Physiological Effects of Frontopolar TMS in Alcohol Craving

Patients will receive continuous theta burst stimulation, a five minute treatment protocol with inhibitory effects over the respective brain region 3 times daily. A total of 15 treatments, but will be performed in an accelerated design. Treatment site localization will be based on each patient's individual MRI. Following cortical parcellation using FreeSurfer 7.4.1, the centroid coordinates of the frontal pole will be extracted. For frontopolar stimulation, neuronavigation will be employed to guide coil placement to each patient's frontal pole centroid using Localite Neuronavigator. Stimulation will be performed at 110% resting motor threshold. Pulses will be administered in a burst-firing pattern (3 pulse burst, 50 Hz; 5 Hz \[200-ms\] interburst intervals; 1800 pulses/train with a 60-seconds intertrain interval). To enhance tolerability of frontopolar FP1 TBS, stimulation intensity is gradually escalated from 30% to 110% of resting motor threshold over the first 30 sec of each train.