title: Neuromodulation interventions for addictive disorders: challenges, promise, and roadmap for future research.
abstract: 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 malfunction 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.
authors.affiliation: Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, USA.
authors.forename: Primavera A
authors.initials: PA
authors.lastname: Spagnolo
authors.affiliation: Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, USA.|Laboratory of Neurogenetics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, USA.
authors.forename: David
authors.initials: D
authors.lastname: Goldman
mesh_terms: D016739:Behavior, Addictive / Q000628:therapy*; D001921:Brain / Q000503:physiopathology; D046690:Deep Brain Stimulation / Q000009:adverse effects / Q000639:trends*; D006801:Humans; D009434:Neural Pathways / Q000503:physiopathology*; D019966:Substance-Related Disorders / Q000628:therapy*; D065908:Transcranial Direct Current Stimulation / Q000009:adverse effects / Q000639:trends*; D050781:Transcranial Magnetic Stimulation / Q000009:adverse effects / Q000639:trends*
keywords: addictive disorders; deep brain stimulation; neuromodulation; transcranial direct current stimulation; transcranial magnetic stimulation