Journal: Biological Psychiatry: Global Open Science
Authors: D.M. McCalley, N. Kaur, J.P. Wolf, I.E. Contreras, S.W. Book, J.P. Smith, C.A. Hanlon
Background:
Alcohol Use Disorder (AUD) is associated with elevated brain response to cues. Recent studies have suggested that theta burst stimulation (TBS) to the MPFC can decrease reactivity to cues in a transdiagnostic manner.
Objective:
To evaluate the effect of continuous TBS as a tool to decrease drinking behavior and brain reactivity to alcohol cues among individuals with AUD.
Methods:
Fifty individuals with AUD were recruited from an intensive outpatient treatment program. Using a randomized double-blind sham-controlled design, participants received 10 sessions of continuous TBS (left frontal pole; 1 session/10days; 110% RMT, 3600 pulse/session, cue-provocation prior and during session). Brain reactivity to alcohol cues was acquired at 4 timepoints: Baseline, after all TBS sessions (1 month), 2 months, and 3 months.
Results:
80% of the participants completed all TBS sessions. Individuals that received real TBS were 2.71 times more likely to remain enrolled in the study after 3 months and 3.09 times more likely to remain sober 3 months after treatment initiation. Real TBS also led to a significantly greater reduction in brain reactivity to alcohol cues – specifically a reduction in MPFC-striatum and MPFC-insula connectivity 2 and 3 months after TBS treatment.
Conclusion:
10 days of MPFC TBS is well tolerated, reduces drinking, and decreases brain reactivity to alcohol cues for up to three months after treatment initiation. These results pave a critical next step in the path towards developing TMS as an intervention for AUD and disorders associated with elevated cue reactivity.
