Eichhammer Peter, Johann Monika, Kharraz Alexander, Binder Harald, Pittrow David, Wodarz Norbert, Hajak Göran
Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany.
J Clin Psychiatry. 2003 Aug;64(8):951-3. doi: 10.4088/jcp.v64n0815.
The mesolimbic dopaminergic reward system seems to play a crucial role in reinforcing effects of nicotine. Recently, acute high-frequency repetitive transcranial magnetic stimulation (rTMS) of frontal brain regions has been shown to efficiently modulate the mesostriatal and mesolimbic dopaminergic system in both animals and humans. For this reason, we investigated whether high-frequency rTMS would be able to influence nicotine-related behavior by studying rTMS effects on craving and cigarette smoking.
Fourteen treatment-seeking smokers were included in a double-blind crossover trial, conducted in 2002, comparing single days of active versus sham stimulation. Outcome measures were rTMS effects on number of cigarettes smoked during an ad libitum smoking period and effects on craving after a period of acute abstinence.
High-frequency (20-Hz) rTMS of left dorsolateral prefrontal cortex reduced cigarette smoking significantly (p <.01) in an active stimulation compared with sham stimulation. Levels of craving did not change significantly.
High-frequency rTMS may be useful for treatment in smoking cessation.
中脑边缘多巴胺能奖赏系统似乎在尼古丁的强化作用中起着关键作用。最近，已表明对额叶脑区进行急性高频重复经颅磁刺激（rTMS）可有效调节动物和人类的中脑纹状体及中脑边缘多巴胺能系统。因此，我们通过研究rTMS对渴望和吸烟行为的影响，来探究高频rTMS是否能够影响与尼古丁相关的行为。
2002年，14名寻求治疗的吸烟者被纳入一项双盲交叉试验，比较单日的主动刺激与假刺激。观察指标为rTMS对自由吸烟期间吸烟量的影响以及对急性戒烟一段时间后的渴望程度的影响。
与假刺激相比，对左侧背外侧前额叶皮层进行高频（20赫兹）rTMS在主动刺激时显著减少了吸烟量（p<.01）。渴望程度没有显著变化。
高频rTMS可能对戒烟治疗有用。
