Repetitive TMS Modulates Dorsal Lateral Prefrontal-Ventral Medial Prefrontal Pathway to Decrease Craving in Smokers

Date Added
March 4th, 2014
PRO Number
Pro00032649
Researcher
Xingbao Li

List of Studies


Keywords
Brain, Smoking
Summary

Cigarette smoking causes significant morbidity and mortality in the United States. Smoking cessation is difficult, with the average smoker attempting to quit five times before permanent success. Moreover, the majority of smoking quit attempts result in relapse. Brain stimulation for smoke cessation is an exciting new area that builds on advancing neuroscience knowledge concerning the functional neurocircuitry of addiction. Cortical stimulation can now be performed non-invasively by transcranial magnetic stimulation (TMS). Several studies have shown that TMS can reduce cue-elicited craving in smokers. Previous research by our group has shown that a single session of 15 minutes high frequency (10 Hz) repetitive TMS (rTMS) at 100% motor threshold over the left dorsal lateral prefrontal cortex (DLPFC) can reduce cue-induced craving compared to sham TMS. However, the mechanism by which craving is reduced by rTMS is poorly understood both at behavioral and neural levels. Neuroimaging studies in nicotine dependence have revealed cue-related responses in numerous brain areas, including frontal, parietal cortices and subcortical areas. Recently functional magnetic resonance imaging (fMRI) studies by our group have shown that cue-induced craving induced brain activation in ventral medial prefrontal cortex (VMPFC), including medial frontal, orbital frontal and anterior cingulate. This Chair Research Development Fund (CRDF) pilot proposal will integrate two new techniques- TMS and fMRI to investigate DLPFC-VMPFC pathway in smokers. Using double-masked methods we hypothesize that cue-induced exposure will induce brain activity in VMPFC, and 15 minutes rTMS over DLPFC will reduce cue-induced craving through modulating DLPFC-VMPFC pathway (increased activity DLPFC and decreased activity VMPFC). In the one year of project, we plan to recruit 10 non-treatment-seeking nicotine-dependent cigarette smokers and 20 non-smoking participants, both males and females of all ethnic and racial groups between the ages of 18 and 60 to participate in the study. The participants will randomly receive two different types of brain stimulation: active rTMS or sham rTMS over the left DLPFC with a 1 week interval between treatments. MRI scans will be completed pre and post rTMS. The data from this pilot will provide the information needed for submitting a larger-scale investigation (R01) to investigate cue craving neutral pathway and develop a potential clinical applications of TMS in smoke cessation.

Institution
MUSC
Recruitment Contact
William DeVries
843 7925729
devriesw@musc.edu

Synchronized-EEG Method for Automatically-delivered Real Time (SMART) Transcranial Magnetic Stimulation (TMS) for Nicotine Addiction

Date Added
October 7th, 2014
PRO Number
Pro00034876
Researcher
Xingbao Li

List of Studies


Keywords
Healthy Volunteer Studies, Smoking
Summary

Nicotine dependence remains a significant public health concern. Nicotine can affect brain neural oscillations. A magnetic field applied to the outside of the skull can produce electrical activity in the brain without significant pain or the need for anesthesia. In this proposal, we will build an individual brain signal-driven transcranial magnetic stimulation loop, and then test whether this stimulation loop can modulate neural oscillations and reduce cue-induced craving, including nicotine craving. This research will build an innovative brain stimulation method for neuroscientific research and develop a potential efficacy therapy for nicotine dependence as well other neuropsychiatric disorders.

Institution
MUSC
Recruitment Contact
John Henderson
843 792 5560
henderjs@musc.edu

CAROTID REVASCULARIZATION AND MEDICAL MANAGEMENT FOR ASYMPTOMATIC CAROTID STENOSIS TRIAL

Date Added
July 6th, 2015
PRO Number
Pro00043906
Researcher
Christine Holmstedt

List of Studies


Keywords
Stroke
Summary

CREST-2 is two parallel multi-center randomized, observer-blinded endpoint clinical trials. One trial will assess treatment differences between intensive medical management alone compared to carotid endarterectomy procedure plus intensive medical management. The parallel trial will assess treatment differences between intensive medical management alone compared to carotid artery stenting plus intensive medical management. Intensive medical management will involve control of blood pressure, LDL cholesterol, cigarette smoking, and other vascular risk factors.

Institution
MUSC
Recruitment Contact
Vicki Streets
843-792-8606
streetsv@musc.edu

Gain-framed Messages and NRT Sampling to Promote Smoking Cessation in Lung Cancer Screening Programs

Date Added
June 21st, 2016
PRO Number
Pro00055397
Researcher
Benjamin Toll

List of Studies


Keywords
Lung, Pulmonary, Smoking
Summary

This research is a randomized smoking cessation trial conducted within and specifically personalized for lung cancer screening patients presenting to a lung screening clinic. Novel tobacco treatments for this population are critically needed, given the growing population of lung screening patients. In the proposed study, we will test a gain-framed messaging intervention specifically designed for lung screening patients (vs. unframed messaging), as well as evaluating NRT sampling (vs. no medication).

Institution
MUSC
Recruitment Contact
Kayla Haire
843-509-7589
hairek@musc.edu

CONNECT (Clinical Outcomes of a Nationwide, Naturalistic E-Cig Trial)

Date Added
June 6th, 2017
PRO Number
Pro00066540
Researcher
Matthew Carpenter

List of Studies


Keywords
Smoking
Summary

The purpose of this study is to measure changes in smoking behavior during and following sampling of an e-cigarette product. E-cigarettes are classified by the US Food and Drug Administration (FDA) as a tobacco product, though they contain no tobacco. Unlike regular cigarettes, which are burned (creating smoke that is inhaled), e-cigarettes include a heating element that vaporizes nicotine. E-cigarettes are likely much safer than conventional cigarettes, but they may not be entirely safe. We are testing the effects of one specific e-cigarette (NJoy) on smoking behavior. Neither the tobacco industry nor any e-cigarette manufacturer provides support of any kind to this study. There is no requirement to quit smoking in this study.

Institution
MUSC
Recruitment Contact
Amy Boatright
843-876-2440
boatrigh@musc.edu

Tobacco treatment in the context of lung cancer screening: NRT and text messaging

Date Added
August 15th, 2017
PRO Number
Pro00068951
Researcher
Alana Rojewski

List of Studies


Keywords
Cancer/Lung, Lung, Pulmonary, Smoking
Summary

Screening for lung cancer at earlier, more treatable stages has the potential to reduce mortality from the U.S.'s most deadly cancer. Annual lung cancer screening with low-dose computed tomography is now recommended for high risk individuals based on age and smoking history. This study will evaluate a smoking cessation intervention for lung cancer screening patients. We will evaluate quit rates after a standard intervention (brief counseling session at time of LCS) versus a medication and text messaging intervention.

Institution
MUSC
Recruitment Contact
Alana Rojewski
843-876-1593
rojewski@musc.edu

Targeting Foundational Memory Processes in Nicotine Addiction: A Translational Clinical Neuroscience Study of a Retrieval-Extinction Intervention to Reduce Craving and Smoking Behavior

Date Added
September 5th, 2017
PRO Number
Pro00069355
Researcher
Michael Saladin

List of Studies


Keywords
Smoking
Summary

We recently published results from a NIDA-funded study of a brief behavioral treatment that was designed to reduce the troublesome cravings that smokers encounter when they attempt to quit smoking. This intervention was based on a growing body of neuroscience studies showing that memories for prior learning can be retrieved by the presentation of cues involved in that learning. Once retrieved, the memories enter into a brief period of vulnerability, during which they can be modified, but after which they are reconsolidated (restabilized) back into long-term storage. The treatment potential of this phenomenon was initially demonstrated in a Science report in which inpatient heroin addicts were briefly exposed to cues associated with heroin use in order to prompt the heroin use memories into a vulnerable state. Once the memories were in this state, the heroin addicts received extinction training consisting of protracted exposure to heroin associated cues. It was argued that extinction would change the memories such that the cues would no longer be associated with heroin administration and reward. Remarkably, after just two sessions of retrieval-extinction training (RET), the investigators found that craving in response to heroin cues was substantially reduced for up to 6-months post-treatment. This effect was observed relative to a control group that received retrieval involving non-heroin cues, followed by extinction. These impressive initial findings led us to replicate and extend the study in cigarette smokers. In our study, one group of smokers received two sessions of RET with smoking cues whereas a control group received the same training except that retrieval consisted of brief exposure to neutral, smoking-unrelated cues. Craving and other reactions to familiar and novel smoking cues were assessed in test sessions performed 24-hrs, 2-weeks and 1-month after intervention; smoking behavior was also assessed over 1-month follow-up. Remarkably, at 1-month follow-up, craving to both familiar and novel smoking cues was significantly lower in the group receiving R-E training vs. control. Even more striking was the 25% reduction in the number of cigarettes smoked per day in the RET group vs. control. [Also of significance was suggestive evidence that, relative to control participants, more participants in the RET group achieved a 60% reduction in smoking (from pretreatment levels)]. The proposed project will replicate and extend these findings by 1) increasing the dose of intervention so as to bolster the observed treatment effects, 2) employing brain imaging methods to identify patterns of brain activity uniquely associated with the intervention and potentially predictive of treatment outcome, 3) adding a control group that will enhance understanding of the effects of RET, and 4) extending follow-up period to more completely document the long-term effects of RET. Positive findings from this study could lead to the development of a brief, effective behavioral intervention to reduce the burden levied against society by smoking. Importantly, this intervention could be easily adapted to treat other forms of addiction and co-occurring anxiety disorders, such as PTSD.

Institution
MUSC
Recruitment Contact
Brittany Frasier
843-792-6984
frasibri@musc.edu

Impact of e-cigarette characteristics on reinforcement and tobacco use patterns among current smokers

Date Added
September 4th, 2018
PRO Number
Pro00081069
Researcher
Tracy Smith

List of Studies


Keywords
Smoking
Summary

The purpose of this project is to understand how different e-cigarettes influence their likeability and use among current smokers who try using e-cigarettes. Participants will receive an e-cigarette to sample over a three week period. During this time period they will complete daily electronic diaries and weekly lab visits. The results from this information will help us understand how different types of e-cigarettes are likely to influence cigarette and e-cigarette use.

Institution
MUSC
Recruitment Contact
Lisa Coles
843-876-2291
colesl@musc.edu

A prospective trial of varenicline and incentives for tobacco cessation in adults

Date Added
April 6th, 2019
PRO Number
Pro00086954
Researcher
Erin McClure

List of Studies


Keywords
Smoking, Substance Use
Summary

The purpose of this study is to better understand tobacco outcomes using a well-known stop smoking medication, varenicline, and financial incentives with tobacco users. We are also interested in how cannabis/marijuana and tobacco interact during a tobacco quit attempt. All participants will receive tobacco cessation treatment (varenicline) for 12 weeks. This study will recruit adult tobacco users (ages 18-40) who are motivated to quit smoking cigarettes.

Institution
MUSC
Recruitment Contact
Elizabeth Bradley
843-792-4097
smokingstudy@musc.edu

Neural mechanisms mediating appetitive regulation and smoking in nicotine addiction

Date Added
April 16th, 2019
PRO Number
Pro00086509
Researcher
Michael Saladin

List of Studies


Keywords
Smoking
Summary

Nicotine addiction is a chronic, relapsing brain disorder and although it is the leading cause of preventable premature death in the US, ~20% of adults smoke and among those that try to quit, the majority relapse.Research suggest that nicotine addiction disrupts the working in the brain involved in motivation and reward. The overarching goal of this proposal is to utilize clinical neuroscience to investigate the effects of Mindfulness Oriented Recovery Enhancement (MORE) on modifying behavior to help treat nicotine addiction.

Institution
MUSC
Recruitment Contact
Brittany Frasier
843-792-6984
frasibri@musc.edu



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