title: Repetitive transcranial magnetic stimulation of the superior frontal gyrus modulates craving for cigarettes.
abstract: BACKGROUND
  Previous functional magnetic resonance imaging studies have shown strong correlations between cue-elicited craving for cigarettes and activation of the superior frontal gyrus (SFG). Repetitive transcranial magnetic stimulation (rTMS) offers a noninvasive means to reversibly affect brain cortical activity, which can be applied to testing hypotheses about the causal role of SFG in modulating craving.
  
  
  METHODS
  Fifteen volunteer smokers were recruited to investigate the effects of rTMS on subjective responses to smoking versus neutral cues and to controlled presentations of cigarette smoke. On different days, participants were exposed to three conditions: 1) high-frequency (10 Hz) rTMS directed at the SFG; 2) low-frequency (1 Hz) rTMS directed at the SFG; and 3) low-frequency (1 Hz) rTMS directed at the motor cortex (control condition).
  
  
  RESULTS
  Craving ratings in response to smoking versus neutral cues were differentially affected by the 10-Hz versus 1-Hz SFG condition. Craving after smoking cue presentations was elevated in the 10-Hz SFG condition, whereas craving after neutral cue presentations was reduced. Upon smoking in the 10-Hz SFG condition, ratings of immediate craving reduction as well as the intensity of interoceptive airway sensations were also attenuated.
  
  
  CONCLUSIONS
  These results support the view that the SFG plays a role in modulating craving reactivity; moreover, the results suggest that the SFG plays a role in both excitatory and inhibitory influences on craving, consistent with prior research demonstrating the role of the prefrontal cortex in the elicitation as well as inhibition of drug-seeking behaviors.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina. Electronic address: rose0003@mc.duke.edu.
authors.forename: Jed E
authors.initials: JE
authors.lastname: Rose
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina; Durham Veterans Affairs Medical Center and Veterans Integrated Service Network Number 6 Mental Illness Research, Education, and Clinical Center, Durham, North Carolina.
authors.forename: F Joseph
authors.initials: FJ
authors.lastname: McClernon
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina.
authors.forename: Brett
authors.initials: B
authors.lastname: Froeliger
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina.
authors.forename: Frédérique M
authors.initials: FM
authors.lastname: Behm
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina.
authors.forename: Xavier
authors.initials: X
authors.lastname: Preud'homme
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina.
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Krystal
mesh_terms: D000328:Adult; D016739:Behavior, Addictive / Q000628:therapy*; D003463:Cues; D005260:Female; D005625:Frontal Lobe / Q000502:physiology*; D006801:Humans; D008297:Male; D012907:Smoking / Q000523:psychology* / Q000628:therapy*; D014029:Tobacco Use Disorder / Q000523:psychology* / Q000628:therapy*; D050781:Transcranial Magnetic Stimulation / Q000379:methods / Q000523:psychology*