Advanced search
1 file | 339.31 KB

Accelerated HF-rTMS protocol has a rate-dependent effect on dACC activation in alcohol-dependent patients: an open-label feasibility study

Author
Organization
Project
The integrative neuroscience of behavioral control (Neuroscience)
Abstract
Background: The application of accelerated high-frequency (HF) repetitive transcranial magnetic stimulation (rTMS) could be a potential treatment option for alcohol-dependent patients and may result in a faster clinical response. In this open-label HF-rTMS feasibility study, we wanted to replicate previous findings of baseline brain activation as a predictor of relapse, and to evaluate how this intervention influences the relapse neurocircuit of "treatment-seeking" alcohol-dependent patients, by means of functional magnetic resonance imaging (fMRI) cue-exposure paradigms. Because relapsing patients have a diminished resilience of the emotion regulation/cognitive control system, before HF-rTMS treatment, we expected lower neuronal activation of especially the ventromedial prefrontal cortex and anterior cingulate cortex (ACC) during the presentation of alcohol-related cues in these patients. The relapse neurocircuit should be modified after accelerated HF-rTMS treatment, only in those patients who did not relapse. Methods: After being administered a single sham-controlled HF-rTMS session (20 Hz to 110% motor threshold), 19 alcohol-dependent patients received an accelerated HF-rTMS protocol, consisting of 14 right dorsolateral prefrontal cortical sessions spread over 3 days. Before and after stimulation, during fMRI patients were confronted with a block and an event-related alcoholic cue-exposure paradigm. Relapse was defined as the consumption of any amount of alcohol within 4 weeks after the stimulation. A region of interest analysis was performed to evaluate how HF-rTMS exerts its effect. Results: After 4 weeks, 13 of 19 patients had already consumed alcohol. When abstainers were compared to patients who had relapsed, we found higher dorsal ACC (dACC) activation at baseline, but only during the blocked cue-exposure paradigm. The effects of HF-rTMS on dACC blood oxygen level-dependent response were negatively correlated with the baseline dACC activation. Due to susceptibility artifacts located at the ventral cortical aspects in 6 of our participants, reliable data were only obtained for the ACC. Conclusions: Our data indicate that higher baseline dACC activation may serve as a protective mechanism regarding relapse. For the first time, it is demonstrated that accelerated HF-rTMS treatment influences dACC activation in a rate-dependent manner: the lower the baseline dACC activation, the more dACC activity was increased after HF-rTMS treatment.
Keywords
Cue Exposure, Relapse, Accelerated HF-rTMS, Rate Dependence, ANTERIOR CINGULATE, TRANSCRANIAL MAGNETIC STIMULATION, RELAPSE PREVENTION, RESPONSE-INHIBITION, TALAIRACH ATLAS, Alcohol Addiction, ADDICTION, FMRI, SENSITIVITY, FUNCTIONAL CONNECTIVITY, DORSOLATERAL PREFRONTAL CORTEX

Downloads

  • (...).pdf
    • full text
    • |
    • UGent only
    • |
    • PDF
    • |
    • 339.31 KB

Citation

Please use this url to cite or link to this publication:

Chicago
Herremans, Sarah C, Rudi De Raedt, Peter Van Schuerbeek, Daniele Marinazzo, Frieda Matthys, Johan De Mey, and Chris Baeken. 2016. “Accelerated HF-rTMS Protocol Has a Rate-dependent Effect on dACC Activation in Alcohol-dependent Patients: An Open-label Feasibility Study.” Alcoholism-clinical and Experimental Research 40 (1): 196–205.
APA
Herremans, S. C., De Raedt, R., Van Schuerbeek, P., Marinazzo, D., Matthys, F., De Mey, J., & Baeken, C. (2016). Accelerated HF-rTMS protocol has a rate-dependent effect on dACC activation in alcohol-dependent patients: an open-label feasibility study. ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH, 40(1), 196–205.
Vancouver
1.
Herremans SC, De Raedt R, Van Schuerbeek P, Marinazzo D, Matthys F, De Mey J, et al. Accelerated HF-rTMS protocol has a rate-dependent effect on dACC activation in alcohol-dependent patients: an open-label feasibility study. ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH. 2016;40(1):196–205.
MLA
Herremans, Sarah C, Rudi De Raedt, Peter Van Schuerbeek, et al. “Accelerated HF-rTMS Protocol Has a Rate-dependent Effect on dACC Activation in Alcohol-dependent Patients: An Open-label Feasibility Study.” ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH 40.1 (2016): 196–205. Print.
@article{7076085,
  abstract     = {Background: The application of accelerated high-frequency (HF) repetitive transcranial magnetic stimulation (rTMS) could be a potential treatment option for alcohol-dependent patients and may result in a faster clinical response. In this open-label HF-rTMS feasibility study, we wanted to replicate previous findings of baseline brain activation as a predictor of relapse, and to evaluate how this intervention influences the relapse neurocircuit of {\textacutedbl}treatment-seeking{\textacutedbl} alcohol-dependent patients, by means of functional magnetic resonance imaging (fMRI) cue-exposure paradigms. Because relapsing patients have a diminished resilience of the emotion regulation/cognitive control system, before HF-rTMS treatment, we expected lower neuronal activation of especially the ventromedial prefrontal cortex and anterior cingulate cortex (ACC) during the presentation of alcohol-related cues in these patients. The relapse neurocircuit should be modified after accelerated HF-rTMS treatment, only in those patients who did not relapse. 
Methods: After being administered a single sham-controlled HF-rTMS session (20 Hz to 110\% motor threshold), 19 alcohol-dependent patients received an accelerated HF-rTMS protocol, consisting of 14 right dorsolateral prefrontal cortical sessions spread over 3 days. Before and after stimulation, during fMRI patients were confronted with a block and an event-related alcoholic cue-exposure paradigm. Relapse was defined as the consumption of any amount of alcohol within 4 weeks after the stimulation. A region of interest analysis was performed to evaluate how HF-rTMS exerts its effect. 
Results: After 4 weeks, 13 of 19 patients had already consumed alcohol. When abstainers were compared to patients who had relapsed, we found higher dorsal ACC (dACC) activation at baseline, but only during the blocked cue-exposure paradigm. The effects of HF-rTMS on dACC blood oxygen level-dependent response were negatively correlated with the baseline dACC activation. Due to susceptibility artifacts located at the ventral cortical aspects in 6 of our participants, reliable data were only obtained for the ACC. 
Conclusions: Our data indicate that higher baseline dACC activation may serve as a protective mechanism regarding relapse. For the first time, it is demonstrated that accelerated HF-rTMS treatment influences dACC activation in a rate-dependent manner: the lower the baseline dACC activation, the more dACC activity was increased after HF-rTMS treatment.},
  author       = {Herremans, Sarah C and De Raedt, Rudi and Van Schuerbeek, Peter and Marinazzo, Daniele and Matthys, Frieda and De Mey, Johan and Baeken, Chris},
  issn         = {0145-6008},
  journal      = {ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH},
  keyword      = {Cue Exposure,Relapse,Accelerated HF-rTMS,Rate Dependence,ANTERIOR CINGULATE,TRANSCRANIAL MAGNETIC STIMULATION,RELAPSE PREVENTION,RESPONSE-INHIBITION,TALAIRACH ATLAS,Alcohol Addiction,ADDICTION,FMRI,SENSITIVITY,FUNCTIONAL CONNECTIVITY,DORSOLATERAL PREFRONTAL CORTEX},
  language     = {eng},
  number       = {1},
  pages        = {196--205},
  title        = {Accelerated HF-rTMS protocol has a rate-dependent effect on dACC activation in alcohol-dependent patients: an open-label feasibility study},
  url          = {http://dx.doi.org/10.1111/acer.12937},
  volume       = {40},
  year         = {2016},
}

Altmetric
View in Altmetric
Web of Science
Times cited: