title: Cortical inhibition within motor and frontal regions in alcohol dependence post-detoxification: A pilot TMS-EEG study.
abstract: Preclinical studies suggest that cortical alterations within the prefrontal cortex (PFC) are critical to the pathophysiology of alcohol dependence. Combined transcranial magnetic stimulation (TMS) and electroencephalography (EEG) allows direct assessment of cortical excitability and inhibition within the PFC of human subjects. We report the first application of TMS-EEG to measure these indices within the PFC of alcohol-dependent (ALD) patients post-detoxification.
  
  
  
  Cortical inhibition was assessed in 12 ALD patients and 14 healthy controls through single and paired-pulse TMS paradigms. Long-interval cortical inhibition indexed cortical inhibition in the PFC. In the motor cortex (MC), short- interval intracortical inhibition and cortical silent period determined inhibition, while intracortical facilitation measured facilitation, resting and active motor threshold indexed cortical excitability.
  
  
  
  ALD patients demonstrated altered cortical inhibition across the bilateral frontal cortices relative to controls. There was evidence of altered cortical excitability in ALD patients; however, no significant differences in MC inhibition.
  
  
  
  Our study provides first direct evidence of reduced cortical inhibition in the PFC of ALD patients post-detoxification. Altered cortical excitability in the MC may reflect hyper-excitability within the cortex associated with chronic alcohol consumption. These findings provide initial neurophysiological evidence of disrupted cortical excitability within the PFC of ALD patients.
authors.affiliation: a Monash Alfred Psychiatry Research Centre, The Alfred and Monash University, Central Clinical School , Prahran, Victoria , Australia.|b School of Psychology and Psychiatry, Monash University , Clayton, Victoria , Australia.|c Department of Physics of Complex Systems , The Weizmann Institute of Science , Rehovot , Israel.
authors.forename: Jodie
authors.initials: J
authors.lastname: Naim-Feil
authors.affiliation: b School of Psychology and Psychiatry, Monash University , Clayton, Victoria , Australia.
authors.forename: John L
authors.initials: JL
authors.lastname: Bradshaw
authors.affiliation: a Monash Alfred Psychiatry Research Centre, The Alfred and Monash University, Central Clinical School , Prahran, Victoria , Australia.|d Brain and Mental Health Laboratory, School of Psychological Sciences and Monash Biomedical Imaging, Monash University , Melbourne , Australia.
authors.forename: Nigel C
authors.initials: NC
authors.lastname: Rogasch
authors.affiliation: e Temetry Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, University of Toronto , Toronto , Canada.
authors.forename: Zafiris J
authors.initials: ZJ
authors.lastname: Daskalakis
authors.affiliation: f Monash Injury Research Institute, Monash University , Clayton, Victoria , Australia.
authors.forename: Dianne M
authors.initials: DM
authors.lastname: Sheppard
authors.affiliation: g Turning Point Alcohol and Drug Centre, Eastern Health and Monash University , Victoria , Australia.
authors.forename: Dan I
authors.initials: DI
authors.lastname: Lubman
authors.affiliation: a Monash Alfred Psychiatry Research Centre, The Alfred and Monash University, Central Clinical School , Prahran, Victoria , Australia.
authors.forename: Paul B
authors.initials: PB
authors.lastname: Fitzgerald
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000503:physiopathology / Q000628:therapy*; D016022:Case-Control Studies; D004569:Electroencephalography; D005260:Female; D005625:Frontal Lobe / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009433:Neural Inhibition; D010865:Pilot Projects; D050781:Transcranial Magnetic Stimulation
keywords: alcohol dependence; cortical inhibition; dorsolateral prefrontal cortex; electroencephalography; transcranial magnetic stimulation