Using Functional Connectivity-Guided Transcranial Magnetic Stimulation to Treat Moderate to Severe Alcohol Use Disorder in Adults Aged 25 to 75

What this Trial Is About

Alcohol Use Disorder AUD is a major cause of preventable death and relapse rates remain high despite existing treatments. This research aims to evaluate one session of functional Magnetic Resonance Imaging fMRI guided transcranial magnetic stimulation TMS as a method to reduce brain reactivity to alcohol cues, which may contribute to relapse. The study focuses on delivering TMS to individual brain areas showing peak response to alcohol stimuli, with the goal of improving treatment outcomes. Participants will receive either one session of active continuous theta burst TMS or a sham version, both targeting the brain region with strongest functional connectivity to the ventral striatum. The active TMS involves 3600 pulses at 110% resting motor threshold using the Magventure MagPro X100 device. The sham treatment mimics the sensation without stimulating the brain to serve as a comparison. The study will assess brain response changes before and after TMS using fMRI. During the study, participants will undergo brain imaging and TMS sessions with monitoring of brain signals related to alcohol cue reactivity. The main measure is the change in blood-oxygen level dependent signal from baseline to the day after TMS. The study includes a randomized, quadruple-blind design and participants are monitored for safety and adherence. The total age range for participants is 25 to 75 years, and all study visits and assessments are planned according to the protocol.

Developing Functional Connectivity-Guided TMS for Alcohol Use Disorder