AUTHOR=Shevorykin Alina , Carl Ellen , Mahoney Martin C. , Hanlon Colleen A. , Liskiewicz Amylynn , Rivard Cheryl , Alberico Ronald , Belal Ahmed , Bensch Lindsey , Vantucci Darian , Thorner Hannah , Marion Matthew , Bickel Warren K. , Sheffer Christine E. 

TITLE=Transcranial Magnetic Stimulation for Long-Term Smoking Cessation: Preliminary Examination of Delay Discounting as a Therapeutic Target and the Effects of Intensity and Duration

JOURNAL=Frontiers in Human Neuroscience

VOLUME=Volume 16 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/human-neuroscience/articles/10.3389/fnhum.2022.920383

DOI=10.3389/fnhum.2022.920383

ISSN=1662-5161

ABSTRACT=Background: Repetitive transcranial magnetic stimulation (rTMS) is a novel treatment for smoking cessation and delay discounting rate is novel therapeutic target. Research to determine optimal therapeutic targets and dosing parameters for long-term smoking cessation is needed. Due to potential biases and confounds introduced by the COVID-19 pandemic, we report preliminary results from an ongoing study among participants who reached study end prior to the pandemic. Methods: In a 3x2 randomized factorial design, participants (n=23) received 900 pulses of 20Hz rTMS to the left dorsolateral prefrontal cortex in one of three Durations (8, 12, or 16 days of stimulation) and two Intensities (1 or 2 sessions per day). We examined direction and magnitude of the effect sizes on latency to relapse, 6-month point-prevalence abstinence rates, research burden, and delay discounting rates. Results: A large effect size was found for Duration and a medium for Intensity for latency to relapse. Increasing Duration increased the odds of abstinence 7-8 fold while increasing Intensity doubled the odds of abstinence. A large effect size was found for Duration, a small for Intensity for delay discounting rate. Increasing Duration and Intensity had a small effect on participant burden. Conclusions: Findings provide preliminary support for delay discounting as a therapeutic target and for increasing Duration and Intensity to achieve larger effect sizes for long-term smoking cessation and will provide a pre-pandemic comparison for data collected during the pandemic.