Clinical Research Component
Cortical rTMS as a Treatment for Craving & Brain Reactivity to Alcohol Cues
Principal Investigator: Colleen Hanlon, Ph.D.
Co-Principal Investigator: James Prisciandaro, Ph.D.
This project involves a novel and innovative treatment approach involving transcranial magnetic stimulation (TMS). This non-invasive and non-pharmacological intervention was recently FDA-approved for treatment of depression, and has gained increasing attention as a potential treatment for drug and alcohol use disorders. The project employs different repetitive TMS (rTMS) protocols involving different frequencies and patterns of stimulation to selectively modulate corticostriatal circuits putatively involved in reward (“limbic drive”) and executive control functions.
More specifically, the project will determine whether reducing activity in the brain region known as the medial prefrontal cortex (mPFC) (via LTD-like stimulation) versus increasing activity in the dorsolateral prefrontal cortex (dlPFC) (via LTP-like stimulation) is effective in reducing brain activation to alcohol cues (fMRI BOLD response), and self-reports of craving in non-treatment seeking individuals with alcohol use disorders. Applying the LTD stimulation protocol to the mPFC is hypothesized to weaken “limbic drive” circuitry, while LTP stimulation of dlPFC is hypothesized to strengthen executive control circuitry.
Innovative features of this project are that it employs sophisticated imaging technology to confirm (via fMRI) changes in cortical activation following LTP-like or LTP-like TMS, and that it will determine whether such changes are mediated by changes in PFC excitatory/inhibitor neurochemical balance (i.e., glutamate, glutamine, GABA concentrations) via MR Spectroscopy. This work will lay the foundation for more extensive future studies that will fully characterize the efficacy of this novel treatment approach for individuals with alcohol use disorders.