Imaging the Effect of rTMS on Brain Activity in Cocaine Abusers

描述(由申请人提供)：可卡因依赖的治疗是研究的优先事项，需要创新的治疗方法。这项应用的目标是调查一项针对可卡因滥用的创新技术的潜力，该技术针对的是大脑区域而不是药物。利用新开发的线圈(H1线圈)的重复经颅磁刺激(RTMS)，这一拟议的应用将研究针对背内侧前额叶皮质和前扣带回的深层rTMS的影响。可卡因滥用受试者将接受使用正电子发射断层扫描(PET)和磁共振成像(FMRI)的功能成像研究。PET扫描将使用[18F]FDG来测量局部葡萄糖摄取，而fMRI扫描将成像深度rTMS对颜色词STROOP任务的血氧水平依赖反应的影响。除了成像，还将使用复发的实验室模型，在该模型中，寻求可卡因滥用的非治疗对象参与可卡因自我管理会议。在这个模型中，可卡因滥用受试者可以选择在另一种增强剂(Money)的设置下自我给药，假设大脑刺激会减少可卡因的自我给药。虽然这项研究不是rTMS的临床试验，但它使用了创新的 能够提供对其治疗潜力的快速评估的方法。除了提供关于反应背后的机制的信息外，这种类型的翻译工作可以比临床研究更快地完成。 公共卫生相关性：这项研究的目标是评估一种新的经颅磁刺激方法对实验室复发的影响。此外，功能成像扫描将用于测量大脑刺激对前额叶皮质和与可卡因滥用有关的大脑区域的影响。这些扫描将提供对这一大脑区域新陈代谢和血液流动的测量，我们将调查这些变化是否在减少寻求可卡因的行为方面发挥作用。

DESCRIPTION (provided by applicant): Treatment for cocaine dependence is a research priority, and innovative treatment approaches are needed. The goal of this application is to investigate the potential of a innovative technology that targets a brain region, rather than a medication, for cocaine abuse. Using a repetitive transcranial magnetic stimulation (rTMS) with a newly developed coil that can reach deeper brain regions (the H1 coil), this proposed application will study the effects of deep rTMS directed at the dorsomedial prefrontal cortex and anterior cingulate. Cocaine abusing subjects will undergo functional imaging studies using Positron Emission Tomography (PET) and Magnetic Resonance Imaging (fMRI). The PET scans will use [18F]FDG to measure regional glucose uptake and the fMRI scans will image the effect of deep rTMS on the blood-oxygen-level dependence response to the color-word stroop task. In addition to imaging, a laboratory model of relapse will be used, in which non-treatment seeking cocaine abusing subjects participate in cocaine self-administration sessions. In this model, cocaine abusing subjects are given the choice to self-administer cocaine in the setting of an alternative reinforcer (money), and the hypothesis is that brain stimulation will reduce cocaine self- administration. While this study is not a clinical trail for rTMS, it uses innovative methods that can provide a rapid assessment of its therapeutic potential. This type of translational work can be performed much more rapidly than a clinical study, in addition to providing information on the mechanism behind the response. PUBLIC HEALTH RELEVANCE: The goal of this study is to evaluate the effect of a new method of transcranial magnetic stimulation on a laboratory relapse. In addition, functional imaging scans will be used to measure the effect of brain stimulation on the prefrontal cortex, and area of the brain that has been implicated in cocaine abuse. The scans will provide a measure of metabolism and blood flow in this brain region, and we will investigate whether these changes play a role in reducing cocaine-seeking behavior.