Tang Victor M, Goud Rachel, Zawertailo Laurie, Selby Peter, Coroiu Adina, Sloan Matthew E, Chenoweth Meghan Jo-Ann, Buchman Daniel, Ibrahim Christine, Blumberger Daniel M, Le Foll Bernard
Addictions Division, Centre for Addiction and Mental Health, 100 Stokes St, Toronto, ON, Canada; Institute for Medical Science, Temerty Faculty of Medicine, University of Toronto, Canada; Department of Psychiatry, University of Toronto, Temerty Faculty of Medicine, Canada; Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Canada; Centre for Addiction and Mental Health, Institute of Mental Health Policy Research, Canada; Centre for Addiction and Mental Health, Temerty Centre for Therapeutic Brain Intervention, Canada.
Addictions Division, Centre for Addiction and Mental Health, 100 Stokes St, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Temerty Faculty of Medicine, Canada.
Psychiatry Res. 2023 Aug;326:115340. doi: 10.1016/j.psychres.2023.115340. Epub 2023 Jul 11.
Tobacco smoking is a significant determinant of preventable morbidity and mortality worldwide. It is now possible to modulate the activity of the neurocircuitry associated with nicotine dependence using repetitive Transcranial Magnetic Stimulation (rTMS), a non-invasive neurostimulation approach, which has recently demonstrated efficacy in clinical trials and received regulatory approval in the US and Canada. However there remains a paucity of replication studies and real-world patient effectiveness data as access to this intervention is extremely limited. There are a number of unique challenges related to the delivery of rTMS that need to be addressed prior to widespread adoption and implementation of this treatment modality for smoking cessation. In this paper, we review the accessibility, scientific, technological, economical, and social challenges that remain before this treatment can be translated into clinical practice. By addressing these remaining barriers and scientific challenges with rTMS for smoking cessation and delineating implementation strategies, we can greatly reduce the burden of tobacco-related disease worldwide.
吸烟是全球可预防发病和死亡的一个重要决定因素。现在可以使用重复经颅磁刺激（rTMS）来调节与尼古丁依赖相关的神经回路活动，rTMS是一种非侵入性神经刺激方法，最近已在临床试验中证明其有效性，并在美国和加拿大获得监管批准。然而，由于这种干预措施的获取极其有限，复制研究和真实世界患者有效性数据仍然匮乏。在广泛采用和实施这种戒烟治疗方式之前，有许多与rTMS治疗相关的独特挑战需要解决。在本文中，我们回顾了在这种治疗方法转化为临床实践之前仍然存在的可及性、科学、技术、经济和社会挑战。通过解决rTMS戒烟治疗中这些剩余的障碍和科学挑战，并勾勒实施策略，我们可以大大减轻全球烟草相关疾病的负担。
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