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重点，需要创新的治疗方法。这项应用程序的目的是研究一种针对可卡因滥用的创新技术的潜力，这种技术针对的是大脑区域，而不是药物。使用一种新开发的线圈，可以到达更深的大脑区域（H1线圈）的重复经颅磁刺激（rTMS），这项拟议的应用将研究针对背内侧前额叶皮层和前扣带的深度rTMS的影响。可卡因滥用者将接受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来测量区域葡萄糖摄取，fMRI扫描将成像深度rTMS对颜色单词stroop任务的血氧水平依赖性反应的影响。除了成像之外，还将使用一个复发的实验室模型，其中不寻求治疗的可卡因滥用者参加可卡因自我给药会议。在这个模型中，可卡因滥用者被赋予在另一种强化物（金钱）的环境下自我使用可卡因的选择，假设大脑刺激会减少可卡因的自我使用。虽然这项研究不是rTMS的临床试验，但它使用了创新的方法

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.