{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T14:08:01Z","timestamp":1789826881115,"version":"4.0.1"},"posted":{"date-parts":[[2026,9,16]]},"group-title":"Psychiatry and Clinical Psychology","reference-count":52,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"award":["R01MH116170"],"award-info":[{"award-number":["R01MH116170"]}],"id":[{"id":"https:\/\/ror.org\/01cwqze88","id-type":"ROR","asserted-by":"publisher"}]},{"award":["KL2TR002245"],"award-info":[{"award-number":["KL2TR002245"]}],"id":[{"id":"https:\/\/ror.org\/01cwqze88","id-type":"ROR","asserted-by":"publisher"}]},{"award":["K23DA059690"],"award-info":[{"award-number":["K23DA059690"]}],"id":[{"id":"https:\/\/ror.org\/01cwqze88","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,9,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Nicotine 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.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Study Design<\/jats:title>\n                  <jats:p>63 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.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Study Results<\/jats:title>\n                  <jats:p>At 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&lt;0.005, cluster p&lt;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).<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>DMN-targeted TMS is a promising intervention that modulates nicotine cue-elicited brain activity in schizophrenia.<\/jats:p>\n                <\/jats:sec>","DOI":"10.64898\/2026.09.15.26363162","type":"posted-content","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T02:02:12Z","timestamp":1789610532000},"source":"Crossref","is-referenced-by-count":0,"title":["DMN-Targeted TMS Reduces Neural Cue-Reactivity in Individuals with Schizophrenia who Use Nicotine"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-0721-6594","authenticated-orcid":false,"given":"Yunong","family":"Bai","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jillian G.","family":"Connolly","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophia H.","family":"Blyth","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Vandekar","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baxter P.","family":"Rogers","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Libby","family":"Tunison","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catie","family":"Chang","sequence":"additional","affiliation":[{"name":"Departments of Electrical Engineering and Computer Science, Vanderbilt University, Nashville, TN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hilary","family":"Tindle","sequence":"additional","affiliation":[{"name":"Department of Medicine, Vanderbilt University Medical Center and Geriatric Research Education and 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