Potential Treatment for Nicotine Dependence is Unveiled

According to new research from the University of Missouri School of Medicine, there may be an alternative way to alleviate nicotine dependence. Researchers discovered that theta-burst transcranial magnetic stimulation (TBS)—strong, rapidly varying magnetic field pulses that might change brain activity—can lead to increased self-control, decreased cravings, and decreased smoking. When compared to healthy nonsmokers, those with nicotine dependence have significant anatomical and functional changes in the brain. Cigarette smoking has been linked to lower gray matter, which indicates fewer neurons and other cells in the brain.

According to research, these differences may have an impact on inhibitory control (IC), which is our control over spontaneous drives and responses to stimuli—what allows humans to cease having an impulsive reaction to something.

“Having difficulties with IC may make it harder to avoid smoking when the urge arises, in response to all the cues and contexts in the environment that trigger the behavior to light a cigarette,” said lead author Brett Froeliger, Ph.D., professor of Psychiatry.

TBS refers to the application of magnetic pulses to the brain in three-second bursts and comes in two varieties: continuous TBS (cTBS) and intermittent TBS (iTBS). cTBS involves repeating these three bursts for 40 seconds, but iTBS involves applying the same number of pulses intermittently for more than 190 seconds.

Other mental ailments and disorders have been treated with magnetic stimulation. cTBS has been studied in the laboratory to treat generalized anxiety disorder, whereas iTBS to the left dorsolateral prefrontal cortex—a portion of the brain responsible for cognitive processes—is FDA-approved for the treatment of major depressive disorder.

The study included 37 subjects, the majority of whom were in their late 40s, and looked at the effects of both cTBS and iTBS on the right inferior frontal gyrus, a brain region extensively linked with IC. Researchers discovered that cTBS enhanced IC while both cTBS and iTBS lowered urges and, as a result, smoking.

Identifying treatments that improve IC may help reduce smoking and can potentially help with preventing relapse following when a person attempts to quit smoking,” Froeliger said. “Treatments that improve IC may also help disrupt the cycle of drug use among individuals with other substance use disorders; however, further research is needed to examine the clinical value of TBS for treating substance use disorders.”

“Effects of Hyperdirect Pathway Theta-Burst Transcranial Magnetic Stimulation on Inhibitory Control, Craving, and Smoking in Adults with Nicotine Dependence: A Double-Blind Randomized Crossover Trial” was recently published in Biological Psychiatry CNNI.

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