title: Neurophysiological, psychological and behavioural correlates of rTMS treatment in alcohol dependence.
abstract: BACKGROUND
  Addiction is associated with dorso-lateral prefrontal cortex (DLPFC) dysfunction and altered brain-oscillations. High frequency repetitive transcranial magnetic stimulation (HFrTMS) over DLPFC reportedly reduces drug craving. Its effects on neuropsychological, behavioural and neurophysiological are unclear.
  
  
  METHODS
  We assessed psychological, behavioural and neurophysiological effects of 4 sessions of 10-min adjunctive HFrTMS over the left DLPFC during two weeks during a residential programme for alcohol detoxification. Participants were randomized to active HFrTMS (10 Hz, 100% motor threshold) or sham. Immediately before the first and after the last session, 32-channels EEG was recorded and alcohol craving Visual Analogue Scale, Symptom Check List-90-R, Numeric Stroop task and Go/No-go task administered. Tests were repeated at 1-month follow-up.
  
  
  RESULTS
  17 subjects (mean age 44.7 years, 4 F) were assessed. Active rTMS subjects performed better at Stroop test at end of treatment (p=0.036) and follow up (p=0.004) and at Go-NoGo at end of treatment (p=0.05) and follow up (p=0.015). Depressive symptoms decreased at end of active treatment (p=0.036). Active-TMS showed an overall decrease of fast EEG frequencies after treatment compared to sham (p=0.026). No significant modifications over time or group emerged for craving and number of drinks at follow up.
  
  
  CONCLUSIONS
  4 HFrTMS sessions over two weeks on the left DLPFC can improve inhibitory control task and selective attention and reduce depressive symptoms. An overall reduction of faster EEG frequencies was observed. Nonetheless, this schedule is ineffective in reducing craving and alcohol intake.
authors.affiliation: Department of Neuroscience-DSN, University of Padova, Via Giustiniani 2, Padua, Italy. Electronic address: alessandra.delfelice@unipd.it.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Del Felice
authors.affiliation: Department of Neurological and Movement Sciences, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Bellamoli
authors.affiliation: Department of Neurophysiology, Foundation IRCCS San Camillo Hospital, 30126 Venice, Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Formaggio
authors.affiliation: Neurology Clinic, University Hospital, Strada di Fiume, 447, 34149 Trieste, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Manganotti
authors.affiliation: Department of Neuroscience-DSN, University of Padova, Via Giustiniani 2, Padua, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Masiero
authors.affiliation: Institute of Constructivist Psychology, Via Martiri della Libertà 13, 35137 Padua, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Cuoghi
authors.affiliation: National Coordination Centre for NIDA Collaborations, Via Germania 20, 37136 Verona, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Rimondo
authors.affiliation: Explora-Centro di Ricerca e Analisi Statistica, Via Cà Pisani 7, Padua, Vigodarzere, Italy.
authors.forename: Bruno
authors.initials: B
authors.lastname: Genetti
authors.affiliation: Explora-Centro di Ricerca e Analisi Statistica, Via Cà Pisani 7, Padua, Vigodarzere, Italy.
authors.forename: Milena
authors.initials: M
authors.lastname: Sperotto
authors.affiliation: Addiction Department, ULSS 20, Via Germania 20, 37136 Verona, Italy.
authors.forename: Flavia
authors.initials: F
authors.lastname: Corso
authors.affiliation: Addiction Department, ULSS 20, Via Germania 20, 37136 Verona, Italy.
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Brunetto
authors.affiliation: Addiction Department, ULSS 20, Via Germania 20, 37136 Verona, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Bricolo
authors.affiliation: Addiction Department, ULSS 20, Via Germania 20, 37136 Verona, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Gomma
authors.affiliation: Addiction Department, ULSS 20, Via Germania 20, 37136 Verona, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Serpelloni
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000503:physiopathology / Q000523:psychology* / Q000628:therapy*; D001288:Attention / Q000502:physiology; D016739:Behavior, Addictive / Q000503:physiopathology / Q000523:psychology* / Q000628:therapy*; D066249:Craving / Q000502:physiology; D004569:Electroencephalography / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017397:Prefrontal Cortex / Q000503:physiopathology; D011446:Prospective Studies; D016037:Single-Blind Method; D050781:Transcranial Magnetic Stimulation / Q000379:methods*; D016896:Treatment Outcome
keywords: Alcohol craving; Alcohol detoxification; Brain oscillations; High-frequency transcranial magnetic stimulation; Inhibitory control; Psychological symptoms; Selective attention; Thalamo-cortical dysrhythmias