One session of high frequency repetitive transcranial magnetic stimulation (rTMS) to the right prefrontal cortex transiently reduces cocaine craving

Background: Cocaine dependence is a public health problem affecting 2 million individuals in USA. Craving is a predictor of subsequent cocaine use and is related to changes in brain activity in networks involving the prefrontal cortex. Methods: We investigated the efficacy of one session of high frequency repetitive transcranial magnetic stimulation (rTMS) to reduce craving in cocaine addicted subjects. Six patients underwent two sessions of 10 Hz rTMS over left or right dorsolateral prefrontal cortex (DLPFC). Before, immediately after and 4 h after rTMS we measured craving using visual analogue scales. Results: Right. but not left, DLPFC stimulation significantly reduced craving over time (F(2,10)= 11.07, p=0.0029). The reduction was 19% (13.4-24.6%) from baseline and disappeared after 4 h. The interaction of time by site of stimulation for craving was also significant (F(2,25) = 6.13, p = 0.0068). Conclusion: One session of 10 Hz rTMS over right, but not left, DLPFC transiently reduces craving in cocaine dependent individuals. These results highlight the potential of non-invasive neuromodulation as a therapeutic tool for cocaine addiction. (c) 2006 Elsevier Ireland Ltd. All rights reserved.