Alcohol use disorder (AUD) is a major cause of morbidity and mortality. More treatments are needed. Repetitive transcranial magnetic stimulation (rTMS) alters neuroplasticity and connectivity within the brain, is an FDA-approved treatment for major depressive disorder, and is being explored for the treatment of AUD. To date, however, an efficacious rTMS protocol for reduction of drinking and other important clinical outcomes in AUD have yet to be identified. Preliminary data indicates that the cerebellum may be an important treatment target for reduction of negative affect and downstream alcohol use in individuals with AUD. In particular, greater activation in cerebellum during a multisensory Stroop task is strongly correlated with both self-reported negative affect and alcohol use disorder severity. The overall aim of this study is to investigate the efficacy of inhibitory rTMS on self-reported negative affect and on activation in cerebellum during a multisensory Stroop task. Thirty-four treatment-seeking individuals with AUD will be recruited from local intensive outpatient treatment programs (IOPs), enrolled, randomized to active treatment or sham (blinded), and treated in 10 sessions over 2 weeks. To assess changes in brain function that result from treatment with rTMS, fMRI scans will be obtained at baseline and 2 weeks (baseline and 1 day following treatment completion). Our primary outcome measures will include self-reported negative affect, cerebellar activation during the Stroop task, and alcohol use outcomes. We hypothesize that reductions in negative affect and in BOLD signal will be greater in individuals on active compared to sham inhibitory rTMS. We also hypothesize that these reductions and active treatment will be related to better alcohol use outcomes (greater percent days abstinent, longer time to relapse). Findings will provide critical information about whether or not a larger clinical-trial investigating the efficacy of rTMS to the cerebellum for individuals with AUD is warranted.

Public Health Relevance

The proposed study will investigate whether neurostimulation using repetitive transcranial magnetic stimulation (rTMS) can improve mood (anxiety and depression) in individuals who are in treatment for their alcohol use disorder and help them stay abstinent. In particular, we will investigate the effects of two weeks of daily treatment (10 total sessions) with inhibitory rTMS applied to the cerebellum, a structure in the back of the brain. Moreover, we will investigate whether this treatment normalizes a neural marker of negative mood: specifically heightened brain activation in the cerebellum during a cognitive task. This innovative study will help researchers develop better treatments for alcohol use disorder.

Agency
National Institute of Health (NIH)
Institute
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Type
Exploratory/Developmental Grants (R21)
Project #
1R21AA026573-01A1
Application #
9653682
Study Section
National Institute on Alcohol Abuse and Alcoholism Initial Review Group (AA)
Program Officer
Bechtholt, Anita J
Project Start
2018-09-20
Project End
2020-08-31
Budget Start
2018-09-20
Budget End
2019-08-31
Support Year
1
Fiscal Year
2018
Total Cost
Indirect Cost
Name
The Mind Research Network
Department
Type
DUNS #
098640696
City
Albuquerque
State
NM
Country
United States
Zip Code
87106