Tobacco smoking is the leading cause of preventable death in developed countries. Smoking is not merely a bad habit, but also a serious addiction. Nicotine, like other drugs of abuse, activates the mesolimbic dopamine system, which originates in the ventral tegmental area (VTA) and projects to limbic areas such as the nucleus accumbens, amygdala and hippocampus. Decreased activity of the brain reward systems during nicotine withdrawal has been closely associated with craving, relapse, and continued nicotine consumption.
For this reason, dopaminergic neurotransmission might serve as a potential target for treating tobacco addiction. Additional support for this hypothesis comes from studies of bupropion, an atypical antidepressant which inhibits neuronal uptake of dopamine, and which has recently been approved as treatment for smoking cessation.
Conventional Treatments: Several standard TMS studies demonstrated a direct effect of single rTMS sessions targeting the dorsolateral prefrontal cortex (DLPFC) on cigarette consumption. A recent study1 found that 10 days of high-frequency rTMS over the left DLPFC reduced cigarette consumption and nicotine dependence. However, this effect tended to dissipate after the acute treatment. In a follow-up six months later the reduction in cigarette consumption did not persist and only 12.5% of smokers who responded to the treatment remained in full abstinence.
Brainsway* Deep TMS therapy, or Deep Transcranial Magnetic Stimulation, offers an effective*, safe, non-invasive treatment for smoking cessation. Brainsway Deep TMS therapy performs magnetic stimulation of brain structures and networks related to this addiction and brings significant improvement to patients. It is an outpatient procedure which does not require hospitalization or anesthesia, is generally well tolerated and entails no systemic side effects*.
The insula was shown in several recent studies to have a crucial role in craving in several types of addictions including smoking 2-5. Deep TMS therapy can directly stimulate the insula as well as deeper PFC structures which are not directly affected with standard TMS.
A recent study [Dinur-Klein et al., In Press] tested the efficacy of Deep TMS over the PFC and the insula bilaterally on smoking addiction in 115 subjects who smoke at least 20 cigarettes per day and failed previous treatment. Subjects were randomized into 6 groups forming 3 Deep TMS stimulation conditions (10 Hz frequency, 1 Hz and sham) with or without presentation of smoking cues prior to Deep TMS sessions.
The best results were found in the high-frequency Deep TMS group that was exposed to smoking cues. In this group the response rate was 81%, the complete abstinence rate at the end of treatment was 44%, and the complete abstinence rate in a follow-up 6 months after the end of treatment was 33%. Urinary cotinine levels were also measured as an objective measure of cigarette consumption and showed significant reduction at the end of treatment in the 10 Hz + cue group, compared to baseline and to the other groups. These results correlated well with self-reported cigarette consumption. The results of this study suggest high-frequency Deep TMS of the PFC and insula in combination with presentation of smoking cue is an effective and durable treatment for smoking addiction.
Brainsway Deep TMS therapy is approved by the CE* for treating smoking addiction.
IMPORTANT: Brainsway is at different stages of regulatory approval for different indications in different countries. While the status of our regulatory approvals is generally updated on this website, in order to verify whether Brainsway is currently approved for the treatment of this indication in your area, please contact us at firstname.lastname@example.org