Elevated brain activity in response to drug cues, referred to as cue reactivity, occurs with many types of drugs, including nicotine, alcohol, marijuana, and cocaine. Cue reactivity also predicts relapse in addiction, so treatment approaches targeting the neural circuitry related to cue reactivity may directly impact cue-induced relapse in patients.
First author of the paper Tonisha Kearney-Ramos, PhD, and colleagues performed two independent studies at the same time, one involving 25 people with cocaine use disorder and the other involving 24 people with alcohol use disorder. The participants received one session of TMS, which targeted magnetic stimulation to circuitry critical for drug-taking behaviors -- the ventromedial prefrontal cortex. The real stimulation session was compared against a sham session that mimicked the experience of receiving TMS without actual brain stimulation. Brain imaging before and after TMS revealed that when alcohol users viewed images of alcohol-related cues, such as a liquor bottle, the single TMS session significantly reduced their drug cue reactivity. The same was true for cocaine users when viewing images of cocaine-related cues.
Since cue reactivity has previously been associated with abstinence, these studies suggest a common mechanism for treatment effects across disorders, with fMRI serving as a promising neural readout of treatment effects. However, it is still unclear if the changes in brain activity observed in the study will translate to reduced drug or alcohol use.
In future, repeated sessions of the targeted stimulation may be needed to see changes in self-reported craving. Also, in addition to substance abuse, elevated cue-reactivity is a core symptom of many diseases, such as post-traumatic stress disorder, generalized anxiety disorder, traumatic brain injury, smoking, and obesity. Therefore, the treatment described may have implications beyond the substance abuse field.
Category(s):Addictions, Drug Addiction
Source material from Science Daily
