Deep rTMS of the insula and prefrontal cortex in smokers with schizophrenia: Proof-of-concept study.
Journal
Schizophrenia (Heidelberg, Germany)
ISSN: 2754-6993
Titre abrégé: Schizophrenia (Heidelb)
Pays: Germany
ID NLM: 9918367987006676
Informations de publication
Date de publication:
25 02 2022
25 02 2022
Historique:
received:
26
08
2021
accepted:
17
12
2021
entrez:
26
2
2022
pubmed:
27
2
2022
medline:
27
2
2022
Statut:
epublish
Résumé
Patients with schizophrenia have a high prevalence of cigarette smoking and respond poorly to conventional treatments, highlighting the need for new therapies. We conducted a mechanistic, proof-of-concept study using bilateral deep repetitive transcranial magnetic stimulation (dTMS) of insular and prefrontal cortices at high frequency, using the specialized H4 coil. Feasibility of dTMS was tested for disruption of tobacco self-administration, insula target engagement, and insula circuit modulation, all of which were a priori outcomes of interest. Twenty patients completed the study, consisting of weekday dTMS sessions (randomization to active dTMS or sham; double-blind; 10 patients per group), a laboratory tobacco self-administration paradigm (pre/post assessments), and multimodal imaging (three MRI total sessions). Results showed that participants assigned to active dTMS were slower to initiate smoking their first cigarette compared with sham, consistent with smoking disruption. The imaging analyses did not reveal significant Time × Group interactions, but effects were in the anticipated directions. In arterial spin labeling analyses testing for target engagement, an overall decrease in insula blood flow, measured during a post-treatment MRI versus baseline, was numerically more pronounced in the active dTMS group than sham. In fMRI analyses, resting-state connectivity between the insula and default mode network showed a numerically greater change from baseline in the active dTMS group than sham, consistent with a functional change to insula circuits. Exploratory analyses further suggested a therapeutic effect of dTMS on symptoms of psychosis. These initial observations pave the way for future confirmatory studies of dTMS in smoking patients with schizophrenia.
Identifiants
pubmed: 35217662
doi: 10.1038/s41537-022-00224-0
pii: 10.1038/s41537-022-00224-0
pmc: PMC8881463
doi:
Types de publication
Journal Article
Langues
eng
Pagination
6Subventions
Organisme : U.S. Department of Health & Human Services | NIH | National Institute of Mental Health (NIMH)
ID : F30MH122136
Organisme : U.S. Department of Health & Human Services | NIH | National Institute on Drug Abuse (NIDA)
ID : K01DA037452
Organisme : U.S. Department of Health & Human Services | NIH | National Institute of Mental Health (NIMH)
ID : K01MH107763
Organisme : U.S. Department of Health & Human Services | NIH | National Institute of Mental Health (NIMH)
ID : K23MH115291
Organisme : NIGMS NIH HHS
ID : T32 GM008444
Pays : United States
Organisme : U.S. Department of Health & Human Services | NIH | National Institute on Drug Abuse (NIDA)
ID : R21DA041128
Organisme : NIMH NIH HHS
ID : K23 MH115291
Pays : United States
Organisme : NIDA NIH HHS
ID : K01 DA037452
Pays : United States
Organisme : NIDA NIH HHS
ID : R21 DA041128
Pays : United States
Organisme : U.S. Department of Health & Human Services | NIH | National Institute on Drug Abuse (NIDA)
ID : R21DA051179
Organisme : NIMH NIH HHS
ID : F30 MH122136
Pays : United States
Organisme : NIDA NIH HHS
ID : R21 DA051179
Pays : United States
Organisme : NIMH NIH HHS
ID : K01 MH107763
Pays : United States
Informations de copyright
© 2022. The Author(s).
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