A comprehensive study of sensorimotor cortex excitability in chronic cocaine users: Integrating TMS and functional MRI data

Colleen A. Hanlon, William DeVries, Logan T. Dowdle, Julia A. West, Bradley Siekman, Xingbao Li, Mark S. George

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


Background: Disruptions in motor control are often overlooked features of chronic cocaine users. During a simple sensorimotor integration task, for example, cocaine users activate a larger area of cortex than controls but have lower functional connectivity between the cortex and dorsal striatum, which is further correlated with poor performance. The purpose of this study was to determine whether abnormal cortical excitability in cocaine users was related to disrupted inhibitory or excitatory mechanisms, as measured by transcranial magnetic stimulation (TMS). Methods: A battery of TMS measures were acquired from 87 individuals (50 cocaine dependent, 37 controls). Functional MRI data were acquired from a subset of 28 individuals who performed a block-design finger tapping task. Results: TMS measures revealed that cocaine users had significantly higher resting motor thresholds and higher intracortical cortical facilitation (ICF) than controls. There was no between-group difference in either measure of cortical inhibition. Task-evoked BOLD signal in the motor cortex was significantly correlated with ICF in the cocaine users. There was no significant difference in brain-skull distance between groups. Conclusion: These data demonstrated that cocaine users have disrupted cortical facilitation (as measured with TMS), which is related to elevated BOLD signal. Cortical inhibition, however, is largely intact. Given the relationship between ICF and glutamatergic agents, this may be a potentially fruitful and treatable target in addiction. Finally, among controls the distance from the scalp to the cortex was correlated with the motor threshold which may be a useful parameter to integrate into therapeutic TMS protocols in the future.

Original languageEnglish (US)
Pages (from-to)28-35
Number of pages8
JournalDrug and alcohol dependence
StatePublished - 2015
Externally publishedYes

Bibliographical note

Funding Information:
Funding was provided by NIDA K01DA027756 (Hanlon), R01DA036617 , and MUSC's CTSA UL1 RR029882 from the National Center for Research Resources . The funding source had no further role in study design, collection, analysis, interpretation or in the decision to submit the paper for publication.


  • Addiction
  • Brain stimulation
  • Cortex
  • Electrophysiology
  • Recruitment curve

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