Abstract

Repetitive transcranial magnetic stimulation (rTMS) can reduce cue-elicited craving, decrease cigarette consumption, and increase the abstinence rate in tobacco use disorders (TUDs). We used functional magnetic resonance imaging (fMRI) to investigate the effect of 10 sessions of rTMS on cortical activity and neural networks in treatment-seeking smokers. Smoking cue exposure fMRI scans were acquired before and after the 10 sessions of active or sham rTMS (10 Hz, 3000 pulses per session) to the left dorsal lateral prefrontal cortex (DLPFC) in 42 treatment-seeking smokers (≥ 10 cigarettes per day). Brain activity and functional connectivity were compared before and after 10 sessions of rTMS. Ten sessions of rTMS significantly reduced the number of cigarettes consumed per day (62.93%) compared to sham treatment (39.43%) at the end of treatment (p = 0.027). fMRI results showed that the rTMS treatment increased brain activity in the dorsal anterior cingulate cortex (dACC) and DLPFC, but decreased brain activity in the bilateral medial orbitofrontal cortex (mOFC). The lower strength of dACC and mOFC connectivity was associated with quitting smoking (Wald score = 5.00, p = 0.025). The reduction of cigarette consumption significantly correlated with the increased brain activation in the dACC (r = 0.76, p = 0.0001). By increasing the brain activity in the dACC and prefrontal cortex and decreasing brain activity in the mOFC, 10 sessions of rTMS significantly reduced cigarette consumption and increased quit rate. Reduced drive-reward and executive control functional connectivity was associated with the smoking cessation effect from rTMS.

Trial Registration

ClinicalTrials.gov identifier: NCT02401672.

中文翻译：

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执行和奖励连接的减少与重复经颅磁刺激的戒烟反应相关：一项双盲、随机、假对照试验

摘要

重复经颅磁刺激（rTMS）可以减少提示引发的渴望，减少香烟消费，并提高烟草使用障碍（TUD）的戒烟率。我们使用功能磁共振成像 (fMRI) 来研究 10 次 rTMS 对寻求治疗的吸烟者皮质活动和神经网络的影响。吸烟提示暴露 fMRI 扫描是在 42 名寻求治疗的吸烟者（每天≥ 10 支香烟）的左背外侧前额叶皮层 (DLPFC) 进行 10 次主动或假 rTMS（每次 10 Hz，3000 个脉冲）治疗之前和之后获得的。比较 10 次 rTMS 治疗前后的大脑活动和功能连接。治疗结束时，与假治疗 (39.43%) 相比，十次 rTMS 显着减少了每天消耗的香烟数量 (62.93%) (p = 0.027)。fMRI 结果显示，rTMS 治疗增加了背侧前扣带皮层 (dACC) 和 DLPFC 的大脑活动，但降低了双侧内侧眶额皮层 (mOFC) 的大脑活动。dACC 和 mOFC 连接强度较低与戒烟相关（Wald 评分 = 5.00，p = 0.025）。吸烟量的减少与 dACC 中大脑激活的增加显着相关（r = 0.76，p = 0.0001）。通过增加 dACC 和前额皮质的大脑活动并减少 mOFC 的大脑活动，10 次 rTMS 显着减少了吸烟量并提高了戒烟率。驾驶奖励和执行控制功能连接的减少与 rTMS 的戒烟效果相关。

试用注册

ClinicalTrials.gov 标识符：NCT02401672。