Neuromodulation interventions for addictive disorders: challenges, promise, and roadmap for future research

Primavera A. Spagnolo, David Goldman
2017 Brain  
Addictive disorders are a major public health concern, associated with high relapse rates, significant disability and substantial mortality. Unfortunately, current interventions are only modestly effective. Preclinical studies as well as human neuroimaging studies have provided strong evidence that the observable behaviours that characterize the addiction phenotype, such as compulsive drug consumption, impaired self-control, and behavioural inflexibility, reflect underlying dysregulation and
more » ... function in specific neural circuits. These developments have been accompanied by advances in neuromodulation interventions, both invasive as deep brain stimulation, and non-invasive such as repetitive transcranial magnetic stimulation and transcranial direct current stimulation. These interventions appear particularly promising as they may not only allow us to probe affected brain circuits in addictive disorders, but also seem to have unique therapeutic applications to directly target and remodel impaired circuits. However, the available literature is still relatively small and sparse, and the long-term safety and efficacy of these interventions need to be confirmed. Here we review the literature on the use of neuromodulation in addictive disorders to highlight progress limitations with the aim to suggest future directions for this field. Abbreviations: DBS = deep brain stimulation; DLPFC = dorsolateral prefrontal cortex; NAc = nucleus accumbens; OCD = obsessive-compulsive disorder; rTMS = repetitive transcranial magnetic stimulation; tDCS = transcranial direct current stimulation
doi:10.1093/brain/aww284 pmid:28082299 pmcid:PMC6059187 fatcat:m7mjhb4cwzar5k2gbkz6zhfjme