title: Noninvasive brain stimulation treatments for addiction and major depression.
abstract: Major depressive disorder (MDD) and substance use disorders (SUDs) are prevalent, disabling, and challenging illnesses for which new treatment options are needed, particularly in comorbid cases. Neuroimaging studies of the functional architecture of the brain suggest common neural substrates underlying MDD and SUDs. Intrinsic brain activity is organized into a set of functional networks, of which two are particularly relevant to psychiatry. The salience network (SN) is crucial for cognitive control and response inhibition, and deficits in SN function are implicated across a wide variety of psychiatric disorders, including MDD and SUDs. The ventromedial network (VMN) corresponds to the classic reward circuit, and pathological VMN activity for drug cues/negative stimuli is seen in SUDs/MDD. Noninvasive brain stimulation (NIBS) techniques, including rTMS and tDCS, have been used to enhance cortico-striatal-thalamic activity through the core SN nodes in the dorsal anterior cingulate cortex, dorsolateral prefrontal cortex, and anterior insula. Improvements in both MDD and SUD symptoms ensue, including in comorbid cases, via enhanced cognitive control. Inhibition of the VMN also appears promising in preclinical studies for quenching the pathological incentive salience underlying SUDs and MDD. Evolving techniques may further enhance the efficacy of NIBS for MDD and SUD cases that are unresponsive to conventional treatments.
authors: MRI-Guided rTMS Clinic, University Health Network, Toronto, Ontario, Canada.|Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada.
authors: Katharine
authors: K
authors: Dunlop
authors: Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina.|Department of Neurosciences, Medical University of South Carolina, Charleston, South Carolina.|Center for Biomedical Imaging, Medical University of South Carolina, Charleston, South Carolina.
authors: Colleen A
authors: CA
authors: Hanlon
authors: MRI-Guided rTMS Clinic, University Health Network, Toronto, Ontario, Canada.|Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada.|Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.|Toronto Western Research Institute, University Health Network, Toronto, Ontario, Canada.
authors: Jonathan
authors: J
authors: Downar
mesh_terms: D016739:Behavior, Addictive / Q000503:physiopathology / Q000628:therapy*; D001921:Brain / Q000503:physiopathology; D003865:Major Depressive Disorder / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008279:Magnetic Resonance Imaging; D001523:Mental Disorders / Q000503:physiopathology / Q000628:therapy; D009434:Neural Pathways; D019966:Substance-Related Disorders / Q000503:physiopathology / Q000628:therapy; D065908:Transcranial Direct Current Stimulation / Q000379:methods; D050781:Transcranial Magnetic Stimulation / Q000379:methods
keywords: addiction; depression; fMRI; rTMS; tDCS