit for Neurorehabilitation South Tyrol, Bolzano, Italy
| | - Viviana Versace
- Department of Neurorehabilitation, Hospital of Vipiteno, Vipiteno, Italy.,Research Unit for Neurorehabilitation South Tyrol, Bolzano, Italy
| | - Leopold Saltuari
- Department of Neurorehabilitation, Hospital of Vipiteno, Vipiteno, Italy.,Research Unit for Neurorehabilitation South Tyrol, Bolzano, Italy.,Department of Neurology, Hochzirl Hospital, Zirl, Austria
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15
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Pearson-Dennett V, Faulkner PL, Collie B, Wilcox RA, Vogel AP, Thewlis D, Esterman A, McDonnell MN, Gandevia SC, White JM, Todd G. Use of illicit amphetamines is associated with long-lasting changes in hand circuitry and control. Clin Neurophysiol 2019; 130:655-665. [PMID: 30870801 DOI: 10.1016/j.clinph.2019.02.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 01/16/2019] [Accepted: 02/04/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The study aim was to determine if use of illicit amphetamines or ecstasy is associated with abnormal excitability of the corticomotoneuronal pathway and manipulation of novel objects with the hand. METHODS Three groups of adults aged 18-50 years were investigated: individuals with a history of illicit amphetamine use, individuals with a history of ecstasy use but minimal use of other stimulants, and non-drug users. Transcranial magnetic stimulation was delivered to the motor cortex and the electromyographic response (motor evoked potential; MEP) was recorded from a contralateral hand muscle. Participants also gripped and lifted a novel experimental object consisting of two strain gauges and an accelerometer. RESULTS Resting MEP amplitude was larger in the amphetamine group (6M, 6F) than the non-drug and ecstasy groups (p < 0.005) in males but not females. Overestimation of grip force during manipulation of a novel object was observed in the amphetamine group (p = 0.020) but not the ecstasy group. CONCLUSIONS History of illicit amphetamine use, in particular methamphetamine, is associated with abnormal motor cortical and/or corticomotoneuronal excitability in males and abnormal manipulation of novel objects in both males and females. SIGNIFICANCE Abnormal excitability and hand function is evident months to years after cessation of illicit amphetamine use.
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Affiliation(s)
- Verity Pearson-Dennett
- School of Pharmacy and Medical Sciences, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia.
| | - Patrick L Faulkner
- School of Pharmacy and Medical Sciences, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia; School of Health Sciences, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia.
| | - Brittany Collie
- School of Pharmacy and Medical Sciences, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia.
| | - Robert A Wilcox
- School of Pharmacy and Medical Sciences, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia; Department of Neurology, Flinders Medical Centre, Bedford Park, SA 5042, Australia; Human Physiology, Medical School, Flinders University, Bedford Park, SA 5042, Australia.
| | - Adam P Vogel
- Centre for Neuroscience of Speech, The University of Melbourne, Carlton, VIC 3010, Australia; Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen 72076, Germany; Redenlab, Carlton, VIC 3053, Australia.
| | - Dominic Thewlis
- Centre for Orthopaedic & Trauma Research, The University of Adelaide, Adelaide, SA 5000, Australia.
| | - Adrian Esterman
- School of Nursing and Midwifery, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia.
| | - Michelle N McDonnell
- Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia.
| | - Simon C Gandevia
- Neuroscience Research Australia, PO Box 1165, Randwick, NSW 2031, Australia; Prince of Wales Clinical School, University of New South Wales, Sydney, NSW 2052, Australia.
| | - Jason M White
- School of Pharmacy and Medical Sciences, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia.
| | - Gabrielle Todd
- School of Pharmacy and Medical Sciences, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia.
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16
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Pressman MR. The neurophysiological and neurochemical effects of alcohol on the brain are inconsistent with current evidence based models of sleepwalking. Sleep Med Rev 2018; 43:92-95. [PMID: 30537569 DOI: 10.1016/j.smrv.2018.10.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 09/06/2018] [Accepted: 10/24/2018] [Indexed: 11/24/2022]
Abstract
The DSM-5 and ICSD-3 have removed alcohol from the list of potential triggers for sleepwalking due to the lack of empirical evidence. Recent imaging and EEG based studies of sleepwalking and confusional arousals have provided a more data-based method of examining if alcohol is compatible with what is known about the neurophysiology and neurochemistry of sleepwalking. These studies have demonstrated a deactivation of the frontal areas of the brain, while the cingulate or motor cortex remains active and characterized activation in the form of beta EEG. This increase in activation is attributed to a decrease in the inhibitory activity the neurotransmitter GABAA. This cerebral excitability of the cingulate cortex of sleepwalkers is also present in the brains of sleepwalkers during wakefulness compared to normal controls. Alcohol is well established to have an inhibitory effect on the brain and specifically on the motor areas via the inhibitory effects of increased GABAA activity. Thus, the empirical data show sleepwalking is characterized by a decrease in the inhibitory activity of GABAA - permitting or facilitating motor activity while alcohol has the opposite effect of increasing GABAA and inhibiting motor activity. This is inconsistent with theories that alcohol is somehow a trigger or facilitator for sleepwalking.
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Affiliation(s)
- Mark R Pressman
- Sleep Medicine Services, Lankenau Medical Center, Wynnewood, PA, USA; Lankenau Institute for Medical Research, Wynnewood, PA, USA; Department of Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA; Charles Widger School of Law, Villanova University, Villanova, PA, USA.
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17
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Sandrini M, Caronni A, Corbo M. Modulating Reconsolidation With Non-invasive Brain Stimulation-Where We Stand and Future Directions. Front Psychol 2018; 9:1430. [PMID: 30150956 PMCID: PMC6099108 DOI: 10.3389/fpsyg.2018.01430] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 07/23/2018] [Indexed: 11/25/2022] Open
Affiliation(s)
- Marco Sandrini
- Department of Neurorehabilitation Sciences, Casa Cura Policlinico, Milan, Italy.,Department of Psychology, University of Roehampton, London, United Kingdom
| | - Antonio Caronni
- Department of Neurorehabilitation Sciences, Casa Cura Policlinico, Milan, Italy
| | - Massimo Corbo
- Department of Neurorehabilitation Sciences, Casa Cura Policlinico, Milan, Italy
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18
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Hanlon CA, Dowdle LT, Henderson JS. Modulating Neural Circuits with Transcranial Magnetic Stimulation: Implications for Addiction Treatment Development. Pharmacol Rev 2018; 70:661-683. [PMID: 29945899 PMCID: PMC6020107 DOI: 10.1124/pr.116.013649] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Although the last 50 years of clinical and preclinical research have demonstrated that addiction is a brain disease, we still have no neural circuit-based treatments for substance dependence or cue reactivity at large. Now, for the first time, it appears that a noninvasive brain stimulation technique known as transcranial magnetic stimulation (TMS), which is Food and Drug Administration approved to treat depression, may be the first tool available to fill this critical void in addiction treatment development. The goals of this review are to 1) introduce TMS as a tool to induce causal change in behavior, cortical excitability, and frontal-striatal activity; 2) describe repetitive TMS (rTMS) as an interventional tool; 3) provide an overview of the studies that have evaluated rTMS as a therapeutic tool for alcohol and drug use disorders; and 4) outline a conceptual framework for target selection when designing future rTMS clinical trials in substance use disorders. The manuscript concludes with some suggestions for methodological innovation, specifically with regard to combining rTMS with pharmacotherapy as well as cognitive behavioral training paradigms. We have attempted to create a comprehensive manuscript that provides the reader with a basic set of knowledge and an introduction to the primary experimental questions that will likely drive the field of TMS treatment development forward for the next several years.
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Affiliation(s)
- Colleen A Hanlon
- Departments of Psychiatry (C.A.H., L.T.D., J.S.H.) and Neurosciences (C.A.H., L.T.D.), Medical University of South Carolina, Charleston, South Carolina; and Ralph Johnson VA Medical Center, Charleston, South Carolina (C.A.H.)
| | - Logan T Dowdle
- Departments of Psychiatry (C.A.H., L.T.D., J.S.H.) and Neurosciences (C.A.H., L.T.D.), Medical University of South Carolina, Charleston, South Carolina; and Ralph Johnson VA Medical Center, Charleston, South Carolina (C.A.H.)
| | - J Scott Henderson
- Departments of Psychiatry (C.A.H., L.T.D., J.S.H.) and Neurosciences (C.A.H., L.T.D.), Medical University of South Carolina, Charleston, South Carolina; and Ralph Johnson VA Medical Center, Charleston, South Carolina (C.A.H.)
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19
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Charalambous CC, Dean JC, Adkins DL, Hanlon CA, Bowden MG. Characterizing the corticomotor connectivity of the bilateral ankle muscles during rest and isometric contraction in healthy adults. J Electromyogr Kinesiol 2018; 41:9-18. [PMID: 29715530 DOI: 10.1016/j.jelekin.2018.04.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 04/20/2018] [Accepted: 04/23/2018] [Indexed: 01/19/2023] Open
Abstract
The investigation of the corticomotor connectivity (CMC) to leg muscles is an emerging research area, and establishing reliability of measures is critical. This study examined the measurement reliability and the differences between bilateral soleus (SOL) and tibialis anterior (TA) CMC in 21 neurologically intact adults. Using single pulse transcranial magnetic stimulation (TMS), each muscle's CMC was assessed twice (7 ± 2 days apart) during rest and active conditions. CMC was quantified using a standardized battery of eight measures (4/condition): motor threshold during resting (RMT), motor evoked potential amplitude and latency (raw and normalized to height) in both conditions, contralateral silent period (CSP) during active. Using two reliability metrics (intraclass correlation coefficient and coefficient of variation of method error; good reliability: ≥0.75 and ≤15, respectively) and repeated-measures ANOVA, we investigated the reliability and Muscle X Body Side interaction. For both muscles, RMT, resting raw and normalized latencies, and active raw latency demonstrated good reliability, while CSP had good reliability only for TA. Amplitude did not demonstrate good reliability for both muscles. SOL CMC was significantly different from TA CMC for all measures but CSP; body side had no significant effect. Therefore, only certain measures may reliably quantify SOL and TA CMC while different CMC (except CSP) between SOL and TA suggests dissimilar corticospinal drive to each muscle regardless of the side.
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Affiliation(s)
- Charalambos C Charalambous
- Department of Neurology, New York University School of Medicine, New York, NY, USA; Department of Health Sciences and Research, Medical University of South Carolina, Charleston, SC, USA.
| | - Jesse C Dean
- Department of Health Sciences and Research, Medical University of South Carolina, Charleston, SC, USA; Ralph H. Johnson VA Medical Center, Charleston, SC, USA; Division of Physical Therapy, Medical University of South Carolina, Charleston, SC, USA
| | - DeAnna L Adkins
- Department of Health Sciences and Research, Medical University of South Carolina, Charleston, SC, USA; Department of Neurosciences, Medical University of South Carolina, Charleston, SC, USA; Center for Biomedical Imaging, Medical University of South Carolina, Charleston, SC, USA
| | - Colleen A Hanlon
- Ralph H. Johnson VA Medical Center, Charleston, SC, USA; Department of Neurosciences, Medical University of South Carolina, Charleston, SC, USA; Center for Biomedical Imaging, Medical University of South Carolina, Charleston, SC, USA; Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA
| | - Mark G Bowden
- Department of Health Sciences and Research, Medical University of South Carolina, Charleston, SC, USA; Ralph H. Johnson VA Medical Center, Charleston, SC, USA; Division of Physical Therapy, Medical University of South Carolina, Charleston, SC, USA
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20
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Kaarre O, Kallioniemi E, Könönen M, Tolmunen T, Kekkonen V, Kivimäki P, Heikkinen N, Ferreri F, Laukkanen E, Määttä S. Heavy alcohol use in adolescence is associated with altered cortical activity: a combined TMS-EEG study. Addict Biol 2018; 23:268-280. [PMID: 28008690 DOI: 10.1111/adb.12486] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 11/19/2016] [Accepted: 11/21/2016] [Indexed: 12/13/2022]
Abstract
Long-term alcohol use affects cognitive and neurophysiological functioning as well as structural brain development. Combining simultaneous electroencephalogram (EEG) recording with transcranial magnetic stimulation (TMS) enables direct, in vivo exploration of cortical excitability and assessment of effective and functional connectivity. In the central nervous system, the effects of alcohol are particularly mediated by alterations in gamma-aminobutyric acid (GABA)ergic neurotransmission, and TMS-evoked potentials (TEPs) N45 and N100 in EEG are known to reflect GABAergic function. However, no previous studies have examined the effects of long-term alcohol use in adolescence on TEPs. In this study, a total of 27 young adults with heavy alcohol use in adolescence and 25 age-matched, gender-matched and education-matched controls with little or no alcohol use participated in TMS-EEG measurements. The motor cortex (M1) was stimulated with an intensity of 90 percent of the resting motor threshold of the abductor pollicis brevis muscle. No significant differences were found in the resting motor threshold, TEP latencies or neuropsychological functioning between the groups. We observed an increase in the global mean field power in the time window of 54- to 75-millisecond post-TMS, as well as significant topographical differences in the P60 and N100 in those with a history of heavy drinking. Furthermore, there was a marked increase in the GABAergic N45 amplitude in alcohol users. These findings suggest that long-term alcohol use in adolescence, even when not meeting the diagnostic criteria for a disorder, is associated with changes in connectivity and cortical excitability.
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Affiliation(s)
- Outi Kaarre
- Department of Adolescent Psychiatry; Kuopio University Hospital; Kuopio Finland
- Doctoral Programme of Clinical Research, School of Medicine; University of Eastern Finland; Kuopio Finland
| | - Elisa Kallioniemi
- Department of Applied Physics; University of Eastern Finland; Kuopio Finland
- Department of Clinical Neurophysiology; Kuopio University Hospital; Kuopio Finland
| | - Mervi Könönen
- Department of Clinical Neurophysiology; Kuopio University Hospital; Kuopio Finland
- Department of Clinical Radiology; Kuopio University Hospital; Kuopio Finland
| | - Tommi Tolmunen
- Department of Adolescent Psychiatry; Kuopio University Hospital; Kuopio Finland
- Department of Psychiatry, School of Medicine; University of Eastern Finland; Kuopio Finland
| | - Virve Kekkonen
- Department of Adolescent Psychiatry; Kuopio University Hospital; Kuopio Finland
| | - Petri Kivimäki
- Doctoral Programme of Clinical Research, School of Medicine; University of Eastern Finland; Kuopio Finland
| | - Noora Heikkinen
- Doctoral Programme of Clinical Research, School of Medicine; University of Eastern Finland; Kuopio Finland
| | - Florinda Ferreri
- Department of Neurology; University Campus Biomedico; Rome Italy
| | - Eila Laukkanen
- Department of Adolescent Psychiatry; Kuopio University Hospital; Kuopio Finland
- Department of Psychiatry, School of Medicine; University of Eastern Finland; Kuopio Finland
| | - Sara Määttä
- Department of Clinical Neurophysiology; Kuopio University Hospital; Kuopio Finland
- Department of Clinical Neurophysiology, Institute of Clinical Medicine, Faculty of Health; University of Eastern Finland; Kuopio Finland
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Naim-Feil J, Bradshaw JL, Rogasch NC, Daskalakis ZJ, Sheppard DM, Lubman DI, Fitzgerald PB. Cortical inhibition within motor and frontal regions in alcohol dependence post-detoxification: A pilot TMS-EEG study. World J Biol Psychiatry 2016; 17:547-56. [PMID: 26243644 DOI: 10.3109/15622975.2015.1066512] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Preclinical studies suggest that cortical alterations within the prefrontal cortex (PFC) are critical to the pathophysiology of alcohol dependence. Combined transcranial magnetic stimulation (TMS) and electroencephalography (EEG) allows direct assessment of cortical excitability and inhibition within the PFC of human subjects. We report the first application of TMS-EEG to measure these indices within the PFC of alcohol-dependent (ALD) patients post-detoxification. METHODS Cortical inhibition was assessed in 12 ALD patients and 14 healthy controls through single and paired-pulse TMS paradigms. Long-interval cortical inhibition indexed cortical inhibition in the PFC. In the motor cortex (MC), short- interval intracortical inhibition and cortical silent period determined inhibition, while intracortical facilitation measured facilitation, resting and active motor threshold indexed cortical excitability. RESULTS ALD patients demonstrated altered cortical inhibition across the bilateral frontal cortices relative to controls. There was evidence of altered cortical excitability in ALD patients; however, no significant differences in MC inhibition. CONCLUSIONS Our study provides first direct evidence of reduced cortical inhibition in the PFC of ALD patients post-detoxification. Altered cortical excitability in the MC may reflect hyper-excitability within the cortex associated with chronic alcohol consumption. These findings provide initial neurophysiological evidence of disrupted cortical excitability within the PFC of ALD patients.
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Affiliation(s)
- Jodie Naim-Feil
- a Monash Alfred Psychiatry Research Centre, The Alfred and Monash University, Central Clinical School , Prahran, Victoria , Australia.,b School of Psychology and Psychiatry, Monash University , Clayton, Victoria , Australia.,c Department of Physics of Complex Systems , The Weizmann Institute of Science , Rehovot , Israel
| | - John L Bradshaw
- b School of Psychology and Psychiatry, Monash University , Clayton, Victoria , Australia
| | - Nigel C Rogasch
- a Monash Alfred Psychiatry Research Centre, The Alfred and Monash University, Central Clinical School , Prahran, Victoria , Australia.,d Brain and Mental Health Laboratory, School of Psychological Sciences and Monash Biomedical Imaging, Monash University , Melbourne , Australia
| | - Zafiris J Daskalakis
- e Temetry Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, University of Toronto , Toronto , Canada
| | - Dianne M Sheppard
- f Monash Injury Research Institute, Monash University , Clayton, Victoria , Australia
| | - Dan I Lubman
- g Turning Point Alcohol and Drug Centre, Eastern Health and Monash University , Victoria , Australia
| | - Paul B Fitzgerald
- a Monash Alfred Psychiatry Research Centre, The Alfred and Monash University, Central Clinical School , Prahran, Victoria , Australia
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Hortensius R, de Gelder B, Schutter DJLG. When anger dominates the mind: Increased motor corticospinal excitability in the face of threat. Psychophysiology 2016; 53:1307-16. [PMID: 27325519 PMCID: PMC5113684 DOI: 10.1111/psyp.12685] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 05/10/2016] [Indexed: 02/06/2023]
Abstract
Threat demands fast and adaptive reactions that are manifested at the physiological, behavioral, and phenomenological level and are responsive to the direction of threat and its severity for the individual. Here, we investigated the effects of threat directed toward or away from the observer on motor corticospinal excitability and explicit recognition. Sixteen healthy right‐handed volunteers completed a transcranial magnetic stimulation (TMS) task and a separate three‐alternative forced‐choice emotion recognition task. Single‐pulse TMS to the left primary motor cortex was applied to measure motor evoked potentials from the right abductor pollicis brevis in response to dynamic angry, fearful, and neutral bodily expressions with blurred faces directed toward or away from the observer. Results showed that motor corticospinal excitability increased independent of direction of anger compared with fear and neutral. In contrast, anger was better recognized when directed toward the observer compared with when directed away from the observer, while the opposite pattern was found for fear. The present results provide evidence for the differential effects of threat direction on explicit recognition and motor corticospinal excitability. In the face of threat, motor corticospinal excitability increases independently of the direction of anger, indicative of the importance of more automatic reactions to threat.
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Affiliation(s)
- Ruud Hortensius
- Brain and Emotion Laboratory, Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, The Netherlands.,Cognitive and Affective Neuroscience Laboratory, Department of Medical and Clinical Psychology, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands.,Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Beatrice de Gelder
- Brain and Emotion Laboratory, Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, The Netherlands.,Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Dennis J L G Schutter
- Donders Institute of Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands
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Abstract
Alcoholic drinks (ADs) have been reported as a migraine trigger in about one-third of the migraine patients in retrospective studies. Some studies found that ADs trigger also other primary headaches. The studies concerning the role of ADs in triggering various types of primary headaches published after the International Headache Society classification criteria of 1988 were reviewed, and the pathophysiological mechanisms were discussed. Many studies show that ADs are a trigger of migraine without aura (MO), migraine with aura (MA), cluster headache (CH), and tension-type headache (TH). While data on MO and CH are well delineated, those in MA and TH are discordant. There are sparse reports that ADs are also triggers of less frequent types of primary headache such as familial hemiplegic migraine, hemicrania continua, and paroxysmal hemicrania. However, in some countries, the occurrence of alcohol as headache trigger is negligible, perhaps determined by alcohol habits. The frequency estimates vary widely based on the study approach and population. In fact, prospective studies report a limited importance of ADs as migraine trigger. If ADs are capable of triggering practically all primary headaches, they should act at a common pathogenetic level. The mechanisms of alcohol-provoking headache were discussed in relationship to the principal pathogenetic theories of primary headaches. The conclusion was that vasodilatation is hardly compatible with ADs trigger activity of all primary headaches and a common pathogenetic mechanism at cortical, or more likely at subcortical/brainstem, level is more plausible.
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Affiliation(s)
- Alessandro Panconesi
- Department of Neurology, Headache Center, San Giuseppe Hospital, Empoli, FI, Italy
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Abadie-Guedes R, Bezerra RDS, Guedes RCA. Alpha-Tocopherol Counteracts the Effect of Ethanol on Cortical Spreading Depression in Rats of Various Ages, With and Without Ethanol Abstinence. Alcohol Clin Exp Res 2016; 40:728-33. [DOI: 10.1111/acer.12998] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2015] [Accepted: 12/30/2015] [Indexed: 01/28/2023]
Affiliation(s)
- Ricardo Abadie-Guedes
- Departamento de Fisiologia e Farmacologia; CCB; Universidade Federal de Pernambuco; Recife Pernambuco Brazil
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Yavari F, Shahbabaie A, Leite J, Carvalho S, Ekhtiari H, Fregni F. Noninvasive brain stimulation for addiction medicine: From monitoring to modulation. PROGRESS IN BRAIN RESEARCH 2015; 224:371-99. [PMID: 26822367 DOI: 10.1016/bs.pbr.2015.08.007] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Addiction is a chronic relapsing brain disease with significant economical and medical burden on the societies but with limited effectiveness in the available treatment options. Better understanding of the chemical, neuronal, regional, and network alterations of the brain due to drug abuse can ultimately lead to tailoring individualized and more effective interventions. To this end, employing new assessment and intervention procedures seems crucial. Noninvasive brain stimulation (NIBS) techniques including transcranial electrical and magnetic stimulations (tES and TMS) have provided promising opportunities for the addiction medicine in two main domains: (1) providing new insights into neurochemical and neural circuit changes in the human brain cortex and (2) understanding the role of different brain regions by using NIBS and modulating cognitive functions, such as drug craving, risky decision making, inhibitory control and executive functions to obtain specific treatment outcomes. In spite of preliminary positive results, there are several open questions, which need to be addressed before routine clinical utilization of NIBS techniques in addiction to medicine, such as how to account for interindividual differences, define optimal cognitive and neural targets, optimize stimulation protocols, and integrate NIBS with other therapeutic methods. Therefore, in this chapter we revise the available literature on the use of NIBS (TMS and tES) in the diagnostic, prognostic, and therapeutic aspects of the addiction medicine.
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Affiliation(s)
- Fatemeh Yavari
- Neurocognitive Laboratory, Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Shahbabaie
- Neurocognitive Laboratory, Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran; Translational Neuroscience Program, Institute for Cognitive Science Studies (ICSS), Tehran, Iran; Neuroimaging and Analysis Group, Research Center for Molecular and Cellular Imaging (RCMCI), Tehran University of Medical Sciences, Tehran, Iran
| | - Jorge Leite
- Department of Physical Medicine and Rehabilitation, Laboratory of Neuromodulation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Neuropsychophysiology Laboratory, CIPsi, School of Psychology (EPsi), University of Minho, Braga, Portugal
| | - Sandra Carvalho
- Department of Physical Medicine and Rehabilitation, Laboratory of Neuromodulation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Neuropsychophysiology Laboratory, CIPsi, School of Psychology (EPsi), University of Minho, Braga, Portugal
| | - Hamed Ekhtiari
- Neurocognitive Laboratory, Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran; Translational Neuroscience Program, Institute for Cognitive Science Studies (ICSS), Tehran, Iran; Neuroimaging and Analysis Group, Research Center for Molecular and Cellular Imaging (RCMCI), Tehran University of Medical Sciences, Tehran, Iran.
| | - Felipe Fregni
- Department of Physical Medicine and Rehabilitation, Laboratory of Neuromodulation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
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Deleterious effects of a low amount of ethanol on LTP-like plasticity in human cortex. Neuropsychopharmacology 2014; 39:1508-18. [PMID: 24385131 PMCID: PMC3988555 DOI: 10.1038/npp.2013.350] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2013] [Revised: 12/28/2013] [Accepted: 12/28/2013] [Indexed: 11/08/2022]
Abstract
Ingesting ethanol (EtOH) at low doses during social drinking is a common human behavior for its facilitating effects on social interactions. However, low-dose EtOH may have also detrimental effects that so far are underexplored. Here we sought to test the effects of low-dose EtOH on long-term potentiation (LTP)-like plasticity in human motor cortex. Previous cellular experiments showed that low-dose EtOH potentiates extrasynaptic GABAAR and reduces NMDAR-mediated currents, processes that would limit the expression of LTP. Paired associative transcranial magnetic stimulation (PASLTP) was employed in nine healthy subjects for induction of LTP-like plasticity, indexed by a long-term increase in motor-evoked potential input-output curves. Synaptic α1-GABAAR function was measured by saccadic peak velocity (SPV). Very low doses of EtOH (resulting in blood concentrations of <5 mM) suppressed LTP-like plasticity but did not affect SPV when compared with a placebo condition. In contrast, 1 mg of alprazolam, a classical benzodiazepine, or 10 mg of zolpidem, a non-benzodiazepine hypnotic, decreased SPV but did not significantly affect LTP-like plasticity when compared with placebo. This double dissociation of low-dose EtOH vs alprazolam/zolpidem effects is best explained by the putatively high affinity of EtOH but not alprazolam/zolpidem to extrasynaptic GABAARs and to NMDARs. Findings suggest that enhancement of extrasynaptic GABAAR-mediated tonic inhibition and/or reduction of NMDAR-mediated neurotransmission by EtOH blocks LTP-like plasticity in human cortex at very low doses that are easily reached during social drinking. Therefore, low-dose EtOH may jeopardize LTP-dependent processes, such as learning and memory formation.
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rTMS in the treatment of drug addiction: an update about human studies. Behav Neurol 2014; 2014:815215. [PMID: 24803733 PMCID: PMC4006612 DOI: 10.1155/2014/815215] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2013] [Accepted: 04/22/2013] [Indexed: 01/29/2023] Open
Abstract
Drug addiction can be a devastating and chronic relapsing disorder with social, psychological, and physical consequences, and more effective treatment options are needed. Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive brain stimulation technique that has been assessed in a growing number of studies for its therapeutic potential in treating addiction. This review paper offers an overview on the current state of clinical research in treating drug addiction with rTMS. Because of the limited research in this area, all studies (including case reports) that evaluated the therapeutic use of rTMS in nicotine, alcohol, or illicit drug addiction were included in this review. Papers published prior to December 2012 were found through an NCBI PubMed search. A total of eleven studies were identified that met review criteria. There is nascent evidence that rTMS could be effective in reducing cocaine craving and nicotine and alcohol craving and consumption and might represent a potential therapeutic tool for treating addiction. Further studies are needed to identify the optimal parameters of stimulation for the most effective treatment of drug addiction, to improve our comprehension of the treatment neurophysiological effects, and to conduct rigorous, controlled efficacy studies with adequate power.
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Rangaswamy M, Porjesz B. Understanding alcohol use disorders with neuroelectrophysiology. HANDBOOK OF CLINICAL NEUROLOGY 2014; 125:383-414. [PMID: 25307587 DOI: 10.1016/b978-0-444-62619-6.00023-9] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Neurocognitive deficits associated with impairments in various brain regions and neural circuitries, particularly involving frontal lobes, have been associated with chronic alcoholism, as well as with a predisposition to develop alcohol use and related disorders (AUDs). AUD is a multifactorial disorder caused by complex interactions between behavioral, genetic, and environmental liabilities. Neuroelectrophysiologic techniques are instrumental in understanding brain and behavior relationships and have also proved very useful in evaluating the genetic diathesis of alcoholism. This chapter describes findings from neuroelectrophysiologic measures (electroencephalogram, event-related potentials, and event-related oscillations) related to acute and chronic effects of alcohol on the brain and those that reflect underlying deficits related to a predisposition to develop AUDs and related disorders. The utility of these measures as effective endophenotypes to identify and understand genes associated with brain electrophysiology, cognitive networks, and AUDs has also been discussed.
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Affiliation(s)
- Madhavi Rangaswamy
- Henri Begleiter Neurodynamics Laboratory, Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, NY, USA
| | - Bernice Porjesz
- Henri Begleiter Neurodynamics Laboratory, Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, NY, USA.
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Motor cortical excitability assessed by transcranial magnetic stimulation in psychiatric disorders: a systematic review. Brain Stimul 2013; 7:158-69. [PMID: 24472621 DOI: 10.1016/j.brs.2013.08.009] [Citation(s) in RCA: 93] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Revised: 08/16/2013] [Accepted: 08/26/2013] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Transcranial magnetic stimulation (TMS) is a popular neurostimulation technique suitable for the investigation of inhibitory and facilitatory networks in the human motor system. In the last 20 years, several studies have used TMS to investigate cortical excitability in various psychiatric disorders, leading to a consequent improvement in pathophysiological understanding. However, little is known about the overlap and specificity of these findings across these conditions. OBJECTIVE To provide a systematic review of TMS studies (1985-2013) focusing on motor cortical excitability in dementia, schizophrenia, affective disorders (major depression and bipolar), attention deficit hyperactivity disorder (ADHD), obsessive compulsive disorder (OCD), Tourette Syndrome (TS), substance abuse (alcohol, cocaine, cannabis, nicotine) and other disorders (borderline personality disorder, posttraumatic stress disorder (PTSD)). METHODS Systematic literature-based review. RESULTS Across disorders, patients displayed a general pattern of cortical disinhibition, while the most consistent results of reduced short-interval intracortical inhibition could be found in schizophrenia, OCD and Tourette Syndrome. In dementia, the most frequently reported finding was reduced short-latency afferent inhibition as a marker of cholinergic dysfunction. CONCLUSIONS The results of this systematic review indicate a general alteration in motor cortical inhibition in mental illness, rather than disease-specific changes. Changes in motor cortical excitability provide insight that can advance understanding of the pathophysiology underlying various psychiatric disorders. Further investigations are needed to improve the diagnostic application of these parameters.
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Nocente R, Vitali M, Balducci G, Enea D, Kranzler HR, Ceccanti M. Varenicline and neuronal nicotinic acetylcholine receptors: a new approach to the treatment of co-occurring alcohol and nicotine addiction? Am J Addict 2013; 22:453-9. [PMID: 23952890 DOI: 10.1111/j.1521-0391.2013.12037.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2011] [Revised: 12/06/2011] [Accepted: 03/12/2012] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Alcohol and nicotine dependence are serious public health problems worldwide. They are associated with substantial morbidity and mortality, as well as adverse social effects and increased healthcare costs. Although efficacious treatments are available for these disorders, additional therapeutic options are required to ensure greater treatment utilization. In this paper, we describe the empirical basis on which varenicline, a nicotinic partial agonist approved for smoking cessation, may also have utility in the treatment of alcohol addiction. METHODS We sought to identify papers examining nicotine dependence, alcohol dependence, smoking, alcohol, and varenicline for possible inclusion in the present review. We identified over 600 papers through Pubmed/Medline, PsychINFO, and Google Scholar. We found 12 papers taking into consideration the following criteria: original language English, varenicline effect on alcohol consumption. RESULTS Animal studies have shown that varenicline reduces alcohol consumption. Two recent studies showed that varenicline also reduces alcohol consumption in humans. Both nicotine and alcohol interact with α4β2 and α3β4 nicotinic acetylcholine (ACh) receptors located in the ventral tegmental area of the brain, inducing dopamine (DA) release at the nucleus accumbens. Varenicline binds to nicotinic ACh receptors, where it has partial agonist effects, producing a moderate and constant level of DA release both in the mesolimbic pathway and in the prefrontal cortex. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE Through these effects, varenicline may reduce alcohol craving, seeking, and consumption, in addition to promoting smoking cessation. Additional studies are needed to confirm the efficacy of varenicline in the treatment of alcohol dependence.
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Affiliation(s)
- Roberto Nocente
- Department of Clinical Medicine, Sapienza-University of Rome, Italy
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Abstract
Drug and alcohol addiction is a debilitating disorder characterized by persistent drug-seeking behaviors despite negative physiological, medical, or social consequences. Neurobiological models of addiction propose that the reinforcing effects of addictive drugs are associated with altered neurotransmission within the reward 'mesocorticolimbic' circuitry in the brain. Immense efforts are therefore designed to target the mesocorticolimbic circuitry in attenuating drug dependence and addiction-related behaviors. Yet, to date, most addiction treatments have demonstrated only limited success in reducing addiction-related behaviors. Accumulating and compelling evidence suggests that novel nonsurgical brain stimulation techniques, such as transcranial magnetic stimulation and transcranial direct current stimulation, could serve as promising tools for indexing altered neurotransmission associated with repetitive drug use, and moreover, may hold therapeutic potential for the treatment of drug dependence and addiction-related behaviors. This chapter reviews and discusses the current and potential applications of such techniques in the study and treatment of addiction; we focus on a number of common drugs of abuse, including nicotine, alcohol, cocaine, cannabis, and ecstasy.
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Non-invasive brain stimulation in the functional evaluation of alcohol effects and in the treatment of alcohol craving: A review. Neurosci Res 2012; 74:169-76. [DOI: 10.1016/j.neures.2012.08.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2012] [Revised: 07/21/2012] [Accepted: 08/09/2012] [Indexed: 01/18/2023]
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Abadie-Guedes R, Guedes RCA, Bezerra RS. The impairing effect of acute ethanol on spreading depression is antagonized by astaxanthin in rats of 2 young-adult ages. Alcohol Clin Exp Res 2012; 36:1563-7. [PMID: 22432539 DOI: 10.1111/j.1530-0277.2012.01766.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2011] [Accepted: 01/09/2012] [Indexed: 11/26/2022]
Abstract
BACKGROUND Ethanol (EtOH) abuse and insufficient ingestion of antioxidants are external factors that can alter brain electrophysiology. Our previous studies have demonstrated that the excitability-related brain electrophysiological phenomenon known as cortical spreading depression (CSD) was facilitated by chronic EtOH intake, and chronic treatment with carotenoids attenuated this effect. Here, we investigated the acute effect of a single EtOH administration on CSD in young and adult rats previously (1 hour) treated with 10 μg/kg of astaxanthin. METHODS Male Wistar rats (5 young- and 5 adult groups, 60 to 80 and 150 to 180 days of age, respectively) were treated by 2 gavage procedures at 1-hour interval as follows: groups 1 and 2 received astaxanthin in gavage I combined with EtOH (group 1) or water (group 2) in gavage II; groups 3 and 4 received olive oil (the vehicle in which astaxanthin was dissolved) in gavage I combined with EtOH (group 3) or water (group 4) in gavage II; group 5 received water in gavage I combined with EtOH in gavage II. CSD was recorded on the cortical surface for 4 hours. RESULTS Compared to the respective water and oil controls (groups 2 and 4; CSD velocities: 3.73 ± 0.09 and 3.78 ± 0.07 mm/min in the young groups; 2.99 ± 0.10 and 3.05 ± 0.19 mm/min in the adult groups), a single dose of EtOH (groups 3 and 5) decreased CSD propagation velocities (3.29 ± 0.23 and 3.16 ± 0.10 mm/min in the young groups; 2.71 ± 0.27 and 2.75 ± 0.31 mm/min in the adult groups). Astaxanthin antagonized the impairing effect of acute EtOH on CSD (group 1; mean velocity: 3.70 ± 0.19 and 3.13 ± 0.16 mm/min for the young and adult groups, respectively). CONCLUSIONS The results showed an antagonistic effect of acute EtOH treatment on CSD propagation that was reverted by astaxanthin. The EtOH-astaxanthin interaction was not influenced by the age, as it was found in both young and adult animals.
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Affiliation(s)
- Ricardo Abadie-Guedes
- Laboratório de Enzimologia-LABENZ, Departamento de Bioquímica, CCB, Universidade Federal de Pernambuco, Recife, PE, Brazil
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Barr MS, Farzan F, Wing VC, George TP, Fitzgerald PB, Daskalakis ZJ. Repetitive transcranial magnetic stimulation and drug addiction. Int Rev Psychiatry 2011; 23:454-66. [PMID: 22200135 DOI: 10.3109/09540261.2011.618827] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive brain stimulation technique that is now being tested for its ability to treat addiction. This review discusses current research approaches and results of studies which measured the therapeutic use of rTMS to treat tobacco, alcohol and illicit drug addiction. The research in this area is limited and therefore all studies evaluating the therapeutic use of rTMS in tobacco, alcohol or illicit drug addiction were retained including case studies through NCBI PubMed ( http://www.ncbi.nlm.nih.gov ) and manual searches. A total of eight studies were identified that examined the ability of rTMS to treat tobacco, alcohol and cocaine addiction. The results of this review indicate that rTMS is effective in reducing the level of cravings for smoking, alcohol, and cocaine when applied at high frequencies to the dorsolateral prefrontal cortex (DLPFC). Furthermore, these studies suggest that repeated sessions of high frequency rTMS over the DLPFC may be most effective in reducing the level of smoking and alcohol consumption. Although work in this area is limited, this review indicates that rTMS is a promising modality for treating drug addiction.
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Affiliation(s)
- Mera S Barr
- Schizophrenia Program, Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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Taqi MM, Bazov I, Watanabe H, Nyberg F, Yakovleva T, Bakalkin G. Prodynorphin promoter SNP associated with alcohol dependence forms noncanonical AP-1 binding site that may influence gene expression in human brain. Brain Res 2011; 1385:18-25. [PMID: 21338584 DOI: 10.1016/j.brainres.2011.02.042] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2010] [Revised: 01/19/2011] [Accepted: 02/14/2011] [Indexed: 11/18/2022]
Abstract
Single nucleotide polymorphism (rs1997794) in promoter of the prodynorphin gene (PDYN) associated with alcohol-dependence may impact PDYN transcription in human brain. To address this hypothesis we analyzed PDYN mRNA levels in the dorsolateral prefrontal cortex (dl-PFC) and hippocampus, both involved in cognitive control of addictive behavior and PDYN promoter SNP genotype in alcohol-dependent and control human subjects. The principal component analysis suggested that PDYN expression in the dl-PFC may be related to alcoholism, while in the hippocampus may depend on the genotype. We also demonstrated that the T, low risk SNP allele resides within noncanonical AP-1-binding element that may be targeted by JUND and FOSB proteins, the dominant AP-1 constituents in the human brain. The T to C transition abrogated AP-1 binding. The impact of genetic variations on PDYN transcription may be relevant for diverse adaptive responses of this gene to alcohol.
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Affiliation(s)
- Malik Mumtaz Taqi
- Division of Biological Research on Drug Dependence, Department of Pharmaceutical Biosciences, Uppsala University, Box 591, 751 24, Uppsala, Sweden.
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Diana M. The dopamine hypothesis of drug addiction and its potential therapeutic value. Front Psychiatry 2011; 2:64. [PMID: 22144966 PMCID: PMC3225760 DOI: 10.3389/fpsyt.2011.00064] [Citation(s) in RCA: 141] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2011] [Accepted: 11/02/2011] [Indexed: 01/28/2023] Open
Abstract
Dopamine (DA) transmission is deeply affected by drugs of abuse, and alterations in DA function are involved in the various phases of drug addiction and potentially exploitable therapeutically. In particular, basic studies have documented a reduction in the electrophysiological activity of DA neurons in alcohol, opiate, cannabinoid, and other drug-dependent rats. Further, DA release in the Nucleus accumbens (Nacc) is decreased in virtually all drug-dependent rodents. In parallel, these studies are supported by increments in intracranial self stimulation (ICSS) thresholds during withdrawal from alcohol, nicotine, opiates, and other drugs of abuse, thereby suggesting a hypofunction of the neural substrate of ICSS. Accordingly, morphological evaluations fed into realistic computational analysis of the medium spiny neuron of the Nacc, post-synaptic counterpart of DA terminals, show profound changes in structure and function of the entire mesolimbic system. In line with these findings, human imaging studies have shown a reduction of dopamine receptors accompanied by a lesser release of endogenous DA in the ventral striatum of cocaine, heroin, and alcohol-dependent subjects, thereby offering visual proof of the "dopamine-impoverished" addicted human brain. The lasting reduction in physiological activity of the DA system leads to the idea that an increment in its activity, to restore pre-drug levels, may yield significant clinical improvements (reduction of craving, relapse, and drug-seeking/taking). In theory, it may be achieved pharmacologically and/or with novel interventions such as transcranial magnetic stimulation (TMS). Its anatomo-physiological rationale as a possible therapeutic aid in alcoholics and other addicts will be described and proposed as a theoretical framework to be subjected to experimental testing in human addicts.
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Affiliation(s)
- Marco Diana
- 'G. Minardi' Cognitive Neuroscience Laboratory, Department of Drug Sciences, University of Sassari Sassari, Italy
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Nardone R, Bergmann J, Kronbichler M, Caleri F, Lochner P, Tezzon F, Ladurner G, Golaszewski S. Altered Motor Cortex Excitability to Magnetic Stimulation in Alcohol Withdrawal Syndrome. Alcohol Clin Exp Res 2010; 34:628-32. [DOI: 10.1111/j.1530-0277.2009.01131.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Wobrock T, Hasan A, Malchow B, Wolff-Menzler C, Guse B, Lang N, Schneider-Axmann T, Ecker UKH, Falkai P. Increased cortical inhibition deficits in first-episode schizophrenia with comorbid cannabis abuse. Psychopharmacology (Berl) 2010; 208:353-63. [PMID: 19997844 PMCID: PMC2806533 DOI: 10.1007/s00213-009-1736-8] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2009] [Accepted: 11/16/2009] [Indexed: 12/25/2022]
Abstract
RATIONALE/OBJECTIVES There is a high prevalence of substance use disorder (SUD) in first-episode schizophrenia (SZ), but its contribution to the underlying SZ pathophysiology remains unclear. Several studies using transcranial magnetic stimulation (TMS) have observed abnormalities in human motor cortex (M1) excitability in SZ. Studies on cortical excitability comparing SZ patients with and without comorbid substance abuse are lacking. METHODS A total of 29 first-episode SZ patients participated in this study; 12 had a history of comorbid cannabis abuse (SZ-SUD) and 17 did not (SZ-NSUD). We applied TMS to right and left M1 areas to assess the resting motor threshold (RMT), short-interval cortical inhibition (SICI), intracortical facilitation (ICF), and the contralateral cortical silent period (CSP). RESULTS In SICI and ICF conditions, right M1 stimulation led to significantly higher motor evoked potential ratios in SZ-SUD compared to SZ-NSUD. This suggests lower cortical inhibition and increased ICF in first-episode SZ with previous cannabis abuse. There were no group differences in RMT and CSP duration. Neither were there any significant correlations between psychopathology (as indexed by Positive and Negative Syndrome Scale), disease characteristics, the extent of cannabis abuse, and TMS parameters (SICI, ICF, and CSP). CONCLUSIONS Comorbid cannabis abuse may potentiate the reduced intracortical inhibition and enhanced ICF observed in first-episode SZ patients in some previous studies. This finding suggests an increased alteration of GABA(A) and NMDA receptor activity in cannabis-abusing first-episode patients as compared to schizophrenia patients with no history of substance abuse. This may constitute a distinct vulnerability factor in this special population.
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Affiliation(s)
- Thomas Wobrock
- Department of Psychiatry and Psychotherapy, Georg-August-University Göttingen, Von-Siebold-Strasse 5, 37075 Göttingen, Germany.
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Alcohol breaks down interhemispheric inhibition in females but not in males: alcohol and frontal connectivity. Psychopharmacology (Berl) 2010; 208:469-74. [PMID: 20020107 PMCID: PMC2806530 DOI: 10.1007/s00213-009-1747-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2009] [Accepted: 11/25/2009] [Indexed: 10/31/2022]
Abstract
INTRODUCTION Alcohol has renowned behavioral disinhibitory properties which are suggested to involve reductions in frontal lobe functioning as a result of diminished interhemispheric connectivity. METHODS To examine sex differences in frontal interhemispheric connectivity in response to alcohol, 12 female and ten male healthy volunteers received a single administration of 0.5 per thousand alcohol in a placebo-controlled counterbalanced crossover design. Paired-pulse transcranial magnetic stimulation was applied to measure transcallosal inhibition (TCI) between the left and right primary motor cortex (M1). RESULTS Results showed significant reductions in TCI after alcohol administration in female participants exclusively. DISCUSSION These findings provide the first evidence that moderate doses of alcohol differentially affect frontal interhemispheric connectivity in males and females. The present data may shed new light on the physiological mechanisms underlying sex differences in the susceptibility to alcohol.
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Conte A, Barbanti P, Frasca V, Iacovelli E, Gabriele M, Giacomelli E, Aurilia C, Pichiorri F, Gilio F, Inghilleri M. Differences in short-term primary motor cortex synaptic potentiation as assessed by repetitive transcranial magnetic stimulation in migraine patients with and without aura. Pain 2010; 148:43-48. [DOI: 10.1016/j.pain.2009.09.031] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2009] [Revised: 07/18/2009] [Accepted: 09/29/2009] [Indexed: 11/28/2022]
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Feil J, Zangen A. Brain stimulation in the study and treatment of addiction. Neurosci Biobehav Rev 2009; 34:559-74. [PMID: 19914283 DOI: 10.1016/j.neubiorev.2009.11.006] [Citation(s) in RCA: 109] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2009] [Revised: 10/26/2009] [Accepted: 11/07/2009] [Indexed: 01/19/2023]
Abstract
Addiction is a devastating and chronically relapsing disorder. Repeated drug administration induces neuroadaptations associated with abnormal dopaminergic activity in the mesocorticolimbic circuitry, resulting in altered cortical neurotransmission and excitability. Electrical stimulation of specific brain regions can be used in animal models and humans to induce local activation or disruption of specific circuitries or alter neuronal excitability and cause neuroadaptations. Non-surgical stimulation of specific brain regions in human addicts can be achieved by transcranial magnetic stimulation (TMS). TMS is used for transient stimulation or disruption of neural activity in specific cortical regions, which can be used to assess cortical excitability, and to induce changes in cortical excitability. Moreover, it is suggested that repeated stimulation can cause long-lasting neuroadaptations. Therefore, TMS paradigms were used in some studies to assess the presence of altered cortical excitability associated with chronic drug consumption, while other studies have begun to assess the therapeutic potential of repetitive TMS. Similarly, transcranial direct current stimulation (tDCS) is used to modulate neuronal resting membrane potential in humans and alter cortical excitability. The current review describes how these brain stimulation techniques have recently been used for the study and treatment of addiction in animal models and humans.
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Affiliation(s)
- Jodie Feil
- Department of Neurobiology, The Weizmann Institute of Science, Rehovot 76100, Israel
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Ziemann U, Paulus W, Nitsche MA, Pascual-Leone A, Byblow WD, Berardelli A, Siebner HR, Classen J, Cohen LG, Rothwell JC. Consensus: Motor cortex plasticity protocols. Brain Stimul 2008; 1:164-82. [PMID: 20633383 DOI: 10.1016/j.brs.2008.06.006] [Citation(s) in RCA: 446] [Impact Index Per Article: 27.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2008] [Accepted: 06/09/2008] [Indexed: 12/11/2022] Open
Abstract
Noninvasive transcranial stimulation is being increasingly used by clinicians and neuroscientists to alter deliberately the status of the human brain. Important applications are the induction of virtual lesions (for example, transient dysfunction) to identify the importance of the stimulated brain network for a certain sensorimotor or cognitive task, and the induction of changes in neuronal excitability, synaptic plasticity or behavioral function outlasting the stimulation, for example, for therapeutic purposes. The aim of this article is to review critically the properties of the different currently used stimulation protocols, including a focus on their particular strengths and weaknesses, to facilitate their appropriate and conscientious application.
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Affiliation(s)
- Ulf Ziemann
- Department Neurology, Goethe-University Frankfurt, Germany.
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