Zhao Kanhao, Fonzo Gregory A, Xie Hua, Oathes Desmond J, Keller Corey J, Carlisle Nancy B, Etkin Amit, Garza-Villarreal Eduardo A, Zhang Yu
Department of Bioengineering, Lehigh University, Bethlehem, PA, USA.
Center for Psychedelic Research and Therapy, Department of Psychiatry and Behavioral Sciences, Dell Medical School, The University of Texas at Austin, Austin, TX, USA.
Nat Ment Health. 2024 Apr;2(4):388-400. doi: 10.1038/s44220-024-00209-1. Epub 2024 Feb 16.
Cocaine use disorder (CUD) is prevalent, and repetitive transcranial magnetic stimulation (rTMS) shows promise in reducing cravings. However, the association between a consistent CUD-specific functional connectivity signature and treatment response remains unclear. Here we identify a validated functional connectivity signature from functional magnetic resonance imaging to discriminate CUD, with successful independent replication. We found increased connectivity within the visual and dorsal attention networks and between the frontoparietal control and ventral attention networks, alongside reduced connectivity between the default mode and limbic networks in patients with CUD. These connections were associated with drug use history and cognitive impairments. Using data from a randomized clinical trial, we also established the prognostic value of these functional connectivities for rTMS treatment outcomes in CUD, especially involving the frontoparietal control and default mode networks. Our findings reveal insights into the neurobiological mechanisms of CUD and link functional connectivity biomarkers with rTMS treatment response, offering potential targets for future therapeutic development.
可卡因使用障碍（CUD）很常见，重复经颅磁刺激（rTMS）在减少渴望方面显示出前景。然而，一致的特定于CUD的功能连接特征与治疗反应之间的关联仍不清楚。在这里，我们从功能磁共振成像中识别出一个经过验证的功能连接特征，以区分CUD，并成功进行了独立复制。我们发现，CUD患者的视觉和背侧注意网络内部以及额顶叶控制网络和腹侧注意网络之间的连接性增加，同时默认模式网络和边缘系统网络之间的连接性降低。这些连接与药物使用史和认知障碍有关。利用一项随机临床试验的数据，我们还确定了这些功能连接性对CUD患者rTMS治疗结果的预后价值，特别是涉及额顶叶控制网络和默认模式网络。我们的研究结果揭示了对CUD神经生物学机制的见解，并将功能连接生物标志物与rTMS治疗反应联系起来，为未来的治疗发展提供了潜在靶点。
