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نمایش مقاله

Title:

Individualized fMRI Drug Cue-Reactivity and E-Field Modeling for DLPFC Targeting in Methamphetamine Use Disorder

Subject:

Personalized Interventions and Diagnosis of Complex Neurological Disorders

Presenter Author:
Name:	Mehran Zare-Bidoky

Author:
Name 1:	Mehran Zare-Bidoky - Corresponding - Presenter
Affiliation 1:	Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Iran

Name 2:	Mohammad-Bagher Soleimani
Affiliation 2:	Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Iran

Name 3:	Peyman Ghobadi-Azbari
Affiliation 3:	Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Iran

Name 4:	Sara Jafakesh
Affiliation 4:	Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Iran

Name 5:	Maryam Ardeshir
Affiliation 5:	Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Iran

Name 6:	Mahak Osouli
Affiliation 6:	Department of Medical Physics, Iran University of Medical Sciences, Tehran, Iran

Name 7:	Hamed Ekhtiari
Affiliation 7:	Department of Psychiatry, University of Texas Southwestern (UTSW), USA; Laureate Institute for Brain Research, USA

Name 8:
Affiliation 8:

Name 9:
Affiliation 9:

Name 10:
Affiliation 10:

Abstract

Original Research

introduction :

Transcranial magnetic stimulation (TMS) is increasingly investigated for substance use disorders (SUDs), including methamphetamine use disorder (MUD). The dorsolateral prefrontal cortex (DLPFC) is a prominent target given its role in cognitive control and drug-related behaviors. FMRI drug cue-reactivity (FDCR) is among the most widely used task-based paradigms in SUD research, and may provide a means of characterizing individual-level neural responses to substance-related cues. However, conventional F3-based targeting does not account for inter-individual variation in disorder-relevant neural responses. We aimed to identify individualized DLPFC targets based on maximal cue-related hypoactivation, quantify their spatial relationship to conventional and group-level targets, and compare TMS E-field magnitude at individualized versus F3 targets.

Methods:

FDCR data from 60 individuals with MUD were analyzed. For each participant, the drug cue > neutral cue contrast was examined within an anatomically defined DLPFC region, and the center of the cluster showing the greatest negative activation within the mask was identified as the individualized target. Euclidean distances between individualized targets and a group-level average coordinate and conventional F3 coordinate were calculated. E-field modeling was then performed to compare the induced electric-field magnitude at individualized and F3 targets.

Results:

Individualized targets showed substantial spatial heterogeneity. They were 19.61 ± 10.85 mm (median = 19.19; range = 3.48–42.86) from the group-level target and 20.72 ± 7.92 mm (median = 20.57; range = 7.43– 36.27) from conventional F3. Individualized targets were closer to the group-level target than to F3 in only 30/60 participants (50.0%), with no significant difference in distance between the two reference targets (paired t-test, p = 0.646). E-field modeling showed greater field magnitude at individualized than at F3 targets (1.33 ± 0.26 vs. 0.94 ± 0.27 V/m).

Conclusion:

FDCR identified substantial interindividual variation in disorder-relevant DLPFC targets. Individualized targets were not consistently closer to the group-level target than to conventional F3, highlighting the limitations of relying on group-level coordinates for individual targeting. Moreover, E-field modeling indicated greater field magnitude at individualized targets than at F3 targets, suggesting that FDCR-informed stimulation leads to better target engagement. These findings support further investigation of FDCR-informed individualized targeting as a strategy for precision neuromodulation in MUD.

Keywords:

fMRI, Drug Cue-Reactivity, Individualization, DLPFC