Patients with schizophrenia spectrum disorder (SSD) will be exposed to active repetitive transcranial magnetic stimulation (rTMS) from F8 coil or active rTMS from H coil for smoking cessation. Smoking and brain functional connectivity changes will be assessed at baseline, different stages of rTMS and/or follow-ups.
Neuroimaging studies suggest that high rate of smoking in patients with schizophrenia may be due to an overlap of nicotine addiction-related circuitries and schizophrenia-related circuitries, such that schizophrenia impacts some of the same circuitries that increase risks for severe nicotine addiction in general. Those identified overlapping circuitries have been linked to several key features of nicotine addiction and can be represented by resting-state functional connectivities. The investigators aim to develop a TMS method targeting special brain circuits that are both smoking cessation and schizophrenia-related. If the corresponding brain circuits were successfully modulated, the treatment efficacy will be significantly improved and schizophrenia patients will benefit from the TMS treatment of smoking cessation. The F8 coil based rTMS is not FDA approved for smoking cessation at this point, the rTMS with H4 coil is FDA-cleared for short-term smoking cessation in the general population, its efficacy in SSD has not been evaluated. In this protocol, the investigators will compare them in patients with schizophrenia spectrum disorders.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
50
Multiple trains of rTMS in a day, for multiple days.
Multiple trains of rTMS in a day, for multiple days.
The University of Texas Health Science Center, Houston
Houston, Texas, United States
RECRUITINGResting-state functional connectivity (rsFC) from functional magnetic resonance imaging (fMRI)
The strength of rsFC from fMRI is used to represent the brain activities that are corresponding to the TMS effect on smoking reduction/cessation.
Time frame: 1 month
Cigarette per day
Cigarette per day (CPD) is measured to index smoking reduction and cessation.
Time frame: 1 month
Fagerstrom Test for Nicotine Dependence (FTND)
Fagerstrom Test for Nicotine Dependence (FTND) represents the severity of nicotine severity.
Time frame: 1 month
nicotine/creatinine
nicotine/creatinine is a index of smoking status.
Time frame: 1 month
End-expired carbon monoxide (CO)
End-expired CO measure is an instant measure of smoking status.
Time frame: 1 month
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