Department of Psychology, Yunnan Normal University, Kunming, Yunnan Province, PR China; Center for Cognition and Brain Disorders, the Affiliated Hospital of Hangzhou Normal University, Hangzhou, PR China; Institute of Psychological Science, Hangzhou Normal University, Hangzhou, Zhejiang Province, PR China.
Center for Cognition and Brain Disorders, the Affiliated Hospital of Hangzhou Normal University, Hangzhou, PR China; Institute of Psychological Science, Hangzhou Normal University, Hangzhou, Zhejiang Province, PR China.
J Affect Disord. 2024 Nov 15;365:427-436. doi: 10.1016/j.jad.2024.08.120. Epub 2024 Aug 26.
Studies have demonstrated the potential of repetitive transcranial magnetic stimulation (rTMS) to decrease smoking cravings in individuals with tobacco use disorder (TUD). However, the neural features underlying the effects of rTMS treatment, especially the dynamic attributes of brain networks associated with the treatment, remain unclear.
Using dynamic functional connectivity analysis, this study first explored the differences in dynamic functional network features between 60 subjects with TUD and 64 nonsmoking healthy controls (HCs). Then, the left dorsolateral prefrontal cortex (DLPFC) was targeted for a five-day course of rTMS treatment in the 60 subjects with TUD (active rTMS in 42 subjects and sham treatment in 18 subjects). We explored the effect of rTMS on the dynamic network features associated with rTMS by comparing the actively treated group and the sham group.
Compared to nonsmokers, TUD subjects exhibited an increased integration coefficient between the frontoparietal network (FPN) and the basal ganglia network (BGN) and a reduced integration coefficient between the medial frontal network (MFN) and the FPN. Analysis of variance revealed that rTMS treatment reduced the integration coefficient between the FPN and BGN and improved the recruitment coefficient of the FPN.
This study involved a limited sample of young male smokers, and the findings may not generalize to older smokers or female smokers with an extensive history of smoking.
rTMS treatment of the left DLPFC exhibited significant effectiveness in restructuring the neural circuits associated with TUD while significantly mitigating smoking cravings.
研究表明，重复经颅磁刺激（rTMS）有可能降低患有烟草使用障碍（TUD）的个体对吸烟的渴望。然而，rTMS 治疗效果的神经特征，特别是与治疗相关的脑网络的动态属性，仍不清楚。
本研究首先使用动态功能连接分析，探讨了 60 名 TUD 受试者和 64 名非吸烟健康对照者（HCs）之间动态功能网络特征的差异。然后，对 60 名 TUD 受试者的左背外侧前额叶皮层（DLPFC）进行为期 5 天的 rTMS 治疗（42 名受试者接受主动 rTMS 治疗，18 名受试者接受假治疗）。我们通过比较主动治疗组和假治疗组，探讨了 rTMS 对与 rTMS 相关的动态网络特征的影响。
与非吸烟者相比，TUD 受试者的额顶网络（FPN）和基底节网络（BGN）之间的整合系数增加，内侧前额网络（MFN）和 FPN 之间的整合系数降低。方差分析显示，rTMS 治疗降低了 FPN 和 BGN 之间的整合系数，并改善了 FPN 的募集系数。
本研究涉及的样本量较小，仅限于年轻男性吸烟者，研究结果可能不适用于年龄较大的吸烟者或有长期吸烟史的女性吸烟者。
左 DLPFC 的 rTMS 治疗对与 TUD 相关的神经回路的重构具有显著效果，同时显著减轻了吸烟的渴望。
