[Neuromodulation as an intervention for addiction: overview and future prospects].
BACKGROUND
In recent years several neuromodulation techniques have been introduced as interventions for addiction.


OBJECTIVE
To review and discuss studies that have investigated the effects of treating addiction by means of electroencephalography (EEG) neurofeedback, real-time functional magnetic resonance imaging (rt-fMRI) neurofeedback, transcranial magnetic stimulation/transcranial direct current stimulation (TMS/tDCS) and deep brain stimulation (DBS).


METHODS
We reviewed the literature, focusing on Dutch studies in particular.


RESULTS
Studies using EEG neurofeedback were shown to have positive effects on drug use, treatment compliance, and cue reactivity in patients with cocaine and alcohol dependence. A pilot study investigating the effects of rt-fMRI neurofeedback on nicotine dependent patients showed that modulation of the anterior cingulate cortex can decrease smokers' craving for nicotine. In several studies decreased craving was found in alcohol dependent patients after TMS or tDCS stimulation of the anterior cingulate cortex or the dorsolateral prefrontal cortex. The first DBS pilot studies suggest that the nucleus accumbens is a promising target region for the treatment of alcohol and heroin dependence.


CONCLUSIONS
Neuromodulation provides us with a unique opportunity to directly apply neuroscientific knowledge to the treatment of addiction. However, more research is needed to ensure the efficacy, safety and feasibility of the various neuromodulation techniques that are now available.
J
J
Luigjes
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R
Breteler
S
S
Vanneste
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D
de Ridder
D001921:Brain / Q000503:physiopathology*; D046690:Deep Brain Stimulation; D004599:Electric Stimulation Therapy / Q000379:methods*; D004565:Electroconvulsive Therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D058765:Neurofeedback; D018377:Neurotransmitter Agents / Q000502:physiology*; D019966:Substance-Related Disorders / Q000503:physiopathology / Q000628:therapy*; D050781:Transcranial Magnetic Stimulation; D016896:Treatment Outcome; D055536:Vagus Nerve Stimulation
D018377:Neurotransmitter Agents