Transcranial Magnetic Stimulation in Smokers: an Examination of Mediating Neural Pathways.

The primary objective of this study is to examine the effects of repetitive transcranial magnetic stimulation (rTMS) on a regulation of craving task (ROC task) and evaluate the feasibility of targeting rTMS via fMRI based neuronavigation. Specifically, we will examine BOLD activation within the DLPFC when control over craving is exerted in order to identify if 1) the task produces reliable activations in an area capable of being targeted by a standard figure-8 coil and 2) examine if the coordinates of the area are distinct from the area targeted via anatomical neuronavigation alone. Last, we will examine if rTMS, compared to sham, is capable of improving cognitive control over craving measured at outcome. The current pilot study will examine these aims in a sample of tobacco dependent adults (N=16) (with final sample size dependent on availability of funds).

Inclusion Criteria:Smokers endorsing atleast moderate dependence (total Fagerstrom for Cigarette Dependence score > 4)Endorsing no specific plan to quit smoking in the next 3 months.Must meet safety guidelines for application of rTMS18-60 years of ageSmoked cigarettes regularly for at least one yearCurrently smoke at least 10 cigarettes per dayHave a carbon monoxide (CO) level greater or equal to 10 ppmCurrently be using no other nicotine products.Exclusion Criteria:Subjects will be excluded if they meet criteria for current alcohol (moderate - severe), current substance dependence, current affective disorder (depression, dysthymia, or mania) or current psychotic symptoms as assessed by the (MINI) International Neuropsychiatric ExamAre currently pregnant or lactating, or intend to become pregnantHave a health condition for which rTMS is contraindicatedSubmit a urine drug screen positive for illicit substances or substance misuse.