***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND The mesolimbic dopaminergic reward system seems to play a crucial role in reinforcing effects of nicotine . Recently , acute high-frequency repetitive transcranial magnetic stimulation ( rTMS ) of frontal brain regions has been shown to efficiently modulate the mesostriatal and mesolimbic dopaminergic system in both animals and humans . For this reason , we investigated whether high-frequency rTMS would be able to influence nicotine-related behavior by study ing rTMS effects on craving and cigarette smoking . METHOD Fourteen treatment-seeking smokers were included in a double-blind crossover trial , conducted in 2002 , comparing single days of active versus sham stimulation . Outcome measures were  rTMS effects on number of cigarettes smoked during an ad libitum smoking period and effects on craving after a period of acute abstinence . RESULTS High-frequency ( 20-Hz ) rTMS of left dorsolateral prefrontal cortex reduced cigarette smoking significantly ( p < .01 ) in an active stimulation compared with sham stimulation . Levels of craving did not change significantly . CONCLUSION High-frequency rTMS may be useful for treatment in smoking cessation OBJECTIVE Because neuroimaging studies have shown that cue-provoked smoking craving is associated with changes in the activity of the bilateral dorsolateral prefrontal cortex ( DLPFC ) , we aim ed to investigate whether a powerful technique of noninvasive brain stimulation , transcranial direct current stimulation ( tDCS ) , reduces cue-provoked smoking craving as indexed by a visual analog scale . METHOD We performed a r and omized , sham-controlled crossover study in which 24 subjects received sham and active tDCS ( anodal tDCS of the left and right DLPFC ) in a r and omized order . Craving was induced by cigarette manipulation and exposure to a smoking video . The study ran from January 2006 to October 2006 . RESULTS Smoking craving was significantly increased after exposure to smoking-craving cues ( p < .0001 ) . Stimulation of both left and right DLPFC with active , but not sham , tDCS reduced craving significantly when comparing craving at baseline and after stimulation , without ( p = .007 ) and with ( p = .005 ) smoking-craving cues . There were no significant mood changes in any of the conditions of stimulation . Adverse events were mild and distributed equally across all treatment conditions . CONCLUSIONS Our findings extend the results of a previous study on the use of brain stimulation to reduce craving , showing that cortical stimulation with tDCS is beneficial for reducing cue-provoked craving , and thus support the further exploration of this technique for smoking cessation Background Prefrontal repetitive transcranial magnetic stimulation ( rTMS ) has been used to induce side-specific mood changes in volunteers and patients . To clarify inconsistencies between reports that used different stimulation frequencies , we conducted a controlled study with a low ( 1 Hz ) frequency , comparing left with right-sided stimulation Methods Nineteen healthy volunteers received r and omised left or right prefrontal rTMS at a frequency of 1 Hz and 100 % of motor threshold in two sessions two weeks apart . Results There were significant improvements with TMS for performance in the digit symbol substitution and verbal fluency tests , but no change of mood on a number of measures . There was also a reduction of pulse rate after TMS . The only side-specific TMS-effect was on mean arterial pressure , which decreased pressure after left , but not after right prefrontal TMS . Conclusions Apart from the unexpected and so far unreplicated effect on mean arterial pressure , there were no side-specific effects on mood in volunteers . It is unlikely that a simple laterality model of mood together with the assumed activating effect of higher and ' quenching ' effect of lower stimulation frequency can account for the effects of TMS on mood BACKGROUND Functional neuroimaging studies have shown that specific brain areas are associated with alcohol craving including the dorsolateral prefrontal cortex ( DLPFC ) . We tested whether modulation of DLPFC using transcranial direct current stimulation ( tDCS ) could alter alcohol craving in patients with alcohol dependence while being exposed to alcohol cues . METHODS We performed a r and omized sham-controlled study in which 13 subjects received sham and active bilateral tDCS delivered to DLPFC ( anodal left/cathodal right and anodal right/cathodal left ) . For sham stimulation , the electrodes were placed at the same positions as in active stimulation ; however , the stimulator was turned off after 30s of stimulation . Subjects were presented videos depicting alcohol consumption to increase alcohol craving . RESULTS Our results showed that both anodal left/cathodal right and anodal right/cathodal left significantly decreased alcohol craving compared to sham stimulation ( p<0.0001 ) . In addition , we found that following treatment , craving could not be further increased by alcohol cues . CONCLUSIONS Our findings showed that tDCS treatment to DLPFC can reduce alcohol craving . These findings extend the results of previous studies using noninvasive brain stimulation to reduce craving in humans . Given the relatively rapid suppressive effect of tDCS and the highly fluctuating nature of alcohol craving , this technique may prove to be a valuable treatment strategy within the clinical setting We aim ed to assess whether modulation of the dorsolateral prefrontal cortex ( DLFPC ) with noninvasive brain stimulation , namely transcranial direct current stimulation ( tDCS ) , modifies  food craving in healthy subjects . We performed a r and omized sham-controlled cross-over study in which 23 subjects received sham and active tDCS  ( anode left/cathode right and anode right/cathode left ) of the DLPFC . Subjects were exposed to food and also watched a movie of food associated with strong craving . Desire for food consumption was evaluated by visual analogue scales ( VAS ) and food consumption before and after treatment . In addition we measured visual attention to food using an eye tracking system . Craving for viewed foods as indexed by VAS was reduced by anode right/cathode left tDCS . After sham stimulation , exposure to real food or food-related movie increased craving ; whereas after anode left/cathode right tDCS , the food-related stimuli did not increase craving levels , as revealed by the VAS scale . Moreover , compared with sham stimulation , subjects fixated food-related pictures less frequently after anode right/cathode left tDCS and consumed less food after both active stimulation conditions . These changes were not related to mood changes after any type of tDCS treatment . The effects of tDCS on food craving might be related to a modulation of neural circuits associated with reward and decision-making This study examined whether a single session of repetitive transcranial magnetic stimulation ( rTMS ) of the left prefrontal cortex ( PFC ) would inhibit food cravings in healthy women who endorsed frequent food cravings . Ten participants viewed images of food and completed ratings for food cravings before and after receiving either real or sham rTMS over the left PFC ( 10 Hz , 100 % resting motor threshold , 10 s-on , 20 s-off for 15 min ; 3000 pulses ) . Sham-TMS was matched with real TMS with respect to perceived painfulness of the stimulation . Each participant received both real and sham rTMS in r and om order and were blind to the condition in a within-subject cross-over design . With an improved sham control condition , prefrontal rTMS inhibited food cravings no better than sham rTMS . The mild pain from the real and sham rTMS may distract or inhibit food craving , and the decreased craving may not be caused by the effect of rTMS itself . Further studies are needed to eluci date whether rTMS has any true effects on food craving and whether painful stimuli inhibit food or other cravings . A sham condition which matches the painfulness is important to underst and the true effects of TMS on behaviors and diseases CONTEXT Depressive symptoms predict adverse cardiovascular outcomes in patients with coronary heart disease , but the mechanisms responsible for this association are unknown . OBJECTIVE To determine why depressive symptoms are associated with an increased risk of cardiovascular events . DESIGN AND PARTICIPANTS The Heart and Soul Study is a prospect i ve cohort study of 1017 out patients with stable coronary heart disease followed up for a mean ( SD ) of 4.8 ( 1.4 ) years . SETTING Participants were recruited between September 11 , 2000 , and December 20 , 2002 , from 12 outpatient clinics in the San Francisco Bay Area and were followed up to January 12 , 2008 . MAIN OUTCOME MEASURES Baseline depressive symptoms were assessed using the Patient Health Question naire ( PHQ ) . We used proportional hazards models to evaluate the extent to which the association of depressive symptoms with subsequent cardiovascular events ( heart failure , myocardial infa rct ion , stroke , transient ischemic attack , or death ) was explained by baseline disease severity and potential biological or behavioral mediators . RESULTS A total of 341 cardiovascular events occurred during 4876 person-years of follow-up . The age-adjusted annual rate of cardiovascular events was 10.0 % among the 199 participants with depressive symptoms ( PHQ score > or = 10 ) and 6.7 % among the 818 participants without depressive symptoms ( hazard ratio [ HR ] , 1.50 ; 95 % confidence interval , [ CI ] , 1.16 - 1.95 ; P = .002 ) . After adjustment for comorbid conditions and disease severity , depressive symptoms were associated with a 31 % higher rate of cardiovascular events ( HR , 1.31 ; 95 % CI , 1.00 - 1.71 ; P = .04 ) . Additional adjustment for potential biological mediators attenuated this association ( HR , 1.24 ; 95 % CI , 0.94 - 1.63 ; P = .12 ) . After further adjustment for potential behavioral mediators , including physical inactivity , there was no significant association ( HR , 1.05 ; 95 % CI , 0.79 - 1.40 ; P = .75 ) . CONCLUSION In this sample of out patients with coronary heart disease , the association between depressive symptoms and adverse cardiovascular events was largely explained by behavioral factors , particularly physical inactivity Previous studies in healthy volunteers reported a possible impact of high frequency repetitive transcranial magnetic stimulation ( HF-rTMS ) on stress hormones , like cortisol . In this sham-controlled , “ single blind ” , crossover study , we examined whether HF-rTMS had an effect on the hypothalamic-pituitary-adrenal ( HPA ) axis , by analysing salivary cortisol levels . Two studies were conducted . First , HF-rTMS on the left dorsolateral prefrontal cortex ( DLPFC ) was performed in 28 young healthy female volunteers . Second , in a comparable , but different group of 26 healthy females , HF-rTMS was performed on the right DLPFC . Salivary cortisol levels were assessed before , immediately after and 30 min after real and sham HF-rTMS . We found no support for the hypothesis that one single session of HF-rTMS on the left or the right DLPFC has an immediate or delayed impact on the HPA – axis , as measured by salivary cortisol . Although we controlled for several method ological problems in HF-rTMS research , the hypothesis that one single session of HF-rTMS on the left or on the right DLPFC can influence the HPA-axis in healthy volunteers was not supported Abstract Objectives . Neuroimaging studies have found that alcohol dependent patients display dopaminergic dysfunction in the ventral striatum , which is associated with alcohol craving . Repetitive transcranial magnetic stimulation ( rTMS ) was introduced as a promising new treatment option for depression , and among other neurobiological mechanisms , it is able to stimulate the striatal dopaminergic system . The aim of our study was to investigate the effect of high frequency rTMS of the left dorsolateral prefrontal cortex compared to sham stimulation on craving and mood in alcohol dependent women . Furthermore , the impact on an attentional blink ( AB ) paradigm to pictures with neutral , emotional and alcohol-related contents was proofed . Methods . Nineteen female detoxified patients were r and omized either to a high frequency rTMS ( 20 Hz ) over the left DLPFC ( n = 10 ) or a sham stimulations ( n = 9 ) at 10 days . Alcohol craving was determined with the Obsessive Compulsive Drinking Scale , depressive symptoms were registered by means of Hamilton Depression Rating Scale and Beck ’ Depression Inventory . For the AB paradigm an age-matched control group was investigated . Results . There were no significantly differences between both groups regarding alcohol craving or mood . In the AB paradigm , real stimulated patients detected alcohol related T2 targets incorrectly in comparison to the sham stimulated and control subjects . Summary . Although there were no differences in clinical parameters such as craving or mood after real high frequency rTMS compared to sham stimulation , we found an interesting difference between the real and the sham stimulated group and controls in the AB paradigm indicating an increase of the AB effect to alcohol-related pictures after real stimulation . Further studies are needed to replicate these findings and correlate them to clinical and neurophysiological data BACKGROUND Prior research in substance dependence has suggested potential anti-craving effects of repetitive transcranial magnetic stimulation ( rTMS ) when applied to the dorsolater 
    Output:
    
Our main findings were that NIBS techniques might be effective strategies for down-regulating HPA activity and regulating food , alcohol , and cigarette consumption .