Abstract
Theta burst stimulation (TBS) is thought to affect reward processing mechanisms, which may increase and decrease reward sensitivity. To test the ability of TBS to modulate response to strong primary rewards, participants hypersensitive to primary rewards were recruited. Twenty men and women with at least two opposite-sex, sexual partners in the last year received two forms of TBS. Stimulations were randomized to avoid order effects and separated by 2 hours to reduce carryover. The two TBS forms have been demonstrated to inhibit (continuous) or excite (intermittent) the left dorsolateral prefrontal cortex using different pulse patterns, which links to brain areas associated with reward conditioning. After each TBS, participants completed tasks assessing their reward responsiveness to monetary and sexual rewards. Electroencephalography (EEG) was recorded. They also reported their number of orgasms in the weekend following stimulation. This signal was malleable by TBS, where excitatory TBS resulted in lower EEG alpha relative to inhibitory TBS to primary rewards. EEG responses to sexual rewards in the lab (following both forms of TBS) predicted the number of orgasms experienced over the forthcoming weekend. TBS may be useful in modifying hypersensitivity or hyposensitivity to primary rewards that predict sexual behaviors. Since TBS altered the anticipation of a sexual reward, TBS may offer a novel treatment for sexual desire problems.
Highlights
Reward processing abnormalities, abnormally high reward sensitivity, appears key to many psychopathologies from addictions to mood disorders [1]
One male participant denied being sleepy during the tasks following Intermittent TBS (iTBS), but during that period showed EEG largely devoid of eyeblinks, characterized by slow wave activity, and failed to respond on most reward trials
Data were lost from 3 iTBS trials due to experimenter error
Summary
Abnormally high reward sensitivity, appears key to many psychopathologies from addictions to mood disorders [1]. Individual differences in sensitivity to novelty and rewards are associated with impulsivity [2] and general risk behaviors [3]. These are linked to specific risk behaviors. Sexual risks are important due to their potentially major negative consequences including disease, pregnancy, and social consequences. Impulsive responding has been associated with risky sexual behaviors including unprotected sex [4], sex with strangers and inconsistent condom use [5] and more partners [6]. One goal of the present study was to use neural responses to sexual cues to predict future potentially risky sexual behaviors
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