Heather Burrell Ward, MD, an interventional psychiatrist at Vanderbilt University Medical Center, has received a five-year, $928,000 grant from the National Institute on Drug Abuse to test whether an externally applied magnetic field can reduce nicotine craving in people with schizophrenia.
People with schizophrenia tend to be heavy smokers and die from tobacco-related diseases decades earlier than the general population.
Ward believes that, for these people, nicotine may help clear the disordered thinking caused by their disease. This may explain they are far less likely than others to respond to smoking cessation treatment.
“Nicotine is clearly providing benefit to people with schizophrenia, but we are still trying to understand exactly why,” said Ward, who specializes in the use of repetitive transcranial magnetic stimulation (rTMS) and electroconvulsive therapy (ECT) in psychotic disorders.
In rTMS, an electromagnetic coil is placed on the scalp. An electrical current is pulsed repeatedly through the coil to generate a magnetic field that can modulate — increase or decrease — the firing of nerve cells in the brain.
Noninvasive brain stimulation interventions targeting centers of higher cognitive function, including learning, memory and attention, in the dorsolateral prefrontal cortex can help the average person stop smoking. The FDA has approved rTMS as a treatment for smoking cessation.
Ward’s study, which is supported by a K23 mentored, patient-oriented career development award, will compare two different rTMS interventions to reduce nicotine craving in people with and without schizophrenia. Her goal is to determine whether rTMS is an effective treatment for smoking, specifically for people with schizophrenia.
An assistant professor of Psychiatry and Behavioral Sciences, Ward began researching rTMS during fellowship training in Behavioral Neurology and neuromodulation at the Berenson-Allen Center for Noninvasive Brain Stimulation at Beth Israel Deaconess Medical Center and Harvard Medical School.
“I determined that in schizophrenia, nicotine use is linked to disorganization in a brain network (called) the Default Mode Network and used pharmacology and noninvasive neuromodulation to show that manipulating this network temporarily changes craving for nicotine,” Ward wrote in the project narrative of her grant.
“This project will determine if this network can be changed in an enduring way that leads to decreased nicotine use in schizophrenia,” she wrote.
Ward, who has received Early Career Investigator Awards from the Schizophrenia International Research Society, College on Problems of Drug Dependence, and the American Academy of Addiction Psychiatry, said she came to VUMC in 2022 because of its “rich and welcoming research infrastructure.”
Of particular importance to her was the “world-class research mentorship in schizophrenia” provided by department chair Stephan Heckers, MD, MSc, the smoking cessation clinical trials run by Hilary Tindle, MD, MPH, through the Vanderbilt Center for Tobacco, Addiction, and Lifestyle, and the functional neuroimaging analysis led by Catie Chang, PhD, in the School of Engineering.
Non-invasive brain stimulation is a powerful research tool, Ward noted. VUMC provides fertile ground for growing a rTMS research program that, she said, may lead to potential treatments for other neuropsychiatric conditions.
