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

Journal: Frontiers in Psychiatry 9:80 (2018)

Authors: D Martinez, N Urban, A Grassetti, D Chang, M.C Hu, A Zangen, F.R Levin, R Foltin, E.V Nunes

Background:

Previous studies have shown that deep transcranial magnetic stimulation (Deep TMS™) to the dorsolateral prefrontal cortex may serve as a potential treatment for cocaine use disorder (CUD), which remains a public health problem that is refractory to treatment. Previous imaging studies have demonstrated alterations in the activation and connectivity of the medial prefrontal cortex (mPFC) and the anterior cingulate cortex (ACC) in CUD.

Objective:

The goal of this pilot study was to investigate the effect of Deep TMS over the mPFC and ACC on cocaine self-administration in the laboratory.

Methods:

Volunteers with CUD were admitted to an inpatient unit for the entire study and assigned to one of three Deep TMS groups: high frequency (10 Hz), low frequency (1 Hz), and sham. Six participants were included in each group and the Deep TMS was delivered using the H7 coil on weekdays for 3 weeks. The cocaine self-administration sessions, 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 Deep TMS (session 2), and after 13 days of Deep TMS (session 3). During each self-administration session, the outcome measure was the number of choices for cocaine.

Results:

The results showed a significant group by time effect (p = 0.02), where the choices for cocaine decreased between sessions 2 and 3 in the high frequency group. There was no effect of Deep TMS on cocaine self-administration in 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 the prefrontal cortex may serve as a potential treatment for CUD.

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