MPFC Theta Burst Stimulation as a Treatment Tool for Alcohol Use Disorder: Effects on Drinking and Incentive Salience

Eligibility Criteria

• * Age 21-65 (to maximize participation; note: Scalp-to-Cortex distance will be included as a covariate to calculate adjusted TMS dose given expected cortical atrophy in heavy alcohol users and older adults and the demonstrated effect50 on TMS-fMRI responses in addiction)
• * Alcohol Use Disorder, determined by DSM-V criteria, using the Structured Clinical Interview for DSM-V
• * Consumption of more than 14 drinks (women) or 21 drinks (men) per week, with at least 4 heavy drinking days (defined as ≥ 4 drinks for women and ≥ 5 for men) per week during the 30-days prior to enrolling.
• * Able to read and understand questionnaires and informed consent.
• * Has metal placed above the neck
• * Is at elevated risk of seizure (i.e., has a history of seizures, is currently prescribed medications known to lower seizure threshold)
• * Has a history of moderate to severe alcohol withdrawal or medicated alcohol withdrawal
• * Has a history of claustrophobia
• * Has a history of chronic migraines
• * Has a history of traumatic brain injury, including a head injury that resulted in hospitalization, loss of consciousness for more than 10 minutes, or having ever been informed that they have an epidural, subdural, or subarachnoid hemorrhage
• * Has an unstable medical illness requiring planned medical/surgical intervention (e.g. chemotherapy, surgical procedure)
• * Medications: Is currently taking or initiates a new prescription for drugs known to improve alcohol drinking treatment outcomes (e.g. naltrexone, acamprosate, topiramate) or taking psychiatric/sleeping medications except for stable (1 month) antidepressants/SSRI's. \[Note: this criterion is for scientific rather than safety or patient comfort reasons\].
• * Has a history of substance use disorder (other than nicotine) by DSM-V criteria in the past 6 months
• * Meets DSM V criteria for panic disorder, bipolar disorder, obsessive-compulsive disorder, schizophrenia, dissociative disorders, eating disorders, and any other psychotic disorder. \[Note: The inclusion of participants with other affective and anxiety disorders is essential because of the marked frequency of the co-existence of mood and other anxiety disorders among patients with AUD at large\]
• * Has current suicidal ideation or homicidal ideation
• * Females of childbearing potential who are pregnant (by urine HCG), nursing, or who are not using a reliable form of birth control.