Influencing Craving for Cigarettes by Stimulating the Brain
Featured Thursday Nov 3rd, 2011 on health.msn.com
Targeted brain stimulation increases cigarette cravings, a new study in Biological Psychiatry has
found, which may ultimately lead to new treatments that reverse these effects.
Cues associated with cigarette smoking, such as watching someone else smoke, elicit craving and
may provoke relapse when smokers are attempting to quit. There are many methods that smokers
use in an attempt to reduce their craving for cigarettes, including efficacious pharmacologic
treatments such as nicotine patches, and alternative approaches such as hypnosis and
acupuncture. Scientists have long suspected that these diverse approaches might work through a
common mechanism, the reduction of activity in a brain circuit that is responsible for cigarette
This hypothesis is supported by human functional brain imaging studies, which consistently report
the activation of several brain regions during craving that involve regions in the cerebral cortex as
well as the limbic system, a brain circuit involved in emotion.
Building on these brain imaging studies, scientists at the Center for Nicotine and Smoking Cessation
Research at Duke University Medical Center manipulated this 'craving circuit' activity using
transcranial magnetic stimulation (TMS).
TMS is a non-invasive technique that uses electromagnetic currents to target specific or general
areas of the brain. Depending upon the frequency used, it can either stimulate or depress brain
They found that the delivery of repeated TMS to the superior frontal gyrus at high frequency (10 Hz)
increased craving for cigarettes.
"We directly stimulated a frontal brain region using magnetic fields and showed that it exaggerated
smokers' craving for cigarettes when they viewed smoking related cues. By gaining a better
understanding of how the brain influences craving responses, strategies for blocking these
responses can be devised and ultimately more effective smoking cessation treatments may be
developed," explained Dr. Jed Rose, one of the study authors.
However, they did not find that low frequency (1 Hz) stimulation reduced craving. Thus, a potential
intervention that may have reduced the activation within this circuit did not produce the opposite
Nonetheless, the high frequency stimulation reduced craving when participants were viewing
nonsmoking cues. Moreover, the ability of smoking to satisfy craving, a rewarding effect that helps
keep smokers "hooked," was partially blocked by high frequency stimulation. These effects need to
be explored for potential therapeutic applications.
"This elegant study implicates the superior frontal gyrus in controlling the activity of the craving
circuit," commented Dr. John Krystal, Editor of Biological Psychiatry. "Additional research will be
needed to determine the potential value of repetitive TMS as a treatment for smoking."
# # #
Notes to Editors:
The article is "Repetitive Transcranial Magnetic Stimulation of the Superior Frontal Gyrus Modulates
Craving for Cigarettes" by Jed E. Rose, F. Joseph McClernon, Brett Froeliger, Frédérique M. Behm,
Xavier Preud'homme, and Andrew D. Krystal. The authors are affiliated with Department of
Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina.
McClernon is also with Durham Veterans Affairs Medical Center and Veterans Integrated Service
Network Number 6 Mental Illness Research, Education, and Clinical Center, Durham, North
Carolina. The article appears in Biological Psychiatry, Volume 70, Number 8 (October 15, 2011),
published by Elsevier.
The authors' disclosures of financial and conflicts of interests are available in the article.
John H. Krystal, M.D., is Chairman of the Department of Psychiatry at the Yale University School of
Medicine and a research psychiatrist at the VA Connecticut Healthcare System. His disclosures of
financial and conflicts of interests are available here.
Full text of the article mentioned above is available upon request. Contact Donna Santaromita at
About Biological Psychiatry
Biological Psychiatry is the official journal of the Society of Biological Psychiatry, whose purpose is
to promote excellence in scientific research and education in fields that investigate the nature,
causes, mechanisms and treatments of disorders of thought, emotion, or behavior. In accord with
this mission, this peer-reviewed, rapid-publication, international journal publishes both basic and
clinical contributions from all disciplines and research areas relevant to the pathophysiology and
treatment of major psychiatric disorders.
The journal publishes novel results of original research which represent an important new lead or
significant impact on the field, particularly those addressing genetic and environmental risk factors,
neural circuitry and neurochemistry, and important new therapeutic approaches. Reviews and
commentaries that focus on topics of current research and interest are also encouraged.
Biological Psychiatry is one of the most selective and highly cited journals in the field of psychiatric
neuroscience. It is ranked 4th out of 126 Psychiatry titles and 15th out of 237 Neurosciences titles in
the 2010 ISI Journal Citations Reports® published by Thomson Reuters. The 2010 Impact Factor
score for Biological Psychiatry is 8.674.
Elsevier is a world-leading publisher of scientific, technical and medical information products and
services. The company works in partnership with the global science and health communities to
publish more than 2,000 journals, including The Lancet and Cell, and close to 20,000 book titles,
including major reference works from Mosby and Saunders. Elsevier's online solutions include
SciVerse ScienceDirect, SciVerse Scopus, Reaxys, MD Consult and Nursing Consult, which
enhance the productivity of science and health professionals, and the SciVal suite and MEDai's
Pinpoint Review, which help research and health care institutions deliver better outcomes more
A global business headquartered in Amsterdam, Elsevier employs 7,000 people worldwide. The
company is part of Reed Elsevier Group PLC, a world-leading publisher and information provider,
which is jointly owned by Reed Elsevier PLC and Reed Elsevier NV. The ticker symbols are REN
(Euronext Amsterdam), REL (London Stock Exchange), RUK and ENL (New York Stock Exchange).