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Jin L, Yuan M, Zhang W, Su H, Wang F, Zhu J, Liu T, Wei Y, Li Y, Bai Q, Wang W, Wei L, Li Q. Repetitive transcranial magnetic stimulation modulates coupling among large-scale brain networks in heroin-dependent individuals: A randomized resting-state functional magnetic resonance imaging study. Addict Biol 2022; 27:e13121. [PMID: 34841633 DOI: 10.1111/adb.13121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 11/06/2021] [Accepted: 11/09/2021] [Indexed: 10/19/2022]
Abstract
The abnormal interactions of three key large-scale brain networks (default mode [DMN], salience and executive control [ECN]) were showed underlie dysfunctions in heroin addiction. Repetitive transcranial magnetic stimulation (rTMS) targeting the left dorsolateral prefrontal cortex (DLPFC) is a potential treatment for heroin addiction. It is unclear whether impaired coupling among the large-scale brain networks would be improved by rTMS in treated heroin-dependent individuals. Thirty-five heroin-dependent individuals were included in this sham-controlled, randomized study. The patients received either active or sham rTMS for 1 week. The craving for heroin and resting-state functional magnetic resonance imaging data were collected before and after 1-week rTMS. Twenty-two healthy subjects were included as controls not receiving rTMS. After 1-week rTMS, only the active rTMS group showed a significant decrease in spontaneous and heroin cue-induced craving. The coupling between left DLPFC (a key node of left ECN) and left parahippocampal gyrus (PHG, included in DMN) significantly increased for the active group with a tendency towards that of controls. The coupling between the right precentral gyrus and three key regions included in DMN (posterior cingulate cortex/precuneus and bilateral inferior parietal cortex) significantly decreased for the active group with a tendency towards that of healthy controls. For the active rTMS individuals, the left DLPFC-PHG coupling negatively correlated with the spontaneous craving and the drug cue-induced craving. It suggested that the rTMS could reduce heroin craving, which might be related to the modulation of ECN-DMN coupling. This finding might shed light on the mechanism of rTMS for heroin addiction treatment.
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Affiliation(s)
- Long Jin
- Department of Nuclear Medicine, Tangdu Hospital Fourth Military Medical University Xi'an China
| | - Menghui Yuan
- Department of Nuclear Medicine, Tangdu Hospital Fourth Military Medical University Xi'an China
| | - Wei Zhang
- Department of Nuclear Medicine, Tangdu Hospital Fourth Military Medical University Xi'an China
| | - Hang Su
- Shanghai Mental Health Center Shanghai Jiao Tong University School of Medicine Shanghai China
| | - Fan Wang
- Department of Radiology, Tangdu Hospital Fourth Military Medical University Xi'an China
| | - Jia Zhu
- Department of Radiology, Tangdu Hospital Fourth Military Medical University Xi'an China
| | - Tao Liu
- Department of Radiology, Tangdu Hospital Fourth Military Medical University Xi'an China
| | - Yixin Wei
- Department of Nuclear Medicine, Tangdu Hospital Fourth Military Medical University Xi'an China
| | - Yunbo Li
- Department of Nuclear Medicine, Tangdu Hospital Fourth Military Medical University Xi'an China
| | - Qianrong Bai
- Department of Nuclear Medicine, Tangdu Hospital Fourth Military Medical University Xi'an China
| | - Wei Wang
- Department of Nuclear Medicine, Tangdu Hospital Fourth Military Medical University Xi'an China
| | - Longxiao Wei
- Department of Nuclear Medicine, Tangdu Hospital Fourth Military Medical University Xi'an China
| | - Qiang Li
- Department of Radiology, Tangdu Hospital Fourth Military Medical University Xi'an China
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Hauer L, Scarano GI, Brigo F, Golaszewski S, Lochner P, Trinka E, Sellner J, Nardone R. Effects of repetitive transcranial magnetic stimulation on nicotine consumption and craving: A systematic review. Psychiatry Res 2019; 281:112562. [PMID: 31521838 DOI: 10.1016/j.psychres.2019.112562] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 09/04/2019] [Accepted: 09/06/2019] [Indexed: 12/15/2022]
Abstract
We performed a systematic review of the studies employing repetitive transcranial magnetic stimulation (rTMS) in subjects with smoking addiction. High-frequency (HF) rTMS over the prefrontal cortex (PFC), in particular the left dorsolateral PFC (DLPFC), might represent a save and innovative treatment tool for tobacco consumption and craving in nicotine-dependent otherwise healthy people. rTMS can be effective for this indication also in patients with schizophrenia, but the results are conflicting and sufficient evidence from large-scale trials is still lacking. Promising results have been obtained using particular techniques for brain stimulation, such as deep rTMS and theta burst stimulation. Multiple-target HF rTMS can also have a potential in smoking cessation. fMRI and EEG recordings have proven to be useful for objectively assessing the treatment effects. TMS is likely to be most effective when paired with an evidence-based self-help intervention, cognitive-behavioral interventions and nicotine replacement therapy. However, the most recent studies employed different protocols and yielded heterogeneous results, which should be replicated in further controlled studies with larger sample sizes and rigorous standards of randomization. To date, no recommendation other than that a possible efficacy of HF-rTMS of the left DLPFC can be made for alternative rTMS procedures in nicotine craving and consumption.
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Affiliation(s)
- Larissa Hauer
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Christian Doppler Medical Center, Salzburg, Austria
| | | | - Francesco Brigo
- Department of Neurology, Franz Tappeiner Hospital, Merano, Italy; Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy
| | - Stefan Golaszewski
- Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria; Karl Landsteiner Institut für Neurorehabilitation und Raumfahrtneurologie, Salzburg, Austria
| | - Piergiorgio Lochner
- Department of Neurology, Saarland University Medical Center, Homburg, Germany
| | - 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
| | - Johann Sellner
- Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria; Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Germany
| | - Raffaele Nardone
- Department of Neurology, Franz Tappeiner Hospital, Merano, Italy; Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria.
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Janes AC, Datko M, Roy A, Barton B, Druker S, Neal C, Ohashi K, Benoit H, van Lutterveld R, Brewer JA. Quitting starts in the brain: a randomized controlled trial of app-based mindfulness shows decreases in neural responses to smoking cues that predict reductions in smoking. Neuropsychopharmacology 2019; 44:1631-1638. [PMID: 31039580 PMCID: PMC6785102 DOI: 10.1038/s41386-019-0403-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 04/19/2019] [Accepted: 04/22/2019] [Indexed: 12/13/2022]
Abstract
Current treatments for smoking yield suboptimal outcomes, partly because of an inability to reduce cue-induced smoking. Mindfulness training (MT) has shown preliminary efficacy for smoking cessation, yet its neurobiological target remains unknown. Our prior work with nonsmokers indicates that MT reduces posterior cingulate cortex (PCC) activity. In individuals who smoke, the PCC, consistently a main hub of the "default mode network," activates in response to smoking cues. In this randomized controlled trial, we tested the effects of app-delivered MT on PCC reactivity to smoking cues and whether individual differences in MT-mediated PCC changes predicted smoking outcomes. Smoking cue-induced PCC reactivity was measured using functional magnetic resonance imaging at baseline and 1 month after receiving smartphone app-based MT (n = 33) vs. an active control (National Cancer Institute's QuitGuide, n = 34). Whether individual differences in treatment-related changes in PCC activity predicted smoking behavior was assessed. The MT group demonstrated a significant correlation between a reduction in PCC reactivity to smoking cues and a decline in cigarette consumption (r = 0.39, p = 0.02). No association was found in the control group (r = 0.08, p = 0.65). No effects of group alone were found in PCC or cigarette reduction. Post hoc analysis revealed this association is sex specific (women, r = 0.49, p = 0.03; men: r = -0.08, p = 0.79). This initial report indicates that MT specifically reduces smoking cue-induced PCC activity in a subject-specific manner, and the reduction in PCC activity predicts a concurrent decline in smoking. These findings link the hypothesized behavioral effects of MT for smoking to neural mechanisms particularly in women. This lays the groundwork for identifying individuals who may benefit from targeted digital therapeutic treatments such as smartphone-based MT, yielding improved clinical outcomes.
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Affiliation(s)
- Amy C. Janes
- 0000 0000 8795 072Xgrid.240206.2McLean Imaging Center, McLean Hospital, Belmont, MA 02478 USA ,000000041936754Xgrid.38142.3cHarvard Medical School, Boston, MA 02115 USA
| | - Michael Datko
- 0000 0004 0386 9924grid.32224.35Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, 149 Thirteenth St. #2301, Charlestown, MA 02129 USA ,0000 0000 9419 3149grid.239475.eCenter for Mindfulness and Compassion, Cambridge Health Alliance, 1035 Cambridge St. #21, Cambridge, MA 02141 USA
| | - Alexandra Roy
- 0000 0004 1936 9094grid.40263.33Mindfulness Center, Brown University School of Public Health and Warren Alpert School of Medicine, 121S Main St, Providence, RI 02903 USA
| | - Bruce Barton
- 0000 0001 0742 0364grid.168645.8Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 55 Lake Ave North, Worcester, MA 01655 USA
| | - Susan Druker
- 0000 0001 0742 0364grid.168645.8Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 55 Lake Ave North, Worcester, MA 01655 USA
| | - Carolyn Neal
- 0000 0004 0447 0018grid.266900.bUniversity of Oklahoma-Tulsa School of Community Medicine, Tulsa, OK 74135 USA
| | - Kyoko Ohashi
- 0000 0000 8795 072Xgrid.240206.2McLean Imaging Center, McLean Hospital, Belmont, MA 02478 USA ,000000041936754Xgrid.38142.3cHarvard Medical School, Boston, MA 02115 USA
| | - Hanif Benoit
- 0000 0001 0742 0364grid.168645.8Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 55 Lake Ave North, Worcester, MA 01655 USA
| | - Remko van Lutterveld
- 0000 0004 1936 9094grid.40263.33Mindfulness Center, Brown University School of Public Health and Warren Alpert School of Medicine, 121S Main St, Providence, RI 02903 USA
| | - Judson A. Brewer
- 0000 0004 1936 9094grid.40263.33Mindfulness Center, Brown University School of Public Health and Warren Alpert School of Medicine, 121S Main St, Providence, RI 02903 USA
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Deep TMS of the insula using the H-coil modulates dopamine release: a crossover [ 11C] PHNO-PET pilot trial in healthy humans. Brain Imaging Behav 2019; 12:1306-1317. [PMID: 29170944 DOI: 10.1007/s11682-017-9800-1] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Modulating the function of the insular cortex could be a novel therapeutic strategy to treat addiction to a variety of drugs of abuse as this region has been implicated in mediating drug reward and addictive processes. The recent advent of the H-coil has permitted the targeting of deeper brain structures which was not previously feasible. The goal of this study was to bilaterally target the insular region using the H-coil with repetitive Transcranial Magnetic Stimulation (rTMS) and subsequently measure changes in dopamine levels using Positron Emission Tomography (PET) with [11C]-(+)-propyl-hexahydro-naphtho-oxazin (PHNO). This was a within-subject, crossover, blinded and sham-controlled pilot study. Eight healthy, right-handed subjects, aged 19-45, participated in the investigation. All subjects underwent 3 PHNO-PET scans preceded by rTMS (sham, 1 Hz or 10 Hz), on 3 separate days. Low frequency rTMS (1 Hz), targeting the insular cortex, significantly decreased dopamine levels in the substantia nigra, sensorimotor striatum and associative striatum. Replicating this study in tobacco smokers or alcoholics would be a logical follow-up to assess whether H-coil stimulation of the bilateral insula can be employed as a treatment option for addiction. Trial registration: NCT02212405.
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Amidfar M, Ko YH, Kim YK. Neuromodulation and Cognitive Control of Emotion. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1192:545-564. [DOI: 10.1007/978-981-32-9721-0_27] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Sutherland MT, Stein EA. Functional Neurocircuits and Neuroimaging Biomarkers of Tobacco Use Disorder. Trends Mol Med 2018; 24:129-143. [PMID: 29398401 DOI: 10.1016/j.molmed.2017.12.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2017] [Revised: 12/07/2017] [Accepted: 12/10/2017] [Indexed: 12/30/2022]
Abstract
Drug abuse and addiction remain major public health issues, exemplified by the opioid epidemic currently devastating the United States. Treatment outcomes across substance use disorders remain unacceptably poor, wherein drug discovery/development for this multifaceted neuropsychiatric disorder focuses on single molecular-level targets. Rather, our opinion is that a systems-level neuroimaging perspective is crucial for identifying novel therapeutic targets, biomarkers to stratify patients, and individualized treatment strategies. Focusing on tobacco use disorder, we advocate a brain systems-level perspective linking two abuse-related facets (i.e., statelike withdrawal and traitlike addiction severity) with specific neurocircuitry (insula- and striatum-centered networks). To the extent that precise neurocircuits mediate distinct facets of abuse, treatment development must adopt not only a systems-level perspective, but also multi-intervention rather than mono-intervention practices.
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Affiliation(s)
| | - Elliot A Stein
- Neuroimaging Research Branch, National Institute on Drug Abuse, Intramural Research Program, NIH/DHHS, Baltimore, MD, USA.
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Turel O, Bechara A. A Triadic Reflective-Impulsive-Interoceptive Awareness Model of General and Impulsive Information System Use: Behavioral Tests of Neuro-Cognitive Theory. Front Psychol 2016; 7:601. [PMID: 27199834 PMCID: PMC4845517 DOI: 10.3389/fpsyg.2016.00601] [Citation(s) in RCA: 91] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 04/11/2016] [Indexed: 01/24/2023] Open
Abstract
This study examines a behavioral tripartite model developed in the field of addiction, and applies it here to understanding general and impulsive information technology use. It suggests that technology use is driven by two information-processing brain systems: reflective and impulsive, and that their effects on use are modulated by interoceptive awareness processes. The resultant reflective-impulsive-interoceptive awareness model is tested in two behavioral studies. Both studies employ SEM techniques to time-lagged self-report data from n 1 = 300 and n 2 = 369 social networking site users. Study 1 demonstrated that temptations augment the effect of habit on technology use, and reduce the effect of satisfaction on use. Study 2 showed that temptations strengthen the effect of habit on impulsive technology use, and weaken the effect of behavioral expectations on impulsive technology use. Hence, the results consistently support the notion that information technology users' behaviors are influenced by reflective and impulsive information processing systems; and that the equilibrium of these systems is determined, at least in part, by one's temptations. These results can serve as a basis for understanding the etiology of modern day addictions.
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Affiliation(s)
- Ofir Turel
- Department of Information Systems and Decision Sciences, California State UniversityFullerton, CA, USA; Department of Psychology, Brain and Creativity Institute, University of Southern CaliforniaLos Angeles, CA, USA
| | - Antoine Bechara
- Department of Psychology, Brain and Creativity Institute, University of Southern California Los Angeles, CA, USA
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8
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Hone-Blanchet A, Ciraulo DA, Pascual-Leone A, Fecteau S. Noninvasive brain stimulation to suppress craving in substance use disorders: Review of human evidence and methodological considerations for future work. Neurosci Biobehav Rev 2015; 59:184-200. [PMID: 26449761 PMCID: PMC5365234 DOI: 10.1016/j.neubiorev.2015.10.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Revised: 09/10/2015] [Accepted: 10/01/2015] [Indexed: 12/19/2022]
Abstract
Substance use disorders (SUDs) can be viewed as a pathology of neuroadaptation. The pharmacological overstimulation of neural mechanisms of reward, motivated learning and memory leads to drug-seeking behavior. A critical characteristic of SUDs is the appearance of craving, the motivated desire and urge to use, which is a main focus of current pharmacological and behavioral therapies. Recent proof-of-concept studies have tested the effects of noninvasive brain stimulation on craving. Although its mechanisms of action are not fully understood, this approach shows interesting potential in tuning down craving and possibly consumption of diverse substances. This article reviews available results on the use of repetitive transcranial magnetic stimulation (rTMS) and transcranial electrical stimulation (tES) in SUDs, specifically tobacco, alcohol and psychostimulant use disorders. We discuss several important factors that need to be addressed in future works to improve clinical assessment and effects of noninvasive brain stimulation in SUDs. Factors discussed include brain stimulation devices and parameters, study designs, brain states and subjects' characteristics.
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Affiliation(s)
- Antoine Hone-Blanchet
- Laboratory of Canada Research Chair in Cognitive Neuroplasticity, Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale, Centre de Recherche de l'Institut Universitaire en Santé Mentale de Québec, Faculté de Médecine, Université Laval, Québec, QC, Canada
| | - Domenic A Ciraulo
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Alvaro Pascual-Leone
- Berenson-Allen Center for Noninvasive Brain Stimulation and Division of Translational Cognitive Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Shirley Fecteau
- Laboratory of Canada Research Chair in Cognitive Neuroplasticity, Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale, Centre de Recherche de l'Institut Universitaire en Santé Mentale de Québec, Faculté de Médecine, Université Laval, Québec, QC, Canada; Berenson-Allen Center for Noninvasive Brain Stimulation and Division of Translational Cognitive Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
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9
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Nichols TT, Foulds J, Yingst JM, Veldheer S, Hrabovsky S, Richie J, Eissenberg T, Wilson SJ. Cue-reactivity in experienced electronic cigarette users: Novel stimulus videos and a pilot fMRI study. Brain Res Bull 2015; 123:23-32. [PMID: 26478134 DOI: 10.1016/j.brainresbull.2015.10.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Revised: 09/19/2015] [Accepted: 10/10/2015] [Indexed: 12/31/2022]
Abstract
Some individuals who try electronic cigarettes (e-cigarettes) continue to use long-term. Previous research has investigated the safety of e-cigarettes and their potential for use in smoking cessation, but comparatively little research has explored chronic or habitual e-cigarette use. In particular, the relationship between e-cigarette cues and craving is unknown. We sought to bridge this gap by developing a novel set of e-cigarette (salient) and electronic toothbrush (neutral) videos for use in cue-reactivity paradigms. Additionally, we demonstrate the utility of this approach in a pilot fMRI study of 7 experienced e-cigarette users. Participants were scanned while viewing the cue videos before and after 10min use of their own e-cigarettes (producing an 11.7ng/ml increase in plasma nicotine concentration). A significant session (pre- and post-use) by video type (salient and neutral) interaction was exhibited in many sensorimotor areas commonly activated in other cue-reactivity paradigms. We did not detect significant cue-related activity in other brain regions notable in the craving literature. Possible reasons for this discrepancy are discussed, including the importance of matching cue stimuli to participants' experiences.
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Affiliation(s)
- Travis T Nichols
- Department of Psychology, The Pennsylvania State University, University Park, PA, United States.
| | - Jonathan Foulds
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States
| | - Jessica M Yingst
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States
| | - Susan Veldheer
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States
| | - Shari Hrabovsky
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States
| | - John Richie
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States
| | - Thomas Eissenberg
- Center for The Study of Tobacco Products, Department of Psychology, Virginia Commonwealth University, Richmond, VA, United States
| | - Stephen J Wilson
- Department of Psychology, The Pennsylvania State University, University Park, PA, United States
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10
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Gorelick DA, Zangen A, George MS. Transcranial magnetic stimulation in the treatment of substance addiction. Ann N Y Acad Sci 2014; 1327:79-93. [PMID: 25069523 DOI: 10.1111/nyas.12479] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Transcranial magnetic stimulation (TMS) is a noninvasive method of brain stimulation used to treat a variety of neuropsychiatric disorders, but is still in the early stages of study as addiction treatment. We identified 19 human studies using repetitive TMS (rTMS) to manipulate drug craving or use, which exposed a total of 316 adults to active rTMS. Nine studies involved tobacco, six alcohol, three cocaine, and one methamphetamine. The majority of studies targeted high-frequency (5-20 Hz; expected to stimulate neuronal activity) rTMS pulses to the dorsolateral prefrontal cortex. Only five studies were controlled clinical trials: two of four nicotine trials found decreased cigarette smoking; the cocaine trial found decreased cocaine use. Many aspects of optimal treatment remain unknown, including rTMS parameters, duration of treatment, relationship to cue-induced craving, and concomitant treatment. The mechanisms of rTMS potential therapeutic action in treating addictions are poorly understood, but may involve increased dopamine and glutamate function in corticomesolimbic brain circuits and modulation of neural activity in brain circuits that mediate cognitive processes relevant to addiction, such as response inhibition, selective attention, and reactivity to drug-associated cues. rTMS treatment of addiction must be considered experimental at this time, but appears to have a promising future.
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Affiliation(s)
- David A Gorelick
- Chemistry and Drug Metabolism Section, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, Maryland; Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland
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Mondino M, Bennabi D, Poulet E, Galvao F, Brunelin J, Haffen E. Can transcranial direct current stimulation (tDCS) alleviate symptoms and improve cognition in psychiatric disorders? World J Biol Psychiatry 2014; 15:261-75. [PMID: 24447054 DOI: 10.3109/15622975.2013.876514] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVES Since the discovery of psychopharmacological treatments in the early 1950s, followed by the development of second-generation antidepressants and antipsychotics, biological psychiatry has not achieved much progress. Recent technological advances in the field of non-invasive brain stimulation open new perspectives in the treatment of psychiatric disorders. Amongst them, transcranial direct current stimulation (tDCS) modulates cortical excitability and induces long-lasting effects. Here, we aimed at evaluating whether tDCS has potential to be developed as an innovative treatment in psychiatry. METHODS We conducted a systematic review of the current state of development and application of tDCS in psychiatric disorders, exploring clinical and cognitive effects, especially in major depressive disorder (MDD), schizophrenia and substance use disorder. RESULTS Systematic literature search yielded 40 publications: 22 in MDD, nine in schizophrenia, seven in substance use disorder, one in obsessive-compulsive disorder and one in mania. Our findings indicated beneficial clinical effects of tDCS for MDD and a promising literature in schizophrenia and substance use disorder. CONCLUSIONS Despite methodological differences, the data published to date are promising and supports the use of tDCS as a treatment for psychiatric disorders. However, its place regarding other treatments still has to be determined before becoming a routine clinical treatment.
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Affiliation(s)
- Marine Mondino
- Centre Hospitalier le Vinatier, Université Claude Bernard Lyon I , Bron , France
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12
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Ozomaro U, Wahlestedt C, Nemeroff CB. Personalized medicine in psychiatry: problems and promises. BMC Med 2013; 11:132. [PMID: 23680237 PMCID: PMC3668172 DOI: 10.1186/1741-7015-11-132] [Citation(s) in RCA: 155] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Accepted: 04/19/2013] [Indexed: 01/29/2023] Open
Abstract
The central theme of personalized medicine is the premise that an individual's unique physiologic characteristics play a significant role in both disease vulnerability and in response to specific therapies. The major goals of personalized medicine are therefore to predict an individual's susceptibility to developing an illness, achieve accurate diagnosis, and optimize the most efficient and favorable response to treatment. The goal of achieving personalized medicine in psychiatry is a laudable one, because its attainment should be associated with a marked reduction in morbidity and mortality. In this review, we summarize an illustrative selection of studies that are laying the foundation towards personalizing medicine in major depressive disorder, bipolar disorder, and schizophrenia. In addition, we present emerging applications that are likely to advance personalized medicine in psychiatry, with an emphasis on novel biomarkers and neuroimaging.
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Affiliation(s)
- Uzoezi Ozomaro
- University of Miami, Leonard M. Miller School of Medicine, Miami, FL, USA
| | - Claes Wahlestedt
- University of Miami, Leonard M. Miller School of Medicine, Miami, FL, USA
- Center for Therapeutic Innovation, Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Psychiatry and Behavioral Sciences, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, USA
| | - Charles B Nemeroff
- University of Miami, Leonard M. Miller School of Medicine, Miami, FL, USA
- Center for Therapeutic Innovation, Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Psychiatry and Behavioral Sciences, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, USA
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Bourque J, Mendrek A, Dinh-Williams L, Potvin S. Neural circuitry of impulsivity in a cigarette craving paradigm. Front Psychiatry 2013; 4:67. [PMID: 23874307 PMCID: PMC3712893 DOI: 10.3389/fpsyt.2013.00067] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Accepted: 06/27/2013] [Indexed: 11/13/2022] Open
Abstract
Impulsivity has been shown to play a pivotal role in the onset, pattern of consumption, relapse and, most notably, craving of illicit and licit drugs such as cigarette smoking. The goal of this study was to examine the neurobiological influence of trait impulsivity during cue-induced cigarette craving. Thirty-one chronic smokers passively viewed appetitive smoking-related and neutral images while being scanned and reported their feelings of craving. They completed the Barratt Impulsiveness Scale, a measure of trait impulsivity. We conducted functional connectivity analyses using the psycho-physiological interaction method. During the processing of smoking stimuli, participants presented increased activations in the cingulate and prefrontal cortices. We observed a significant positive relationship between impulsivity scores and reported craving. A negative correlation was observed between the impulsivity score and activity in the posterior cingulate cortex (PCC). The insula, dorsal anterior cingulate cortex (dACC) as well as the dorsolateral prefrontal cortex (DLPFC) presented a negative connectivity with the PCC. Consistent with the view that the PCC is related to the ability to resist cigarette craving, our results suggest that high impulsive smokers have greater difficulty in controlling their cravings, and that this weakness may be mediated by lower PCC activity. Moreover, we argue that the less PCC activity, the greater the probability of a stronger emotional, physiological, and biased attentional response to smoking cues mediated by insula, dACC, and DLPFC activity. This is the first study on this topic, and so, results will need to be replicated in both licit and illicit drug abusers. Our findings also highlight a need for more emphasis on the PCC in drug addiction research, as it is one of the most consistently activated regions in functional magnetic resonance imaging studies examining the neural correlates of cue-induced alcohol, drug, and tobacco cravings.
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Affiliation(s)
- Josiane Bourque
- Centre de Recherche de l'Institut Universitaire de Santé Mentale de Montréal , Montréal, QC , Canada ; Department of Psychiatry, Faculty of Medicine, University of Montreal , Montreal, QC , Canada
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