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. 2024 Mar;54(4):698-709.
doi: 10.1017/S0033291723002374. Epub 2023 Sep 15.

Cortical paired associative stimulation shows impaired plasticity of inhibition networks as a function of chronic alcohol use

Samantha N Sallie  1 , Saurabh Sonkusare  1 , Alekhya Mandali  2   3 , Violeta Casero  1 , Hailun Cui  1 , Natalie V Guzman  4 , Michael Allison  5 , Valerie Voon  1   6
Affiliations

Cortical paired associative stimulation shows impaired plasticity of inhibition networks as a function of chronic alcohol use

Samantha N Sallie et al. Psychol Med. 2024 Mar.

Abstract

Background: Response inhibition - or the ability to withhold a suboptimal response - relies on the efficacy of fronto-striatal networks, and is impaired in neuropsychiatric disorders including addiction. Cortical paired associative stimulation (cPAS) is a form of transcranial magnetic stimulation (TMS) which can strengthen neuronal connections via spike-timing-dependent plasticity mechanisms. Here, we used cPAS targeting the fronto-striatal inhibitory network to modulate performance on a response inhibition measure in chronic alcohol use.

Methods: Fifty-five participants (20 patients with a formal alcohol use disorder (AUD) diagnosis (26-74 years, 6[30%] females) and 20 matched healthy controls (HCs) (27-73 years, 6[30%] females) within a larger sample of 35 HCs (23-84 years, 11[31.4%] females) underwent two randomized sessions of cPAS 1-week apart: right inferior frontal cortex stimulation preceding right presupplementary motor area stimulation by either 4 ms (excitation condition) or 100 ms (control condition), and were subsequently administered the Stop Signal Task (SST) in both sessions.

Results: HCs showed decreased stop signal reaction time in the excitation condition (t(19) = -3.01, p = 0.007, [CIs]:-35.6 to -6.42); this facilitatory effect was not observed for AUD (F(1,31) = 9.57, p = 0.004, CIs: -68.64 to -14.11). Individually, rates of SST improvement were substantially higher for healthy (72%) relative to AUD (13.6%) groups (OR: 2.33, p = 0.006, CIs:-3.34 to -0.55).

Conclusion: In line with previous findings, cPAS improved response inhibition in healthy adults by strengthening the fronto-striatal network through putative long-term potentiation-like plasticity mechanisms. Furthermore, we identified a possible marker of impaired cortical excitability, and, thus, diminished capacity for cPAS-induced neuroplasticity in AUD with direct implications to a disorder-relevant cognitive process.

Keywords: Alcohol use disorder; Impulsivity; Paired associative stimulation; Plasticity; Response inhibition.

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