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Associations Between TMS-Induced Electric Fields and Craving and Consumption Outcomes in Substance Use Disorders: A
Ghazaleh Soleimani1, Martin P Paulus2, Hamed Ekhtiari3
1Department of Psychiatry and Behavioral Sciences, University of Minnesota, MN, USA.
Summary
This study links transcranial magnetic stimulation (TMS) efficacy in substance use disorders (SUDs) to specific brain regions. Findings highlight the frontopolar cortex, pre-SMA, and IFG for optimized neuromodulation strategies in SUD treatment.
Area of Science:
- Neuroscience
- Neuromodulation
- Addiction Research
Background:
- Transcranial magnetic stimulation (TMS) shows promise for treating substance use disorders (SUDs).
- Heterogeneity in TMS stimulation parameters complicates the identification of optimal treatment strategies.
- Meta-modeling was employed to link treatment effect sizes to simulated electric field (E-field) distributions.
Purpose of the Study:
- To identify brain regions associated with variability in TMS treatment efficacy for SUDs.
- To examine the association between study-level effect sizes and simulated local E-field strength.
- To assess the spatial overlap between E-field associations and functional magnetic resonance imaging (fMRI) drug cue-reactivity patterns.
Main Methods:
- Systematic PubMed search for TMS trials in SUDs (through end of 2025).
- Inclusion of studies reporting quantifiable craving or consumption outcomes.
- Meta-modeling of E-field distributions and effect sizes, with spatial overlap analysis against fMRI data.
Main Results:
- Analysis included 81 randomized controlled TMS studies (107 effect size estimates).
- TMS demonstrated small-to-moderate improvements in craving and consumption compared to sham.
- E-field modeling identified pre-SMA and IFG for craving variability, and frontopolar cortex for consumption variability.
Conclusions:
- Frontopolar cortex, pre-SMA, and IFG are key regions where local E-field strength correlates with SUD treatment effects.
- These findings support the development of more precise neuromodulation strategies for SUDs.
- The study provides a foundation for personalized TMS interventions in addiction treatment.
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