Developing Functional Connectivity-Guided TMS for Alcohol Use Disorder

Inclusion Criteria:

• Between age 25 and 75.

• Current DSM-5 diagnosis of moderate to severe AUD (≥4 diagnostic symptoms).

• Able to attend scheduled clinic visits

• Able to read, understand and voluntarily sign Informed Consent prior toparticipating in any study-specific procedures or assessments.

• If on a medication regimen, that regimen will be stable for the duration of thestudy;

• Fluency in English.

Exclusion Criteria:

• Transcranial magnetic stimulation (TMS) and magnetic resonance imaging (MRI)contraindications: such as a cardiac pacemaker, cochlear implant, or an implanteddevice (deep brain stimulation, metal in the head, metal in the body,claustrophobia, pregnant or breastfeeding or other ferromagnetic device/objected inthe head and body within 30 cm of the treatment coil.

• General medical condition, disease or neurological disorder that interferes with theassessments or participation.

• Unable to safely withdraw, at least two weeks prior to treatment, from medicationsthat increase seizure risk.

• Current substance abuse (except caffeine or nicotine) as determined by positivetoxicology screen.

• Have a mass lesion, cerebral infarct, or other active CNS disease, including analcohol-related seizure or a seizure disorder. • A recent suicide attempt (definedas within the last 30 days) or presence of current suicidal plan or intent. Patientsat risk for suicide will be required to establish a written safety plan involvingtheir primary therapist before entering the study.

• Severe impediment to vision, hearing and/or hand movement, likely to interfere withthe ability to follow study protocols. • Greater than mild traumatic brain injury (defined as greater than 10 minutes loss of consciousness).

• Taking benzodiazepine or neuroleptic medications, or any medication known to alterseizure threshold

• unstable chronic illness.

• Current or lifetime history of bipolar disorder or psychosis.

• Participation in another concurrent intervention based clinical trial.