title: Repetitive transcranial magnetic stimulation reduces cigarette consumption in schizophrenia patients.
abstract: BACKGROUND
  High-frequency repetitive transcranial magnetic stimulation (rTMS) over the left dorsolateral prefrontal cortex (DLPFC) seemed to decrease tobacco consumption and craving in nicotine-dependent people without psychiatric disorder or otherwise healthy people. Even if the prevalence of cigarette smoking in schizophrenia patients is high and estimated to be between 45% and 88%, this technique has not been systematically studied in this indication in schizophrenia yet.
  
  
  OBJECTIVE
  The aim of this study was to test the ability of high-frequency (10Hz) rTMS over the left DLPFC to decrease cigarette consumption in schizophrenia patients.
  
  
  METHODS
  The study included 35 male schizophrenia patients on stable antipsychotic medication. The patients were divided into two groups: the first (18 patients) were actively stimulated and the second (17 patients) underwent sham (placebo) stimulation. The sham rTMS was administered using a purpose-built sham coil that was identical in appearance to the real coil and made the same noise but did not deliver a substantial stimulus. The rTMS was administered at the stimulation parameters: location (left dorsolateral prefrontal cortex: DLPFC), intensity of magnetic stimulation in % of motor threshold (110%), stimulation frequency (10Hz), number of trains (20), single train duration (10s), inter-train interval (30s), and total number of stimulation sessions (21). In each stimulation session, 2000TMSpulses were given, with a total of 42,000pulses per treatment course. Patients noted the number of cigarettes smoked in the 7days before treatment, during the whole stimulation treatment (21days), and again for a 7-day period after treatment.
  
  
  RESULTS
  Cigarette consumption was statistically significantly lower in the actively stimulated patients than in the sham rTMS group as early as the first week of stimulation. No statistically relevant correlations were found in the changes of ongoing negative or depressive schizophrenia symptoms and the number of cigarettes smoked.
  
  
  CONCLUSIONS
  High-frequency rTMS over the left DLPFC has the ability to decrease the number of cigarettes smoked in schizophrenia patients.
authors.affiliation: CEITEC - Central European Institute of Technology, Masaryk University, Czech Republic; Department of Psychiatry Faculty of Medicine, Masaryk University, Brno, Czech Republic; Department of Psychiatry, University Hospital Brno, Czech Republic. Electronic address: radovan.prikryl@post.cz.
authors.forename: Radovan
authors.initials: R
authors.lastname: Prikryl
authors.affiliation: CEITEC - Central European Institute of Technology, Masaryk University, Czech Republic; Department of Psychiatry Faculty of Medicine, Masaryk University, Brno, Czech Republic; Department of Psychiatry, University Hospital Brno, Czech Republic.
authors.forename: Libor
authors.initials: L
authors.lastname: Ustohal
authors.affiliation: CEITEC - Central European Institute of Technology, Masaryk University, Czech Republic; Department of Psychiatry Faculty of Medicine, Masaryk University, Brno, Czech Republic; Department of Psychiatry, University Hospital Brno, Czech Republic.
authors.forename: Hana Prikrylova
authors.initials: HP
authors.lastname: Kucerova
authors.affiliation: CEITEC - Central European Institute of Technology, Masaryk University, Czech Republic; Department of Psychiatry Faculty of Medicine, Masaryk University, Brno, Czech Republic; Department of Psychiatry, University Hospital Brno, Czech Republic.
authors.forename: Tomas
authors.initials: T
authors.lastname: Kasparek
authors.affiliation: Institute for Biostatistics and Analyses of the Faculty of Medicine, Masaryk University, Brno, Czech Republic.
authors.forename: Jiri
authors.initials: J
authors.lastname: Jarkovsky
authors.affiliation: CEITEC - Central European Institute of Technology, Masaryk University, Czech Republic; Department of Psychiatry Faculty of Medicine, Masaryk University, Brno, Czech Republic.
authors.forename: Veronika
authors.initials: V
authors.lastname: Hublova
authors.affiliation: CEITEC - Central European Institute of Technology, Masaryk University, Czech Republic; Department of Psychiatry Faculty of Medicine, Masaryk University, Brno, Czech Republic; Department of Psychiatry, University Hospital Brno, Czech Republic.
authors.forename: Michaela
authors.initials: M
authors.lastname: Vrzalova
authors.affiliation: CEITEC - Central European Institute of Technology, Masaryk University, Czech Republic; Department of Psychiatry Faculty of Medicine, Masaryk University, Brno, Czech Republic; Department of Psychiatry, University Hospital Brno, Czech Republic.
authors.forename: Eva
authors.initials: E
authors.lastname: Ceskova
mesh_terms: D000293:Adolescent; D000328:Adult; D004311:Double-Blind Method; D006801:Humans; D008297:Male; D008875:Middle Aged; D017397:Prefrontal Cortex / Q000502:physiology; D012565:Schizophrenic Psychology; D012907:Smoking / Q000523:psychology* / Q000628:therapy; D016540:Smoking Cessation / Q000379:methods*; D000074606:Smoking Prevention; D063189:Symptom Assessment; D050781:Transcranial Magnetic Stimulation; D055815:Young Adult
keywords: ANOVA; CDSS; Calgary Depression Scale for schizophrenia; Consumption; DLPFC; Dorsolateral prefrontal cortex; EEG; EMG; ICD-10; International Classification of Diseases, revision 10; MADRS; MINI; MT; Mini-International Neuropsychiatric Interview; Montgomery and Asberg Depression Scale; PANSS; Positive and Negative Syndrome Scale; Schizophrenia; Smoking; Stimulation; analysis of variance; dorsolateral prefrontal cortex; electroencephalography; electromyography; motor threshold; rTMS; repetitive transcranial magnetic stimulation