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在物质使用障碍中使用TMS针对VMPFC-杏仁体电路:一种机械框架

Ghazaleh Soleimani^1,2, Christine A Conelea¹, Rayus Kuplicki³

¹Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, Minnesota, USA.

Addiction biology

|January 9, 2025

概括

这项研究引入了一种个性化的跨脑磁刺激 (TMS) 方法来治疗使用甲基胺障碍 (MUDs). 通过优化VMPFC-杏仁体电路调制,这种方法显示了改善成治疗结果的希望.

科学领域:

神经科学是一个神经科学.
精神病学是一个精神病学.
医疗成像医学成像

背景情况:

腹中前额叶皮层 (VMPFC) 对于情绪调节至关重要,并与成神经回路有关.
针对VMPFC的跨磁刺激 (TMS) 是对物质使用障碍 (SUD) 的潜在治疗方法.
目前SUD研究中的VMPFC向依赖于固定的解剖学基准,导致治疗结果变化.

研究的目的:

开发和验证一个量身定制的TMS准框架,用于VMPFC-杏仁体电路的个人与甲基胺使用障碍 (MUDs).
优化TMS参数 (位置,方向,强度) 以在个人基础上增强VMPFC-杏仁体电路的参与.
为了研究个性化VMPFC-杏仁体连接和MUDs中的渴望之间的关系.

主要方法:

收集了来自60名MUD参与者的MRI数据.
利用功能连接分析 (心理生理相互作用 - PPI) 来识别基于fMRI药物暗示反应的个人VMPFC-杏仁体目标.
计算电场 (EF) 分布用于固定的与优化的TMS线圈位置和方向.
优化了线圈定向和协调的TMS强度,以最大限度地提高目标参与度.

主要成果:

确定左中枢杏仁体是fMRI药物暗示反应性最高的区域.
个性化的VMPFC-杏仁体连接目标与暗示暴露后的渴望水平有显著的相关性 (R=0.27,p=0.03).
优化了线圈方向,与固定方法 (0.99±0.21V/m对比0.560.78V/m) 相比,在目标电路上显著增加了EF强度.

结论:

一个个性化的VMPFC准框架可以有效地调节MUD中的VMPFC-杏仁体电路.
这种个性化的方法有可能提高成治疗的疗效.
基于个体功能连接的优化TMS参数为SUD治疗中精确神经调节提供了一个有希望的途径.

关键词:

阿米格达拉的桃体 fMRI药物暗示反应性的药物暗示反应性根据fMRI信息的TMS.个性化的刺激,个性化的刺激.风中前额叶皮层 (VMPFC) 是一个前额叶皮层.

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