期刊
JOURNAL OF SUBSTANCE ABUSE TREATMENT
卷 45, 期 2, 页码 206-214出版社
PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.jsat.2013.01.012
关键词
Transcranial magnetic stimulation; Delay discounting; Smoking cessation
资金
- NCRR NIH HHS [P20 RR20146, UL1 RR029884, 1UL1RR029884, P20 RR020146] Funding Source: Medline
- NICHD NIH HHS [R03 HD055269, HD055269, HD055677, R21 HD055677] Funding Source: Medline
- NIDCD NIH HHS [DC011824, R21 DC011824] Funding Source: Medline
- NIGMS NIH HHS [P20 GM103425, P30 GM110702] Funding Source: Medline
Cigarette smokers and substance users discount the value of delayed outcomes more steeply than non-users. Higher discounting rates are associated with relapse and poorer treatment outcomes. The left dorsolateral prefontal cortex (DLPFC) exerts an inhibitory influence on impulsive or seductive choices. Greater activity in the prefrontal cortex is associated with lower discounting rates. We hypothesized that increasing activity in the left DLPFC with high frequency repetitive transcranial magnetic stimulation (HF rTMS) would decrease delay discounting and decrease impulsive decision-making in a gambling task as well as decrease cigarette consumption, similar to other studies. In this single-blind, within-subjects design, smokers with no intention to quit (n = 47) and nonsmokers (n = 19) underwent three counterbalanced sessions of HF rTMS (20 Hz, 10 Hz, sham) delivered over the left DLPFC. Tasks were administered at baseline and after each stimulation session. Stimulation decreased discounting of monetary gains (F-[3,F-250] =. 4.46, p <.01), but increased discounting of monetary losses (F-[3,F-246] = 4.30, p <.01), producing a reflection effect, normally absent in delay discounting. Stimulation had no effect on cigarette consumption. These findings provide new insights into cognitive processes involved with decision-making and cigarette consumption and suggest that like all medications for substance dependence, HF rTMS is likely to be most effective when paired with cognitive-behavioral interventions. (C) 2013 Elsevier Inc. All rights reserved.
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