P-85DOPAMINE TRANSPORTER AVAILABILITY IN ALCOHOL-DEPENDENT PATIENTS BEFORE AND AFTER DEEP REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION: A 123I-FP-CIT STUDY

Abstract

Background and Aim. A striatal dopaminergic dysfunction is detected in alcoholics. Repetitive transcranial magnetic stimulation (rTMS) is an addiction treatment. In alcoholics rTMS of dorsolateral prefrontal cortex increases dopamine release in the striatum, reducing craving. We assessed DAT availability in actively drinking alcoholics before and after deep rTMS by 123I‐FP‐CIT SPECT. Methods. We enrolled 14 untreated active alcoholics according to DSM‐IV. After baseline SPECT scan, 11 patients were randomised to real rTMS (n = 5) or sham stimulation (n = 6), undergoing 12 rTMS sessions for one month; SPECT scan was repeated at the end. Before and after rTMS some scales (like Alcohol Dependence Scale and Penn Alcohol Craving Scale) were performed to evaluate dependence, craving, anxiety, depression. Alcoholics were compared with 20 healthy subjects using SPECT scan. Analysis was performed using VOIs selected from a digital atlas; VOI mean activity concentration was obtained through Marsbar toolbox and Specific Binding Ratios (SBR) were calculated in the caudate nuclei and putamina. Results. At baseline, alcoholics showed higher SBR in caudate nuclei and putamina (p < 0.05) compared to HS. An inverse correlation was found between SBR and the left caudate and anxiety levels (p < 0.05). After treatment, patients submitted to real rTMS had a reduction in SBR and no differences were detected in comparison with HS. In the same patients was detected reduction in alcohol intake (p < 0.05). Conclusion. These data show increased striatal DAT availability in alcoholics. The finding of a SBR "normalization" and reduction in alcohol intake after real rTMS suggest a clinical usefulness of deep rTMS.