# Cortical rTMS as a Treatment for Craving and Brain Reactivity to Alcohol Cues

> **NIH NIH P50** · MEDICAL UNIVERSITY OF SOUTH CAROLINA · 2020 · $204,984

## Abstract

PROJECT SUMMARY
Alcohol Use Disorder (AUD) is prevalent, devastating, and difficult to treat. High relapse rates are likely due to
factors that affect neural circuits that govern craving and cognitive control. There is growing interest in the
utilization of prefrontal cortex repetitive transcranial magnetic stimulation (TMS) as a novel, non-invasive, non-
pharmacologic approach to decreasing craving among individuals with alcohol use disorder (AUD). At this
early stage of development, however, it is unclear if the best TMS strategy is to (1) attenuate activity in the
medial prefrontal cortex (mPFC, which is involved in craving), or (2) amplify activity in the dorsolateral
prefrontal cortex (dlPFC, which is involved in cognitive control). Several laboratories have demonstrated that a
single session of 10 Hz TMS over the dlPFC leads to a decrease in craving for alcohol, nicotine, and cocaine.
We have demonstrated that a single session of continuous theta burst (cTBS) TMS over the mPFC can also
decrease craving, as well as the brain response to drug cues in cocaine users and alcohol users. The
overarching goal of this proposal is to determine which of these brain stimulation strategies is more effective in
decreasing functional activity (measured by BOLD signal) in limbic regions involved in alcohol craving (Aim 1),
and decreasing self-reported craving (Aim 2). This will be achieved through a double-blind, sham-TMS
controlled within-subject crossover study of individuals with AUD. Using functional MRI, the neural response to
alcohol-cues (a task identical to that used in Research Project #2- Anton/Schacht) will be measured within 10
minutes after the participant receives a dose of continuous theta burst TMS to the mPFC, 10 Hz TMS to the
dlPFC, or sham rTMS. Additionally, the effects of these TMS strategies on cortical neurochemistry will be
measured using magnetic resonance spectroscopy (exploratory Aim 3), enabling us to relate the outcomes of
these aims with complementary neurochemical information. The outcomes of this project will provide an
evidence-based foundation for cortical target selection in future clinical trials of TMS as an innovative treatment
strategy for individuals with AUD.

## Key facts

- **NIH application ID:** 9843633
- **Project number:** 5P50AA010761-25
- **Recipient organization:** MEDICAL UNIVERSITY OF SOUTH CAROLINA
- **Principal Investigator:** Colleen A Hanlon
- **Activity code:** P50 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $204,984
- **Award type:** 5
- **Project period:** — → —

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9843633

## Citation

> US National Institutes of Health, RePORTER application 9843633, Cortical rTMS as a Treatment for Craving and Brain Reactivity to Alcohol Cues (5P50AA010761-25). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9843633. Licensed CC0.

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