Accelerated Intermittent Theta Burst Stimulation in Smoking Cessation: Placebo Effects Equal to Active Stimulation When Using Advanced Placebo Coil Technology

Georgios Mikellides; Panayiota Michael; Lilia Psalta; Artemis Stefani; Teresa Schuhmann; Alexander T Sack

doi:10.3389/fpsyt.2022.892075

Accelerated Intermittent Theta Burst Stimulation in Smoking Cessation: Placebo Effects Equal to Active Stimulation When Using Advanced Placebo Coil Technology

Georgios Mikellides^*, Panayiota Michael, Lilia Psalta, Artemis Stefani, Teresa Schuhmann, Alexander T Sack

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

3 Citations (Web of Science)

Abstract

Smoking is currently one of the main public health problems. Smoking cessation is known to be difficult for most smokers because of nicotine dependence. Repetitive transcranial magnetic stimulation (rTMS) over the left dorsolateral prefrontal cortex (DLPFC) has been shown to be effective in the reduction of nicotine craving and cigarette consumption. Here, we evaluated the efficacy of accelerated intermittent theta burst stimulation (aiTBS; four sessions per day for 5 consecutive days) over the left DLPFC in smoking cessation, and we investigated whether the exposure to smoking-related cues compared to neutral cues during transcranial magnetic stimulation (TMS) impacts treatment outcome. A double-blind, randomized, controlled study was conducted in which 89 participants (60 males and 29 females; age 45.62 ± 13.42 years) were randomly divided into three groups: the first group received active aiTBS stimulation while watching neutral videos, the second group received active aiTBS stimulation while watching smoking-related videos and the last group received sham stimulation while watching smoking-related videos. Our results suggest that aiTBS is a tolerable treatment. All treatment groups equally reduced cigarette consumption, nicotine dependence, craving and perceived stress. The effect on nicotine dependence, general craving and perceived stress lasted for at least 1 week after the end of treatment. Active aiTBS over the left DLPFC, combined with smoking related cues, is as effective as active aiTBS combined with neutral cues as well as placebo aiTBS in smoking cessation. These findings extend the results of previous studies indicating that TMS therapy is associated with considerably large placebo effects and that these placebo effects may be further increased when using advanced placebo coil technology.

Clinical Trial Registration: www.clinicaltrials.gov, identifier NCT05271175.

Original language	English
Article number	892075
Number of pages	12
Journal	Frontiers in Psychiatry
Volume	13
DOIs	https://doi.org/10.3389/fpsyt.2022.892075
Publication status	Published - 24 May 2022

Keywords

ADULTS
CORTEX
COUNTRIES
DEPENDENCE
FORM
RTMS
TMS
TOBACCO USE
TRANSCRANIAL MAGNETIC STIMULATION
UNITED-STATES
intermittent theta burst stimulation (iTBS)
placebo effect
provocative smoking cues
repetitive transcranial magnetic stimulation
smoking cessation

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Cite this

@article{743addbbae934dedab873a63e98bc223,

title = "Accelerated Intermittent Theta Burst Stimulation in Smoking Cessation: Placebo Effects Equal to Active Stimulation When Using Advanced Placebo Coil Technology",

abstract = "Smoking is currently one of the main public health problems. Smoking cessation is known to be difficult for most smokers because of nicotine dependence. Repetitive transcranial magnetic stimulation (rTMS) over the left dorsolateral prefrontal cortex (DLPFC) has been shown to be effective in the reduction of nicotine craving and cigarette consumption. Here, we evaluated the efficacy of accelerated intermittent theta burst stimulation (aiTBS; four sessions per day for 5 consecutive days) over the left DLPFC in smoking cessation, and we investigated whether the exposure to smoking-related cues compared to neutral cues during transcranial magnetic stimulation (TMS) impacts treatment outcome. A double-blind, randomized, controlled study was conducted in which 89 participants (60 males and 29 females; age 45.62 ± 13.42 years) were randomly divided into three groups: the first group received active aiTBS stimulation while watching neutral videos, the second group received active aiTBS stimulation while watching smoking-related videos and the last group received sham stimulation while watching smoking-related videos. Our results suggest that aiTBS is a tolerable treatment. All treatment groups equally reduced cigarette consumption, nicotine dependence, craving and perceived stress. The effect on nicotine dependence, general craving and perceived stress lasted for at least 1 week after the end of treatment. Active aiTBS over the left DLPFC, combined with smoking related cues, is as effective as active aiTBS combined with neutral cues as well as placebo aiTBS in smoking cessation. These findings extend the results of previous studies indicating that TMS therapy is associated with considerably large placebo effects and that these placebo effects may be further increased when using advanced placebo coil technology.Clinical Trial Registration: www.clinicaltrials.gov, identifier NCT05271175.",

keywords = "ADULTS, CORTEX, COUNTRIES, DEPENDENCE, FORM, RTMS, TMS, TOBACCO USE, TRANSCRANIAL MAGNETIC STIMULATION, UNITED-STATES, intermittent theta burst stimulation (iTBS), placebo effect, provocative smoking cues, repetitive transcranial magnetic stimulation, smoking cessation",

author = "Georgios Mikellides and Panayiota Michael and Lilia Psalta and Artemis Stefani and Teresa Schuhmann and Sack, {Alexander T}",

note = "Copyright {\textcopyright} 2022 Mikellides, Michael, Psalta, Stefani, Schuhmann and Sack.",

year = "2022",

month = may,

day = "24",

doi = "10.3389/fpsyt.2022.892075",

language = "English",

volume = "13",

journal = "Frontiers in Psychiatry",

issn = "1664-0640",

publisher = "Frontiers Media S.A.",

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TY - JOUR

T1 - Accelerated Intermittent Theta Burst Stimulation in Smoking Cessation

T2 - Placebo Effects Equal to Active Stimulation When Using Advanced Placebo Coil Technology

AU - Mikellides, Georgios

AU - Michael, Panayiota

AU - Psalta, Lilia

AU - Stefani, Artemis

AU - Schuhmann, Teresa

AU - Sack, Alexander T

PY - 2022/5/24

Y1 - 2022/5/24

N2 - Smoking is currently one of the main public health problems. Smoking cessation is known to be difficult for most smokers because of nicotine dependence. Repetitive transcranial magnetic stimulation (rTMS) over the left dorsolateral prefrontal cortex (DLPFC) has been shown to be effective in the reduction of nicotine craving and cigarette consumption. Here, we evaluated the efficacy of accelerated intermittent theta burst stimulation (aiTBS; four sessions per day for 5 consecutive days) over the left DLPFC in smoking cessation, and we investigated whether the exposure to smoking-related cues compared to neutral cues during transcranial magnetic stimulation (TMS) impacts treatment outcome. A double-blind, randomized, controlled study was conducted in which 89 participants (60 males and 29 females; age 45.62 ± 13.42 years) were randomly divided into three groups: the first group received active aiTBS stimulation while watching neutral videos, the second group received active aiTBS stimulation while watching smoking-related videos and the last group received sham stimulation while watching smoking-related videos. Our results suggest that aiTBS is a tolerable treatment. All treatment groups equally reduced cigarette consumption, nicotine dependence, craving and perceived stress. The effect on nicotine dependence, general craving and perceived stress lasted for at least 1 week after the end of treatment. Active aiTBS over the left DLPFC, combined with smoking related cues, is as effective as active aiTBS combined with neutral cues as well as placebo aiTBS in smoking cessation. These findings extend the results of previous studies indicating that TMS therapy is associated with considerably large placebo effects and that these placebo effects may be further increased when using advanced placebo coil technology.Clinical Trial Registration: www.clinicaltrials.gov, identifier NCT05271175.

AB - Smoking is currently one of the main public health problems. Smoking cessation is known to be difficult for most smokers because of nicotine dependence. Repetitive transcranial magnetic stimulation (rTMS) over the left dorsolateral prefrontal cortex (DLPFC) has been shown to be effective in the reduction of nicotine craving and cigarette consumption. Here, we evaluated the efficacy of accelerated intermittent theta burst stimulation (aiTBS; four sessions per day for 5 consecutive days) over the left DLPFC in smoking cessation, and we investigated whether the exposure to smoking-related cues compared to neutral cues during transcranial magnetic stimulation (TMS) impacts treatment outcome. A double-blind, randomized, controlled study was conducted in which 89 participants (60 males and 29 females; age 45.62 ± 13.42 years) were randomly divided into three groups: the first group received active aiTBS stimulation while watching neutral videos, the second group received active aiTBS stimulation while watching smoking-related videos and the last group received sham stimulation while watching smoking-related videos. Our results suggest that aiTBS is a tolerable treatment. All treatment groups equally reduced cigarette consumption, nicotine dependence, craving and perceived stress. The effect on nicotine dependence, general craving and perceived stress lasted for at least 1 week after the end of treatment. Active aiTBS over the left DLPFC, combined with smoking related cues, is as effective as active aiTBS combined with neutral cues as well as placebo aiTBS in smoking cessation. These findings extend the results of previous studies indicating that TMS therapy is associated with considerably large placebo effects and that these placebo effects may be further increased when using advanced placebo coil technology.Clinical Trial Registration: www.clinicaltrials.gov, identifier NCT05271175.

KW - ADULTS

KW - CORTEX

KW - COUNTRIES

KW - DEPENDENCE

KW - FORM

KW - RTMS

KW - TMS

KW - TOBACCO USE

KW - TRANSCRANIAL MAGNETIC STIMULATION

KW - UNITED-STATES

KW - intermittent theta burst stimulation (iTBS)

KW - placebo effect

KW - provocative smoking cues

KW - repetitive transcranial magnetic stimulation

KW - smoking cessation

U2 - 10.3389/fpsyt.2022.892075

DO - 10.3389/fpsyt.2022.892075

M3 - Article

C2 - 35686190

SN - 1664-0640

VL - 13

JO - Frontiers in Psychiatry

JF - Frontiers in Psychiatry

M1 - 892075

ER -