Influencing Craving for Cigarettes by Stimulating the Brain



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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

This email address is being protected from spambots. You need JavaScript enabled to view it. to obtain a copy or to schedule an interview.

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.

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