These authors contributed equally to this work.
Repeated high-frequency transcranial magnetic stimulation over the dorsolateral prefrontal cortex reduces cigarette craving and consumption
Article first published online: 12 JAN 2009
© 2009 The Authors. Journal compilation © 2009 Society for the Study of Addiction
Volume 104, Issue 4, pages 653–660, April 2009
How to Cite
Amiaz, R., Levy, D., Vainiger, D., Grunhaus, L. and Zangen, A. (2009), Repeated high-frequency transcranial magnetic stimulation over the dorsolateral prefrontal cortex reduces cigarette craving and consumption. Addiction, 104: 653–660. doi: 10.1111/j.1360-0443.2008.02448.x
- Issue published online: 17 MAR 2009
- Article first published online: 12 JAN 2009
- Submitted 16 April 2008; initial review completed 3 July 2008; final version accepted 24 October 2008
Aims To evaluate the effect of repeated high-frequency transcranial magnetic stimulation (rTMS) of the left dorsolateral prefrontal cortex (DLPFC), combined with either smoking or neutral cues, on cigarette consumption, dependence and craving.
Design Participants were divided randomly to real and sham stimulation groups. Each group was subdivided randomly into two subgroups presented with either smoking-related or neutral pictures just before the daily TMS intervention. Ten daily rTMS sessions were applied every week-day and then a maintenance phase was conducted in which rTMS sessions were less frequent.
Setting Single-site, out-patient, randomized, double-blind, sham-controlled.
Participants Forty-eight chronic smokers who smoked at least 20 cigarettes per day and were motivated to quit smoking. Healthy males and females were recruited from the general population using advertisements in newspapers and on internet websites.
Intervention Ten daily rTMS sessions were administered using a standard figure-8 coil over the DLPFC. Stimulation included 20 trains/day at 100% of motor threshold. Each train consisted of 50 pulses at 10 Hz with an inter-train interval of 15 seconds.
Measurements Cigarette consumption was evaluated objectively by measuring cotinine levels in urine samples and subjectively by participants' self-reports. Dependence and craving were evaluated by standard questionnaires.
Findings Ten daily rTMS sessions over the DLPFC reduced cigarette consumption and nicotine dependence. Furthermore, treatment blocked the craving induced by daily presentation of smoking-related pictures. However, these effects tended to dissipate over time.
Conclusions Multiple high-frequency rTMS of the DLPFC can attenuate nicotine craving.