Deep TMS on alcoholics: effects on cortisolemia and dopamine pathway modulation. A pilot study.
The hypothalamic pituitary adrenal axis and dopamine have a key role in transition from alcohol social use to addiction. The medial prefrontal cortex was shown to modulate dopaminergic activity and cortisol releasing factor (CRF) release in hypothalamic and extra-hypothalamic systems. The recent advancements in non-invasive neurostimulation technologies has enabled stimulation of deeper brain regions using H-coil transcranial magnetic stimulation (TMS) in humans. This randomized double-blind placebo-controlled pilot study aims to evaluate H-coil efficacy in stimulating the medial prefrontal cortex. Cortisolemia and prolactinemia were evaluated as effectiveness markers. Alcohol intake and craving were considered as secondary outcomes. Eighteen alcoholics were recruited and randomized into 2 homogeneous groups: 9 in the real stimulation group and 9 in the sham stimulation group. Repetitive TMS (rTMS) was administered through a magnetic stimulator over 10 sessions at 20 Hz, directed to the medial prefrontal cortex. rTMS significantly reduced blood cortisol levels and decreased prolactinemia, thus suggesting dopamine increase. Craving visual analogic scale (VAS) in treated patients decreased, as well as mean number of alcoholic drinks/day and drinks on days of maximum alcohol intake (DMAI). In the sham group there was no significant effect observed on cortisolemia, prolactinemia, mean number of alcoholic drinks/day, or drinks/DMAI. Thus, deep rTMS could be considered a potential new treatment for alcoholism.
['Ceccanti|Marco|M|', 'Inghilleri|Maurizio|M|', 'Attilia|Maria Luisa|ML|', 'Raccah|Ruggero|R|', 'Fiore|Marco|M|', 'Zangen|Abraham|A|', 'Ceccanti|Mauro|M|']
D000328:Adult D000428:Alcohol Drinking D000437:Alcoholism D063425:Binge Drinking D015415:Biomarkers D039721:Diagnostic and Statistical Manual of Mental Disorders D059290:Dopaminergic Neurons D004311:Double-Blind Method D005500:Follow-Up Studies D006801:Humans D006854:Hydrocortisone D006966:Hyperprolactinemia D008297:Male D008875:Middle Aged D009474:Neurons D010352:Patient Dropouts D010865:Pilot Projects D017397:Prefrontal Cortex D011388:Prolactin D050781:Transcranial Magnetic Stimulation
alcohol prefrontal cortex cortisol alcool cortex préfrontal prolactin prolactine stimulation magnétique trans-crânienne transcranic magnetic stimulation