Transcranial Magnetic Stimulation of Medial Prefrontal andCingulate Cortices Reduces Cocaine Self-Administration: A Pilot Study

Background:

Previous studies have shown thatdeep transcranial magnetic stimulation (dTMS)to thedorsolateralprefrontalcortex may serve as a potential treatment forcocaineuse disorder (CUD), which remains a public health problem that is refractory to treatment. Previousimaging studies have demonstratedalterations in theactivation and connectivity of the medial prefrontal cortex (mPFC) and the anterior cingulate cortex (ACC) in CUD.

Objective:

The goal of thispilotstudywas to investigate the effect of dTMS over the mPFC and ACC oncocaineself-administrationin the laboratory.

Methods:

Volunteers with CUD were admitted to an inpatient unit for the entirestudyand assigned to one of three dTMS groups: high frequency (10 Hz), low frequency (1 Hz), and sham. Six participants were included in each group and the dTMS was delivered using the H7 coil on weekdays for 3 weeks. Thecocaineself-administrationsessions, in which participants chose between cocaine and an alternative reinforcer (money),were performed at three time points: at baseline (pre-TMS, session 1), after 4 days of dTMS (session 2), and after 13 days of dTMS (session 3). During eachself-administrationsession, the outcome measure was the number of choices forcocaine.

Results:

The results showed a significant group by time effect (p = 0.02), where the choices forcocainedecreased between sessions 2 and 3 in the high frequency group. There was no effect of dTMS oncocaineself-administrationin the low frequency or sham groups.

Conclusions:

Taken in the context of the existing literature, these results contribute to the data showing that high frequency rTMS to theprefrontalcortex may serve as a potential treatment for CUD.

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