Transcranial Magnetic Stimulation and Deep Brain Stimulation in the Treatment of Alcohol Dependence

Abstract

Alcohol dependence is a major social, economic, and public health problem. Alcoholism can lead to damage of the gastrointestinal, nervous, cardiovascular, and respiratory systems and it can be lethal, costing hundreds of billions to the health care system. Despite the existence of cognitive-behavioral therapy, psychosocial interventions, and spiritually integrated treatment to treat it, alcohol dependence has a high relapse rate and poor prognosis, albeit with high interindividual variability. In this review, we discuss the use of two neuromodulation techniques, namely repetitive transcranial magnetic stimulation (rTMS) and deep brain stimulation (DBS), and their advantages and disadvantages compared to first-line pharmacological treatment for alcohol dependence. We also discuss rTMS and DBS targets for alcohol dependence treatment, considering experimental animal and human evidence, with careful consideration of methodological issues preventing the identification of feasible targets for neuromodulation treatments, as well as inter-individual variability factors influencing alcoholism prognosis. Lastly, we anticipate future research aiming to tailor the treatment to each individual patient by combining neurofunctional, neuroanatomical and neurodisruptive techniques optimizing the outcome.

Neuromodulation Therapies for Alcohol Addiction: A Literature Review

“…It involves the implantation of electrodes on either side of the brain that are attached, via wires that run inside the body, to a pair of battery operated generators within the chest which produce and deliver continuous electrical pulses . Stimulation via DBS of the nucleus accumbens, a portion of the brain involved in the pleasure‐reward system, has been associated with reduction in drug‐seeking behavior and alcohol dependence . As such, it has become the main target in the treatment of addiction, including AUD.…”

Effectiveness of Transcranial Direct-Current Stimulation (tDCS) and Emotion Regulation Training in Reducing Current Drug Craving and Drug-Use Thoughts and Fantasies in Opioid-Dependent Patients: The Issue of Precedence

“…Although brain stimulation techniques are recommended for treating drug addiction and other mental disorders, the underlying mechanisms are not yet completely known (37). In addition, due to the specific nature of brain stimulation techniques, they should only be considered after a thorough examination of the pros and cons and therapeutic priorities (38).…”

Substanzgebundene Abhängigkeitserkrankungen und bulimische Essstörungen

“…3). Außerdem wurden zwölf Review-Artikel identifiziert (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). Die Studien wurden entsprechend ihrer methodischen Güte klassifiziert und es werden Empfehlungen entsprechend dem Evidenzstand gegeben.…”