{
  "abstract": "BackgroundNicotine dependence is a major contributor to early mortality in individuals with schizophrenia, yet effective treatments remain limited. Drug cue-reactivity is a key contributor to nicotine use. Although transcranial magnetic stimulation (TMS) can reduce nicotine use and cue-reactivity, conventional left dorsolateral parietal (DLPFC)-targeted TMS is less effective in those with schizophrenia, highlighting the need for alternative, circuit-based targets. Because default node network (DMN) function is implicated in schizophrenia, cue-reactivity, and nicotine use, we investigated whether DMN-targeted TMS modulates cue-elicited brain activity in nicotine-using individuals with schizophrenia.\n\nStudy Design63 nicotine-using individuals (schizophrenia: n=31, non-psychosis control: n=32) participated in a randomized, crossover study comparing DMN-targeted and DLPFC-targeted TMS with pre/post-TMS neuroimaging and craving assessment. A nicotine cue-reactivity task was used concurrently with neuroimaging. Mixed-effect models were used to determine effects of TMS target and diagnosis, and model relationship between baseline craving and cue-reactivity change.\n\nStudy ResultsAt baseline, we found a Cue Reactive Network composed of regions overlapping with the DMN, including clusters in the posterior cingulate cortex, medial prefrontal cortex, and bilateral lateral occipital cortex (voxel-wise p<0.005, cluster p<0.05). Baseline cue-reactivity in schizophrenia did not differ from controls. DMN-targeted TMS decreased cue-reactivity in schizophrenia across Cue Reactive Network (estimate=-0.180, p=0.009). DLPFC-targeted TMS did not impact cue-reactivity. We did not observe an effect of either TMS target in controls. Higher baseline unprovoked craving predicted larger decrease in cue-reactivity across the Cue Reactive Network (estimate=-0.034, p=0.004).\n\nConclusionDMN-targeted TMS is a promising intervention that modulates nicotine cue-elicited brain activity in schizophrenia.",
  "abstract_shown": true,
  "affiliations": [
    "Vanderbilt University Medical Center"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 13,
  "authors": [
    {
      "name": "Y. Bai"
    },
    {
      "name": "A. Huang"
    },
    {
      "name": "J. Connolly"
    },
    {
      "name": "S. H. Blyth"
    },
    {
      "name": "S. Vandekar"
    },
    {
      "name": "B. P. Rogers"
    },
    {
      "name": "L. Tunison"
    },
    {
      "name": "C. Chang"
    },
    {
      "name": "H. Tindle"
    },
    {
      "name": "S. Heckers"
    },
    {
      "name": "R. O. Brady"
    },
    {
      "name": "A. Janes"
    },
    {
      "affs": [
        0
      ],
      "name": "H. B. Ward"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/1gtp6rew15r43.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.09.15.26363162",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.09.15.26363162v1.full",
  "id": "1gtp6rew15r43",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.09.15.26363162v1",
  "language": null,
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "psychiatry and clinical psychology"
    ],
    [
      "openalex",
      "2808|Transcranial Magnetic Stimulation Studies"
    ]
  ],
  "openalex": "W7213416525",
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.09.15.26363162v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-15",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/1gtp6rew15r43.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:18:45Z",
      "native_id": "10.64898/2026.09.15.26363162",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.09.15.26363162v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:psychiatry and clinical psychology",
      "subfield": "psychiatry"
    }
  ],
  "title": "DMN-Targeted TMS Reduces Neural Cue-Reactivity in Individuals with Schizophrenia who Use Nicotine",
  "title_text": "DMN-Targeted TMS Reduces Neural Cue-Reactivity in Individuals with Schizophrenia who Use Nicotine",
  "type": "preprint",
  "updated_at": "2026-10-30T12:18:45Z",
  "url": "https://research.draconitic.com/paper/1gtp6rew15r43",
  "venue": "medRxiv",
  "versions": []
}