Grey matter volume, scalp-to-cortex distance, and electrical field modeling in AUD and healthy controls

Here, we present the first study to comprehensively explore STC and GMV within common TMS cortical targets for AUD treatment. In a large sample of individuals with AUD and age-matched healthy controls (n = 88), this study tested the hypotheses that (1) GMV is reduced within common TMS targets and (2) atrophy within these sites may increase STC distance, thereby reducing the strength of stimulation reach- ing the cortex. The primary conclusions of this work demonstrate that while GMV is reduced within critical TMS targets for AUD, the observed atrophy is not severe enough to impact cortical distance (STC). These results are encouraging and suggest that while GMV should be taken into account when tailoring a TMS treatment protocol for AUD, STC distance is likely not significantly different than their age-matched controls. That said, we also demonstrated that women (controls and AUD) have substantially shorter STC distances at the frontal pole — a timely result which is often overlooked in TMS treatment at large—and suggests women may be receiving a higher dose of TMS than men in standard TMS protocols to the frontal pole.