Rakesh Gopalkumar, Adams Thomas G, Morey Rajendra A, Alcorn Joseph L, Khanal Rebika, Su Amanda E, Himelhoch Seth S, Rush Craig R
Department of Psychiatry, College of Medicine, University of Kentucky, Lexington, KY, United States.
Department of Psychology, College of Arts & Sciences, University of Kentucky, Lexington, KY, United States.
Front Psychiatry. 2024 Mar 4;15:1315854. doi: 10.3389/fpsyt.2024.1315854. eCollection 2024.
People living with HIV (PLWHA) smoke at three times the rate of the general population and respond poorly to cessation strategies. Previous studies examined repetitive transcranial magnetic stimulation (rTMS) over left dorsolateral prefrontal cortex (L. dlPFC) to reduce craving, but no studies have explored rTMS among PLWHA who smoke. The current pilot study compared the effects of active and sham intermittent theta-burst stimulation (iTBS) on resting state functional connectivity (rsFC), cigarette cue attentional bias, and cigarette craving in PLWHA who smoke.
Eight PLWHA were recruited (single-blind, within-subject design) to receive one session of iTBS (n=8) over the L. dlPFC using neuronavigation and, four weeks later, sham iTBS (n=5). Cigarette craving and attentional bias assessments were completed before and after both iTBS and sham iTBS. rsFC was assessed before iTBS (baseline) and after iTBS and sham iTBS.
Compared to sham iTBS, iTBS enhanced rsFC between the L. dlPFC and bilateral medial prefrontal cortex and pons. iTBS also enhanced rsFC between the right insula and right occipital cortex compared to sham iTBS. iTBS also decreased cigarette craving and cigarette cue attentional bias.
iTBS could potentially offer a therapeutic option for smoking cessation in PLWHA.
感染人类免疫缺陷病毒（HIV）的人（PLWHA）吸烟率是普通人群的三倍，且对戒烟策略反应不佳。以往研究检测了经颅磁刺激（rTMS）作用于左侧背外侧前额叶皮质（L. dlPFC）以减轻烟瘾，但尚无研究探讨过在吸烟的PLWHA中进行rTMS治疗的效果。当前的这项初步研究比较了主动和假的间歇性θ爆发刺激（iTBS）对吸烟的PLWHA静息态功能连接（rsFC）、香烟线索注意偏向和烟瘾的影响。
招募了8名PLWHA（单盲、受试者内设计），使用神经导航技术在L. dlPFC上接受1次iTBS治疗（n = 8），四周后接受假iTBS治疗（n = 5）。在iTBS和假iTBS治疗前后均完成烟瘾和注意偏向评估。在iTBS治疗前（基线）以及iTBS和假iTBS治疗后评估rsFC。
与假iTBS相比，iTBS增强了L. dlPFC与双侧内侧前额叶皮质及脑桥之间的rsFC。与假iTBS相比，iTBS还增强了右侧岛叶与右侧枕叶皮质之间的rsFC。iTBS还降低了烟瘾和香烟线索注意偏向。
iTBS可能为PLWHA戒烟提供一种治疗选择。
