Stanford Psychiatry’s Daniel McCalley Receives Grant to Develop Functional Connectivity-Guided TMS for Alcohol Use Disorder

We are pleased to share that Stanford Psychiatry’s Daniel McCalley, postdoctoral scholar of psychiatry and behavioral sciences, has received a grant from the National Institute on Alcohol Abuse and Alcoholism titled “Developing Functional Connectivity-Guided TMS for Alcohol Use Disorder.”

Alcohol Use Disorder (AUD) contributes to 88,000 deaths per year in the United States. Although several pharmacological treatments are available, adherence to these treatments is low and approximately 60% of individuals relapse within six months.

Evidence from neuroimaging studies of patients with AUD has shown that elevated brain response to alcohol cues within specific brain regions, like the prefrontal cortex, predicts future relapse. Thus, there is an emerging interest in developing novel, neural-circuit specific therapeutic tools to reduce this elevated brain signal and enhance AUD treatment outcomes. Transcranial magnetic stimulation (TMS) is one such non-invasive, neural-circuit specific tool which, when delivered the prefrontal cortex can reduce brain response to alcohol cues and improve treatment outcomes. That said, individual patterns of brain response to alcohol cues can be highly variable among AUD patients and elevated brain response to alcohol can often occur outside of the prefrontal cortex. Given this spatial variability, when delivering TMS to a fixed region of the brain, the TMS electrical field does not always overlap with an individual’s peak brain response to alcohol cues. In a proof-of-concept retrospective analysis, Dr. McCalley found that patients who had overlap between alcohol cue-reactivity patterns and TMS electrical fields had the most promising clinical outcomes. This project will build on that line of research by developing prospective functional connectivity-guided TMS (fcg-TMS) clinical trials for AUD to target each individual’s peak brain response to alcohol cues directly.

“This project will improve upon the clinical efficacy of transcranial magnetic form of non-invasive brain stimulation, by developing personalized, fMRI-guided TMS as a strategy to reduce brain reactivity to alcohol cues and reduce relapse rates,” says Dr. McCalley.

Dr. McCalley works with research mentor Claudia Padula, assistant professor of psychiatry and behavioral sciences, in the Padula BRAVE Lab in the Department of Psychiatry and Behavioral Sciences. The Padula BRAVE Lab is a multidisciplinary team that unites under the common goal of providing novel, innovative, and exciting science to improving treatment outcomes for Veterans with addiction. Recent publications written by Dr. McCalley and colleagues include “The importance of overlap: A retrospective analysis of electrical field maps, alcohol cue-reactivity patterns, and treatment outcomes for alcohol use disorder” published in Brain Stimulation, and “Targeting the Salience Network: A Mini-Review on a Novel Neuromodulation Approach for Treating Alcohol Use Disorder” published in the journal Frontiers in Psychiatry.

More Information

For more details about this new grant, visit NIH RePORTER.