rTMS-concurrent Behavioral Priming for Reducing Smoking Cravings

Exclusion Criteria

• •History of epilepsy or seizure disorder
• •History of cerebral vascular accident or cortical stroke
• •History of brain lesions (such as multiple sclerosis, tumor)
• •History of moderate or severe traumatic brain injury
• •Possible DSM-5 Axis-I disorders as suggested by scores on the DSM-5 Self-Rated Level 1 Cross-Cutting Symptom Measure (41) exceeding any domain thresholds set by ratings of 2 or higher on individual item, with two exceptions. 1) For depression and anxiety, item scores of 3 or higher will be exclusionary. 2) For substance use (except nicotine/ tobacco and alcohol), item scores of 1 or higher will be exclusionary. For alcohol, the item score of 2 or higher will be the exclusionary.
• •Active suicidal ideation as assessed by the Columbia Suicide Severity Rating Scale (C-SSRS)
• •Pregnancy
• •Positive urine toxicology for recreational drugs of abuse
• •Shoulder-to-shoulder width of \> 60cm (24'') to ensure fit in the MRI scanner
• •Positive responses to the TMS Screening Form or the MRI checklist that preclude participation at the discretion of the investigator
• •Intracranial metallic objects (excluding dental fillings)
• •Prior rTMS treatment
• •Current treatment with varenicline or nicotine replacement therapy (NRT)
• •A score of \> 6 on the Readiness to Quit Ladder (42) for smoking
• •Intake of one or a combination of the following drugs presenting a 'Strong Potential Hazard' for application of rTMS due to their significant seizure threshold lowering potential:
• •* Imipramine, Amitriptyline, Doxepine, Nortriptyline, Maprotiline, Chlorpromazine, Clozapine, Foscarnet, Ganciclovir, Ritonavir, Amphetamines, Cocaine (MDMA, ecstasy), Phencyclidine (PCP, angel's dust), Ketamine, Gamma-hydroxybutyrate (GHB), Alcohol, Theophylline.
• •* The urine toxicology panel will verify the presence of some of these drugs prior to each rTMS session
• •Recent withdrawal from one of the following drugs representing a 'Strong Relative Hazard' for application of rTMS due to the resulting significant seizure threshold lowering potential:
• •* Alcohol, Barbiturates, Benzodiazepines, Meprobamate, Chloral hydrate