Neuroimaging and neurostimulation in alcohol dependence: a working mechanism study focusing on functional connectivity and emotion regulation

Sandra Helinski

Jansen, JM1,2, van Wingen G1,2, van den Brink, W1,2, van den Heuvel OA3, van der Werff, Y3, Goudriaan, AE1,2,4

1Academic Medical Center, Department of Pychiatry, University of Amsterdam, Amsterdam, The Netherlands and Amsterdam Institute for Addiction Research
2 Amsterdam Brain and Cognition Program, University of Amsterdam, Amsterdam, The Netherlands
3 VU Medical Center, Department of Anatomy and Neurosciences, VU University Amsterdam, Amsterdam, The Netherlands
4 Arkin Mental Health Care, Amsterdam, The Netherlands

Repeated Transcranial Magnetic Stimulation (rTMS) seems to have beneficial effects for diminishing craving in addictive disorders (meta-analysis: Jansen et al., 2013). However, the neural mechanisms through which neurostimulation such as rTMS may exert a beneficial effect for treatment in (alcohol) addiction are not yet understood. In this presentation therefore, the effects of DLPFC stimulation (10Hz rTMS) on brain functioning during an emotion regulation task and it’s effects on resting state activity in alcohol dependent patients and healthy controls are presented. Results: rTMS improves emotion regulation when compared to sham stimulation, in both alcohol dependent patients and healthy controls (unpublished data). In the same study, rTMS also changed resting state brain activity: an increase in fronto-parietal connectivity after right dlPFC rTMS was observed in alcohol dependent patients (Jansen et al., in press). Possible implications: frontal rTMS may have a beneficial influence on cognitive control through alterations in resting state network activity, change of connectivity in the fronto-striatal network and improvement of emotion regulation. Future RCTs using rTMS in addiction should investigate whether this working mechanism is related to the potential therapeutical efficacy of rTMS in addictive disorders.