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Default mode network mechanisms of repeated transcranial magnetic stimulation in heroin addiction

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Abstract

Repetitive transcranial magnetic stimulation (rTMS) over the left dorsolateral prefrontal cortex (DLPFC) has been shown to reduce cravings in heroin-dependent (HD) individuals, but the mechanisms underlying the anti-craving effects of rTMS are unknown. Abnormalities in the default mode network (DMN) are known to be consistent findings in HD individuals and are involved in cravings. We assessed the effect of rTMS on DMN activity and its relationship to the treatment response. Thirty HD individuals were included in this self-controlled study, and all HD participants received 10-Hz rTMS 7-session during a week. Data for cravings and withdrawal symptoms and resting-state functional magnetic resonance imaging data were collected before and after rTMS treatment. Thirty demographically matched healthy individuals who did not receive rTMS were included as controls. We focused on changes in coupling seeded from the medial prefrontal cortex (MPFC), posterior cingulate cortex (PCC), and bilateral inferior parietal lobe (IPL), which are the core regions of the DMN. The craving and withdrawal symptom score of HD individuals decreased significantly after rTMS treatment. The left IPL-left middle frontal gyrus coupling and the left IPL-right inferior occipital gyrus coupling decreased significantly, and the changes in the left IPL-left middle frontal gyrus coupling were positively correlated with changes in drug-cue induced cravings. rTMS could modulate the coupling between the DMN and executive control network (ECN). Alterations of the left IPL-left middle frontal gyrus coupling may play an important mechanistic role in reducing drug cue-induced cravings.

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Funding

This research was funded partly by the Top Talent Foundation of Tangdu Hospital (2019), National Natural Science Foundation of China (number: 81671661), the Discipline Innovation and Development Program of the Second Affiliated Hospital of Air Force Medical University (2021QYJC-003) and Science and Technology Development Fund of Air Force Military Medical University (2022XC053). ClinicalTrials.gov: PET/MRI Study on the Neurological Mechanism of rTMS Treatment for Heroin Addiction, NCT04086459.

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  1. Long Jin and Menghui Yuan contributed equally to this work.

Authors and Affiliations

  1. Department of Nuclear Medicine, Tangdu Hospital, Fourth Military Medical University, 569 Xinsi Road, BaQiao District, 710038, Xi’an, Shaanxi, China

    Long Jin, Menghui Yuan, Wei Zhang, Lei Wang, Yixin Wei, Yunbo Li, Wei Wang & Longxiao Wei

  2. Department of Radiology, Tangdu Hospital, Fourth Military Medical University, 569 Xinsi Road, BaQiao District, 710038, Xi’an, Shaanxi, China

    Jiajie Chen & Qiang Li

  3. Department of Radiology, Qinhuang Hospital, Xi’an, Shaanxi, China

    Fan Wang, Jia Zhu & Tao Liu

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  1. Long Jin
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Contributions

Long Jin contributed to experimental design, manuscript review and write the manuscript. Menghui Yuan contributed to the conception, experimental design, and manuscript review. Lei Wang and Jiajie Chen contributed to analyze data. Wei Zhang, Fan Wang, Jia Zhu, Tao Liu, Yixin Wei, Yunbo Li contributed to acquiring experimental data. Wei Wang, Qiang Li and Longxiao Wei contributed to conception, experimental design and manuscript review.

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Correspondence to Wei Wang, Qiang Li or Longxiao Wei.

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Jin, L., Yuan, M., Zhang, W. et al. Default mode network mechanisms of repeated transcranial magnetic stimulation in heroin addiction. Brain Imaging and Behavior 17, 54–65 (2023). https://doi.org/10.1007/s11682-022-00741-7

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