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Transient alcohol craving suppression by rTMS of dorsal anterior cingulate: an fMRI and LORETA EEG study.

Highlights ► ACC and PCC are phase synchronized on EEG during alcohol craving. ► Alcohol craving is characterized by increased activity in the ACC and PCC on EEG. ► Cue induced worsening of craving pre-rTMS activated the ACC-VMPFC on fMRI. ► Hyperactivity in the ACC craving associated with craving d... Full description

Journal Title: Neuroscience letters May 27, 2011, Vol.496(1), pp.5-10
Main Author: De Ridder, Dirk
Other Authors: Vanneste, Sven , Kovacs, Silvia , Sunaert, Stefan , Dom, Geert
Format: Electronic Article Electronic Article
Language: English
Subjects:
ID: E-ISSN: 1872-7972 ; DOI: 1872-7972 ; DOI: 10.1016/j.neulet.2011.03.074
Link: http://search.proquest.com/docview/865689789/?pq-origsite=primo
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title: Transient alcohol craving suppression by rTMS of dorsal anterior cingulate: an fMRI and LORETA EEG study.
format: Article
creator:
  • De Ridder, Dirk
  • Vanneste, Sven
  • Kovacs, Silvia
  • Sunaert, Stefan
  • Dom, Geert
subjects:
  • Alcoholism–Blood
  • Alcohols–Pathology
  • Brain–Physiopathology
  • Brain Mapping–Therapy
  • Brain Waves–Blood
  • Electroencephalography–Blood Supply
  • Female–Physiopathology
  • Gyrus Cinguli–Physiology
  • Humans–Physiology
  • Image Processing, Computer-Assisted–Blood
  • Magnetic Resonance Imaging–Methods
  • Middle Aged–Methods
  • Oxygen–Methods
  • Transcranial Magnetic Stimulation–Methods
  • Alcohols
  • Oxygen
ispartof: Neuroscience letters, May 27, 2011, Vol.496(1), pp.5-10
description: Highlights ► ACC and PCC are phase synchronized on EEG during alcohol craving. ► Alcohol craving is characterized by increased activity in the ACC and PCC on EEG. ► Cue induced worsening of craving pre-rTMS activated the ACC-VMPFC on fMRI. ► Hyperactivity in the ACC craving associated with craving disappeared after rTMS. ► Relapse was associated with recurrence of ACC and PCC activity. It has recently become clear that alcohol addiction might be related to a brain dysfunction, in which a genetic background and environmental factors shape brain mechanisms involved with alcohol consumption. Craving, a major component determining relapses in alcohol abuse has been linked to abnormal activity in the orbitofrontal cortex, dorsal anterior cingulated cortex (dACC) and amygdala. We report the results of a patient who underwent rTMS targeting the dACC using a double cone coil in an attempt to suppress very severe intractable alcohol craving. Functional imaging studies consisting of fMRI and resting state EEG were performed before rTMS, after successful rTMS and after unsuccessful rTMS with relapse. Craving was associated with EEG beta activity and connectivity between the dACC and PCC in the patient in comparison to a healthy population, which disappeared after successful rTMS. Cue induced worsening of craving pre-rTMS activated the ACC-vmPFC and PCC on fMRI, as well as the nucleus accumbens area, and lateral frontoparietal areas. The nucleus accumbens, ACC-vmPFC and PCC activation disappeared on fMRI following successful rTMS. Relapse was associated with recurrence of ACC and PCC EEG activity, but in gamma band, in comparison to a healthy population. On fMRI nucleus accumbens, ACC and PCC activation returned to the initial activation pattern. A pathophysiological approach is described to suppress alcohol craving temporarily by rTMS directed at the anterior cingulate. Linking functional imaging changes to craving intensity suggests this approach warrants further exploration.
language: eng
source:
identifier: E-ISSN: 1872-7972 ; DOI: 1872-7972 ; DOI: 10.1016/j.neulet.2011.03.074
fulltext: fulltext
issn:
  • 18727972
  • 1872-7972
url: Link


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titleTransient alcohol craving suppression by rTMS of dorsal anterior cingulate: an fMRI and LORETA EEG study.
creatorDe Ridder, Dirk ; Vanneste, Sven ; Kovacs, Silvia ; Sunaert, Stefan ; Dom, Geert
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subjectAlcoholism–Blood ; Alcohols–Pathology ; Brain–Physiopathology ; Brain Mapping–Therapy ; Brain Waves–Blood ; Electroencephalography–Blood Supply ; Female–Physiopathology ; Gyrus Cinguli–Physiology ; Humans–Physiology ; Image Processing, Computer-Assisted–Blood ; Magnetic Resonance Imaging–Methods ; Middle Aged–Methods ; Oxygen–Methods ; Transcranial Magnetic Stimulation–Methods ; Alcohols ; Oxygen
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descriptionHighlights ► ACC and PCC are phase synchronized on EEG during alcohol craving. ► Alcohol craving is characterized by increased activity in the ACC and PCC on EEG. ► Cue induced worsening of craving pre-rTMS activated the ACC-VMPFC on fMRI. ► Hyperactivity in the ACC craving associated with craving disappeared after rTMS. ► Relapse was associated with recurrence of ACC and PCC activity. It has recently become clear that alcohol addiction might be related to a brain dysfunction, in which a genetic background and environmental factors shape brain mechanisms involved with alcohol consumption. Craving, a major component determining relapses in alcohol abuse has been linked to abnormal activity in the orbitofrontal cortex, dorsal anterior cingulated cortex (dACC) and amygdala. We report the results of a patient who underwent rTMS targeting the dACC using a double cone coil in an attempt to suppress very severe intractable alcohol craving. Functional imaging studies consisting of fMRI and resting state EEG were performed before rTMS, after successful rTMS and after unsuccessful rTMS with relapse. Craving was associated with EEG beta activity and connectivity between the dACC and PCC in the patient in comparison to a healthy population, which disappeared after successful rTMS. Cue induced worsening of craving pre-rTMS activated the ACC-vmPFC and PCC on fMRI, as well as the nucleus accumbens area, and lateral frontoparietal areas. The nucleus accumbens, ACC-vmPFC and PCC activation disappeared on fMRI following successful rTMS. Relapse was associated with recurrence of ACC and PCC EEG activity, but in gamma band, in comparison to a healthy population. On fMRI nucleus accumbens, ACC and PCC activation returned to the initial activation pattern. A pathophysiological approach is described to suppress alcohol craving temporarily by rTMS directed at the anterior cingulate. Linking functional imaging changes to craving intensity suggests this approach warrants further exploration.
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