Effects of deep transcranial magnetic stimulation of the medial PFC and ACC on relapse to alcohol use and related brain activity

Alcohol use disorder (AUD) is a highly prevalent disorder in western countries, with high relapse rate and limited treatment options. Current behavioral and neuropathology evidence point to poor response inhibition capacity and multiple brain network deficits. One of the highlighted hubs in that regard is the anterior cingulate cortex (ACC), which is hypoactive in AUD and plays a central role in inhibitory control, drug craving, and relapse. Here, we attempt to reduce craving levels and relapse rates in short-term abstinent AUD subjects using deep transcranial magnetic stimulation (dTMS) over the medial prefrontal cortex (mPFC) and ACC; while examining neuronal and structural correlation to clinical response. Short-term abstinent AUD patients are treated with either high-frequency (10Hz) or sham dTMS for three weeks in a double-blind manner, with 12 weeks’ follow-up. Clinical response to treatment is determined using self-report levels of craving and alcohol consumption, and by urine samples. Pre- and Post-treatment imaging includes EEG and fMRI (during rest and during relevant tasks), as well as DTI measurements. The results that will be obtain in this study may shed light over the neuropathology of AUD and will hopefully lead to better treatment option in this disorder.