Figure 7.

Aberrant functional connectivity of the SN and VMN in cocaine users versus MDD patients.207 TMS of the DLPFC (F3 EEG site) during fMRI elicits local activation of the DLPFC itself, and reciprocal deactivation of the striatum and VMPFC, highlighting the reciprocal relationship of the SN and VMN in healthy controls. In cocaine users, however, TMS of the DLPFC elicited only local activation, suggesting a possible absence of the usual reciprocal relationship between SN and VMN may contribute to the pathophysiology of SUDs. If so, SN excitation alone may fail to inhibit the VMN and therefore may not exert the same degree of therapeutic effect in such cases. Instead, direct intervention to inhibit the VMN may be required.