Developing repetitive transcranial magnetic stimulation (rTMS) as a treatment tool for cocaine use disorder: a series of six translational studies
Open accessAbstract
Purpose of the review Cocaine dependence is a chronic and relapsing disorder which is particularly resistant to behavioral or pharmacologic treatment, and likely involves multiple dysfunctional frontal-striatal circuits. Through advances in preclinical research in the last decade, we now have an unprecedented understanding of the neural control of drug-taking behavior. In both rodent models and human clinical neuroimaging studies, it is apparent that medial frontal-striatal limbic circuits regulate drug cue-triggered behavior. While non-human preclinical studies can use invasive stimulation techniques to inhibit drug cue-evoked behavior, in human clinical neuroscience, we are pursuing non-invasive theta burst stimulation (TBS) as a novel therapeutic tool to inhibit drug cue-associated behavior.Recent findings Our laboratory and others have spent the last 7 years systematically and empirically developing a non-invasive, neural circuit-based intervention for cocaine use disorder. Utilizing a multimodal approach of functional brain imaging and brain stimulation, we have attempted to design and optimize a repetitive transcranial magnetic stimulation treatment protocol for cocaine use disorder. This manuscript will briefly review the data largely from our own lab that motivated our selection of candidate neural circuits, and then summarize the results of six studies, culminating in the first double-blinded, sham-controlled clinical trial of TMS as a treatment adjuvant for treatment-engaged cocaine users (10 sessions, medial prefrontal cortex, 110% resting motor threshold, continuous theta burst stimulation, 3600 pulses/session).Summary The intent of this review is to highlight one example of a systematic path for TMS treatment development in patients. This path is not necessarily optimal, exclusive, or appropriate for every neurologic or psychiatric disease. Rather, it is one example of a reasoned, empirically derived pathway which we hope will serve as scaffolding for future investigators seeking to develop TMS treatment protocols.
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TMS applications to investigate and modulate SUD-related networks have grown exponentially across alcohol, cocaine, methamphetamine, opioid, cannabis, and tobacco use disorders.
“there has been an exponential growth in the application of TMS to investigate and modulate these networks in populations with SUDs including alcohol, cocaine, methamphetamine, opioid, cannabis, and tobacco use disorder [11,12,25–29].”
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- Authors
- Hanlon, C. A., Kearney-Ramos, T., Dowdle, L. T., Hamilton, S., DeVries, W., Mithoefer, O., Austelle, C., Lench, D. H., Correia, B., Canterberry, M., Smith, J. P., Brady, K. T., & George, M. S.
- Affiliations
- Medical University of South Carolina (US)
- Corresponding author
- Hanlon, Colleen A.
- ORCID
- Venue
- Current Behavioral Neuroscience Reports
- Published
- 2017-10-23
- Volume
- 4
- Issue
- 4
- Pages
- 341-352
- ISSN
- 2196-2979 (ISSN-L)
- PMC
- PMC6039979
- OpenAlex
- W2766931993
- Cited by
- 31
- References
- 60
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 5 · 2023: 4 · 2022: 5 · 2021: 5 · 2020: 2 · 2019: 3 · 2018: 5
- FWCI
- 1.36
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Current Behavioral Neuroscience Reports (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Drug Abuse (K01 DA027756, R01DA0036617, R21DA041610, T32DA007288, P50 DA015369)
- National Institute of Alcohol and Alcoholism (P50 AA010761)
- National Institutes of Health (UL1 TR000062)
- Topics
- Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Keywords
- cocaine dependence, repetitive transcranial magnetic stimulation, continuous theta burst stimulation, medial prefrontal cortex, frontostriatal circuits, treatment-resistant addiction, drug use behavior
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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