Repetitive transcranial magnetic stimulation (rTMS) for treatment of alcohol dependence

Abstract

Objectives. Neuroimaging studies have found that alcohol dependent patients display dopaminergic dysfunction in the ventral striatum, which is associated with alcohol craving. Repetitive transcranial magnetic stimulation (rTMS) was introduced as a promising new treatment option for depression, and among other neurobiological mechanisms, it is able to stimulate the striatal dopaminergic system. The aim of our study was to investigate the effect of high frequency rTMS of the left dorsolateral prefrontal cortex compared to sham stimulation on craving and mood in alcohol dependent women. Furthermore, the impact on an attentional blink (AB) paradigm to pictures with neutral, emotional and alcohol-related contents was proofed. Methods. Nineteen female detoxified patients were randomized either to a high frequency rTMS (20 Hz) over the left DLPFC (n = 10) or a sham stimulations (n = 9) at 10 days. Alcohol craving was determined with the Obsessive Compulsive Drinking Scale, depressive symptoms were registered by means of Hamilton Depression Rating Scale and Beck’ Depression Inventory. For the AB paradigm an age-matched control group was investigated. Results. There were no significantly differences between both groups regarding alcohol craving or mood. In the AB paradigm, real stimulated patients detected alcohol related T2 targets incorrectly in comparison to the sham stimulated and control subjects. Summary. Although there were no differences in clinical parameters such as craving or mood after real high frequency rTMS compared to sham stimulation, we found an interesting difference between the real and the sham stimulated group and controls in the AB paradigm indicating an increase of the AB effect to alcohol-related pictures after real stimulation. Further studies are needed to replicate these findings and correlate them to clinical and neurophysiological data.

Key words::

• rTMS
• craving
• alcohol dependence

Acknowledgement

None.

Statement of Interest

Our data are very preliminary. Despite the negative results for craving and mood, we had an interesting effect to a physiological paradigm, the attentional blink effect, which was exclusively increased for alcohol-related pictures. In further investigations, correlation studies between physiological reactions and craving on a higher number of patients have to be executed.