Non-Invasive Brain Stimulation for Nicotine Addiction PPT
NON-INVASIVE BRAIN
STIMULATION (NIBS) IN
TREATMENT FOR
NICOTINE ADDICTION
Yasmine Fafana Seidu
PharmD Candidate 2022
Raabe College of Pharmacy
Ohio Northern University
2
Objectives
➢ Understand how addiction affects the brain
➢ Examine current treatments for nicotine addiction
➢ NIBS and current applications
➢ Evaluate the potential application of NIBS in nicotine
addiction
3
Drug Addiction: What is it?
➢ Chronic relapsing disorder characterized by:
○ Compulsion
○ Loss of Control
○ Negative emotional state
➢ Addiction cycle of 3 stages:
○ Binge/intoxication
○ Withdrawal/negative affect
○ Anticipation/craving
4
Epidemiology
➢ 40 million Americans ages 12 years and older
abuse or are addicted to nicotine, alcohol or
other drugs
➢ Nicotine addiction 5 million deaths per year
○ Projected to kill 10 million smokers by 2025
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Effects of Nicotine Addiction
➢ Lead to other
conditions
○ Cancer
○ Hypertension
○ Diabetes
6
Pathophysiology
➢
➢
➢
➢
➢
➢
Rapidly absorbed into bloodstream
Crosses blood brain barrier (BBB)
Takes 2 to 8 seconds
Selective binder to nAch receptor
Increases activity in the brain
Stimulates release of NT
○
○
Catecholamines, Ach, etc.
Increase heart rate, cardiac contractility, blood pressure
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Nicotine Craving Cycle and Current Treatment
➢ Tolerance builds after chronic nicotine exposure
○
○
Decrease dopamine release
“Binge”
➢ Mood disturbances without nicotine
○
“Withdrawal/negative effects”
➢ Leads to Craving
○
Bilateral dorsolateral prefrontal cortex (DLPFC)
➢ Current treatment do not target craving
○
○
Relieve withdrawal symptoms and desensitize nACHR
NRT, bupropion, varenicline, etc.
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NIBS
➢ FDA Approved for Major Depression Disorder (MDD)
➢ Excite or inhibit target brain region with electrical
current
➢ TMS and DCS most popular
○ rTMS and tDCS
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STUDY 1 Goal: DCS to Reduce Cue-Provoked Smoking
Craving
➢ Randomized, double-blind, sham controlled
➢ Excluded:
○
Neuropsychiatric disorders, other drug abuse, psychiatric medication,
pregnancy, process to stop smoking
➢ Methods
○
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24 Subjects
■ 8, TDCS to left DLPFC
■ 8, TDCS to right DLPFC
■ 8, TDCS to sham TDCS
Instructed to maintain regular smoking habits
■ Not to smoke 90 minutes prior to experiment
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STUDY 1: Procedure
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STUDY 1: Results
➢ Results:
○
○
○
○
Slope T0-T1:
■ Increase craving by 22.6%
Slope T0-T2:
■ Sham returned to baseline
■ TDCS identical slopes
Slope T0-T3:
■ Sham craving increased by
13.4%
TDCS decreased cue provoked
craving by 13.6%
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STUDY 2 Goal: NRT and rTMS to increase abstinence rates
➢
Randomized
controlled trial
➢ rTMS
administered to
right DLPFC
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STUDY 2 Goal: NRT and rTMS to increase abstinence rates
RESULTS
➢ Abstinence rates and
self-report craving
scales
➢ 16 abstinence smokers
active rTMS with NRT
➢ 9 abstinence smokers
sham rTMS with NRT
➢ TMS + NRT
combination increase
abstinence successful
rates
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Conclusion and future application of NIBS
➢ Further research
○
By itself vs combination
➢ Advantages:
○
○
○
Potential combination therapy
Depression and drug addiction
New target of therapy
➢ Disadvantages:
○
○
US$ 1677.20 for tDCS, US$ 2072.40 for rTMS for 10 sessions
Travel time vs going to a pharmacy
➢ Pharmacy application
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References
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Trojak, B., Sauvaget, A., Fecteau, S., Lalanne, L., Chauvet-Gelinier, J. C., Koch, S., et al. Outcome of non-invasive brain stimulation in substance use
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Questions?