Nicotine Use Disorder Clinical Trial
Official title:
Cortical Excitability and Role of rTMS in Nicotine Use Disorder
Cortical excitability and role of repetitive transcranial magnetic stimulation in nicotine use disorder. Estimation of cortical excitability in heavy smoker patients and determination of role of repetitive transcranial magnetic stimulation for reducing nicotine craving.
Nicotine is one of the main components of cigarettes and affects the central nervous system
mainly via nicotinic acetylcholine receptors. It has further effects on neuromodulation by
regulating the release of dopamine, serotonin, glutamate and adrenaline. In studies, it has
been shown that nicotine improves attention and working memory in animals and humans, while
nicotine withdrawal leads to reduced working and verbal memory capacity in otherwise healthy
tobacco smokers. In schizophrenics and patients suffering from attention deficit
hyperactivity disorder, nicotine improves cognitive performance. A likely basis of the
nicotinic effects on cognitive functions is its effect on cortical excitability and activity.
Here, neurophysiological studies mainly base on animal experiments and have shown in vitro
that the nicotinic acetylcholine receptors elicit neuronal depolarisation by inducing
transmembrane cationic inward currents (Calcium), thus being involved in induction and
modulation of neuroplasticity and cortical excitability.
Repetitive transcranial magnetic stimulation: is a non-invasive brain stimulation technique
that has shown positive results in the treatment of depression, schizophrenia, and more
recently addiction. Repetitive transcranial magnetic stimulation uses alternating magnetic
fields to induce electric currents in the cortical tissue. Low-frequency as one hertz
repetitive transcranial magnetic stimulation is believed to inhibit neuronal firing in a
localized area and is used to induce virtual brain lesions. High-frequency as more than three
hertz repetitive transcranial magnetic stimulation is believed to be excitatory in nature and
can result in neuronal depolarization under the stimulating coil. However, the effects of
repetitive transcranial magnetic stimulation are not limited to the site of stimulation and
can induce changes in distant interconnected sites of the brain, and consequently may
influence subcortical regions.
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