Mikellides Georgios, Michael Panayiota, Psalta Lilia, Stefani Artemis, Schuhmann Teresa, Sack Alexander T
Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands.
Cyprus rTMS Centre, Larnaca, Cyprus.
Front Psychiatry. 2022 May 24;13:892075. doi: 10.3389/fpsyt.2022.892075. eCollection 2022.
Smoking is currently one of the main public health problems. Smoking cessation is known to be difficult for most smokers because of nicotine dependence. Repetitive transcranial magnetic stimulation (rTMS) over the left dorsolateral prefrontal cortex (DLPFC) has been shown to be effective in the reduction of nicotine craving and cigarette consumption. Here, we evaluated the efficacy of accelerated intermittent theta burst stimulation (aiTBS; four sessions per day for 5 consecutive days) over the left DLPFC in smoking cessation, and we investigated whether the exposure to smoking-related cues compared to neutral cues during transcranial magnetic stimulation (TMS) impacts treatment outcome. A double-blind, randomized, controlled study was conducted in which 89 participants (60 males and 29 females; age 45.62 ± 13.42 years) were randomly divided into three groups: the first group received active aiTBS stimulation while watching neutral videos, the second group received active aiTBS stimulation while watching smoking-related videos and the last group received sham stimulation while watching smoking-related videos. Our results suggest that aiTBS is a tolerable treatment. All treatment groups equally reduced cigarette consumption, nicotine dependence, craving and perceived stress. The effect on nicotine dependence, general craving and perceived stress lasted for at least 1 week after the end of treatment. Active aiTBS over the left DLPFC, combined with smoking related cues, is as effective as active aiTBS combined with neutral cues as well as placebo aiTBS in smoking cessation. These findings extend the results of previous studies indicating that TMS therapy is associated with considerably large placebo effects and that these placebo effects may be further increased when using advanced placebo coil technology.
www.clinicaltrials.gov, identifier NCT05271175.
吸烟是当前主要的公共卫生问题之一。由于尼古丁依赖，大多数吸烟者戒烟困难。经证实，对左侧背外侧前额叶皮质（DLPFC）进行重复经颅磁刺激（rTMS）可有效减少尼古丁渴望和香烟消费量。在此，我们评估了对左侧DLPFC进行加速间歇性θ波爆发刺激（aiTBS；连续5天每天4次）在戒烟中的疗效，并研究了在经颅磁刺激（TMS）期间，与中性线索相比，接触吸烟相关线索是否会影响治疗结果。我们进行了一项双盲、随机、对照研究，将89名参与者（60名男性和29名女性；年龄45.62±13.42岁）随机分为三组：第一组在观看中性视频时接受主动aiTBS刺激，第二组在观看吸烟相关视频时接受主动aiTBS刺激，最后一组在观看吸烟相关视频时接受假刺激。我们的结果表明，aiTBS是一种可耐受的治疗方法。所有治疗组均同等程度地减少了香烟消费量、尼古丁依赖、渴望和感知压力。对尼古丁依赖、一般渴望和感知压力的影响在治疗结束后至少持续1周。对左侧DLPFC进行主动aiTBS并结合吸烟相关线索，在戒烟方面与主动aiTBS结合中性线索以及安慰剂aiTBS同样有效。这些发现扩展了先前研究的结果，表明TMS治疗与相当大的安慰剂效应相关，并且当使用先进的安慰剂线圈技术时，这些安慰剂效应可能会进一步增加。
