Circuity-guided Repetitive Transcranial Magnetic Stimulation (rTMS) for Tobacco Use in Veterans: A Comparison of Insula-rTMS and Prefrontal-rTMS
VA Office of Research and Development
Summary
Cigarette smoking is a significant public health concern for Veterans. Encouraging smoking cessation continues to be a top priority for the Veterans' Administration as Veterans who use tobacco experience negative health effects, including cancer, heart disease, and mental disorders. Despite the efficacy of current evidence-based pharmacotherapies and psychotherapies for smoking cessation, alternative treatments are critically needed. Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive form of brain stimulation, US FDA-approved for smoking cessation. In this protocol, the investigators propose comparing the two rTMS protocols (standard TMS vs. precision TMS) to find a better treatment parameter for smoking cessation in Veterans. Identifying an efficacious rTMS protocol would benefit Veterans who want to quit smoking.
Description
Cigarette smoking rates are high, and quitting rates are lower in the Veteran population in the United States compared to the nonveteran population. In addition, Veterans report being more likely to have smoking- related illnesses and morbidity. Despite the efficacy of current evidence-based pharmacotherapies and psychotherapies for smoking cessation, alternative treatments are critically needed. Repetitive transcranial magnetic stimulation (rTMS), has already displayed remarkable potential for producing novel, non- pharmacological interventions for neuropsychiatric disorders, including tobacc…
Eligibility
- Age range
- 18–70 years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Veteran * Males and females between the ages of 18 and 70 * Individuals who smoke 10 or more cigarettes per day and have a CO level \> 10 ppm indicative of recent smoking * Those who have not received substance abuse treatment within the previous 30 days * Those who have been stable on psychotropic medications for at least three months * For females, those who test non-pregnant and use adequate birth control * Those who are willing to provide informed consent * Those who can comply with protocol requirements and likely complete all study procedures * Those who are motiva…
Interventions
- DeviceTranscranial Magnetic Stimulation
The first group will receive 10 Hz DTMS (standard TMS) with a protocol of 3 seconds on, 15 seconds off, and a total of 1800 pulses/session, lasting 18 minutes, targeting the bilateral insula and lateral prefrontal cortex.
- Devicepersonalized-image-guided and E-field-modeling dose rTMS (precision TMS)
with a protocol of 5 seconds on, 10 seconds off, and a total of 3000 pulses/session, lasting 15 minutes, targeting the left DLPFC.
Location
- Ralph H. Johnson VA Medical Center, Charleston, SCCharleston, South Carolina