The Impact of Accelerated Right Prefrontal High-Frequency Repetitive Transcranial Magnetic Stimulation (rTMS) on Cue-Reactivity: An fMRI Study on Craving in Recently Detoxified Alcohol-Dependent Patients.
The Impact of Accelerated Right Prefrontal High-Frequency Repetitive Transcranial Magnetic Stimulation (rTMS) on Cue-Reactivity: An fMRI Study on Craving in Recently Detoxified Alcohol-Dependent Patients.
复制标题
加速右侧前额叶高频重复经颅磁刺激（rTMS）对线索反应性的影响：一项针对近期戒酒的酒精依赖患者渴求感的功能磁共振成像（fMRI）研究
DOI：
10.1371/journal.pone.0136182
复制
发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Baeken C
中科院分区：
文献类型：
--
作者：
Herremans SC;Van Schuerbeek P;De Raedt R;Matthys F;Buyl R;De Mey J;Baeken C
在酒精依赖患者中，渴望是一种难以治疗的现象。有人认为，高频（HF）重复经颅磁刺激（rTMS）可能具有有益的效果。然而，目前还不清楚这种应用程序如何对潜在的渴望神经回路产生影响。为了诱导酒精渴求，并最大限度地检测HF-rTMS对线索诱导的酒精渴求的影响，患者暴露于块和事件相关的酒精线索反应性范式，同时用fMRI扫描。因此，我们评估了右背外侧前额叶皮层（DLPFC）刺激对线索诱导和一般酒精渴求的影响，以及相关的渴求神经回路。26名最近戒毒的酒精依赖患者被纳入。首先，我们评估了一个假对照刺激会话的影响。其次，我们检查了加速右侧DLPFC HF-rTMS治疗的效果：患者在开放标签加速设计中接受了15次治疗，连续4天。在15次活跃的HF-rTMS会话后，一般渴望显着下降。然而，线索诱导的酒精渴望没有改变。我们的大脑成像结果并没有显示，在一次和十五次活跃的高频重复经颅磁刺激后，线索暴露影响了潜在的渴望神经回路。然而，大脑激活的变化后，一个和15 HF-rTMS会议，分别观察到与扩展奖励系统和默认模式网络的区域，但只有在演示的事件相关的范例。我们的研究结果表明，加速HF-rTMS应用于右侧DLPFC不会明显影响酒精相关线索暴露期间的渴望神经回路，但相反，它可能会影响注意力网络。
In alcohol-dependent patients craving is a difficult-to-treat phenomenon. It has been suggested that high-frequency (HF) repetitive transcranial magnetic stimulation (rTMS) may have beneficial effects. However, exactly how this application exerts its effect on the underlying craving neurocircuit is currently unclear. In an effort to induce alcohol craving and to maximize detection of HF-rTMS effects to cue-induced alcohol craving, patients were exposed to a block and event-related alcohol cue-reactivity paradigm while being scanned with fMRI. Hence, we assessed the effect of right dorsolateral prefrontal cortex (DLPFC) stimulation on cue-induced and general alcohol craving, and the related craving neurocircuit. Twenty-six recently detoxified alcohol-dependent patients were included. First, we evaluated the impact of one sham-controlled stimulation session. Second, we examined the effect of accelerated right DLPFC HF-rTMS treatment: here patients received 15 sessions in an open label accelerated design, spread over 4 consecutive days. General craving significantly decreased after 15 active HF-rTMS sessions. However, cue-induced alcohol craving was not altered. Our brain imaging results did not show that the cue-exposure affected the underlying craving neurocircuit after both one and fifteen active HF-rTMS sessions. Yet, brain activation changes after one and 15 HF-rTMS sessions, respectively, were observed in regions associated with the extended reward system and the default mode network, but only during the presentation of the event-related paradigm. Our findings indicate that accelerated HF-rTMS applied to the right DLPFC does not manifestly affect the craving neurocircuit during an alcohol-related cue-exposure, but instead it may influence the attentional network.