{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T07:38:12Z","timestamp":1774251492092,"version":"3.50.1"},"reference-count":64,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T00:00:00Z","timestamp":1774224000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:p>Craving is a core symptom and treatment target in tobacco use disorder. However, self-reported craving ratings often show weak or inconsistent associations with clinical outcomes, possibly because they overlook automatic motivational processes central to cue-reactivity. Response time to craving-item ratings has been proposed as an implicit marker of such processes, but its sensitivity to intervention and clinical relevance remain untested. In this exploratory secondary analysis of a randomized trial, tobacco-dependent adults completed an image-based cue-reactivity paradigm immediately before and after a single 1 Hz repetitive transcranial magnetic stimulation (rTMS) session targeting either the left frontopolar cortex (lFPC; n=12) or the vertex (Cz; n=11). We examined whether response time, modeled both as a mean-level measure and as a function of self-reported craving, was modulated by stimulation site and whether these indices were associated with smoking outcomes at baseline and one-week follow-up. Mean response time showed a significant Group \u00d7 Time \u00d7 Stimulus effect (\u03c7\u00b2(1) = 8.64, p = 0.003): lFPC stimulation attenuated the typical post-exposure speeding observed in the vertex group, selectively for smoking cues. Models incorporating self-reported craving yielded convergent smoking-specific effects (Wald \u03c7\u00b2(1) = 4.47, p = 0.034), but the curvature patterns were inconsistent and statistically fragile, limiting interpretability. Exploratory clinical analyses did not reveal reliable associations with smoking-related outcomes, although repeated nominal associations with tonic craving under smoking cues suggested a possible relationship. These findings provide initial evidence that response time may capture implicit components of cue-reactivity and function as a modulable behavioral endpoint sensitive to lFPC neuromodulation.<\/jats:p>","DOI":"10.3389\/fpsyt.2026.1777646","type":"journal-article","created":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T06:43:57Z","timestamp":1774248237000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Do response times add to self-reported craving? A secondary analysis of a neuromodulation trial"],"prefix":"10.3389","volume":"17","author":[{"given":"Larissa","family":"Vieira","sequence":"first","affiliation":[{"name":"Neuropsychiatry and Behavioral Sciences Postgraduate Program, Medical Sciences Center, Federal University of Pernambuco","place":["Recife, Brazil"]},{"name":"Singular Psychiatry and Neuromodulation Clinic","place":["Recife, Brazil"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorena","family":"Melo","sequence":"additional","affiliation":[{"name":"SensoriMotor Laboratory, Jules-Gonin Eye Hospital, Fondation Asile des Aveugles, Department of Ophthalmology, University of Lausanne","place":["Lausanne, Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rodrigo Coelho","family":"Marques","sequence":"additional","affiliation":[{"name":"Neuropsychiatry and Behavioral Sciences Postgraduate Program, Medical Sciences Center, Federal University of Pernambuco","place":["Recife, Brazil"]},{"name":"Singular Psychiatry and Neuromodulation Clinic","place":["Recife, Brazil"]},{"name":"Department of Neuropsychiatry, Medical Sciences Center, Federal University of Pernambuco","place":["Recife, PE, Brazil"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maisa Mendon\u00e7a","family":"Silva","sequence":"additional","affiliation":[{"name":"Department of Engineering Management, Technology and Geosciences Center, Federal University of Pernambuco","place":["Recife, PE, Brazil"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paula Rejane Beserra","family":"Diniz","sequence":"additional","affiliation":[{"name":"Neuropsychiatry and Behavioral Sciences Postgraduate Program, Medical Sciences Center, Federal University of Pernambuco","place":["Recife, Brazil"]},{"name":"Internal Medicine Department, Medical Sciences Center, Federal University of Pernambuco","place":["Recife, PE, Brazil"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,23]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-clinpsy-021815-093351","article-title":"The role of craving in substance use disorders: theoretical and methodological issues","volume":"12","author":"Sayette","year":"2016","journal-title":"Annu Rev Clin Psychol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-psych-011624-024031","article-title":"The incentive-sensitization theory of addiction 30 years on","volume":"76","author":"Robinson","year":"2025","journal-title":"Annu Rev Psychol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"109828","DOI":"10.1016\/j.drugalcdep.2023.109828","article-title":"The centrality of craving in network analysis of five substance use disorders","volume":"245","author":"Gauld","year":"2023","journal-title":"Drug Alcohol Depend"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2022.1240","article-title":"Association of drug cues and craving with drug use and relapse: a systematic review and meta-analysis","volume":"79","author":"Vafaie","year":"2022","journal-title":"JAMA Psychiatry"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2020.108002","article-title":"Is craving a risk factor for substance use among treatment-seeking individuals with alcohol and other drugs use disorders? 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