High-frequency repetitive transcranial magnetic stimulation (rTMS) in alcohol dependence: effects on emotion processing and reappraisal and neural mechanisms: an fMRI study

A. Goudriaan, J. Jansen, R. Schluter, O. van den Heuvel, Y. van der Werf, D. Veltman, R. van Holst

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In neurobiological models on the working mechanisms of addiction, the important role of changes in the motivational (limbic brain) circuitry, which overreacts to addictive stimuli and the diminished functioning of cortical regulatory systems such as the frontal-anterior cingulate circuit is central. Neurostimulation with repetitive high-frequency transcranial magnetic stimulation (rTMS) has been shown to affect both cortical and subcortical functions, but its working mechanisms in addiction are scarcely studied. In this presentation therefore, (1) results are presented on direct effects of 10Hz rTMS (real vs sham) in a sample of 39 abstinent alcohol dependent patients on regulation of emotion, compared to 39 healthy controls. Specifically, the behavioral and neural (fMRI) effects of performing an emotion regulation task after real or sham rTMS are presented. Both in alcohol dependent patients as well as in healthy controls, changes in emotional processing and reappraisal were present, but a group by stimulation effect indicated differential effects in ADPs and healthy controls. In ADPs experienced emotions were reduced by high-frequency rTMS, whereas in healthy controls, the impact of affective pictures was strengthened. Changes in emotion regulation, were accompanied by changes in the frontal circuitry, specifically in the bilateral superior frontal gyrus in ADPs but not in healthy controls. Effects of rTMS on resting state functioning in alcohol dependence indicate that high-frequency rTMS in alcohol dependence influences resting state functioning and functional connectivity of fronto-striatal circuitry, indicating that DLPFC stimulation also affects deeper lying brain circuits. Findings of these acute effects of rTMS in alcohol dependent patients who are abstinent and in treatment will be discussed in relation to cognitive effects of rTMS in addiction, as recently summarized in a systematic review by our group, and to mechanisms of rTMS add-on clinical trials in addiction. Keywords: addiction, emotion regulation, rTMS, fMRI
Original languageEnglish
Pages (from-to)528
JournalBrain Stimulation
Issue number2
Publication statusPublished - Mar 2019

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