Transcranial magnetic stimulation: potential treatment for co-occurring alcohol, traumatic brain injury and posttraumatic stress disorders

Abstract

Alcohol use disorder (AUD), mild traumatic brain injury (mTBI), and posttraumatic stress disorder (PTSD) commonly co-occur (AUD + mTBI + PTSD). These conditions have overlapping symptoms which are, in part, reflective of overlapping neuropathology. These conditions become problematic because their co-occurrence can exacerbate symptoms. Therefore, treatments must be developed that are inclusive to all three conditions. Repetitive transcranial magnetic stimulation (rTMS) is non-invasive and may be an ideal treatment for co-occurring AUD + mTBI + PTSD. There is accumulating evidence on rTMS as a treatment for people with AUD, mTBI, and PTSD each alone. However, there are no published studies to date on rTMS as a treatment for co-occurring AUD + mTBI + PTSD. This review article advances the knowledge base for rTMS as a treatment for AUD + mTBI + PTSD. This review provides background information about these co-occurring conditions as well as rTMS. The existing literature on rTMS as a treatment for people with AUD, TBI, and PTSD each alone is reviewed. Finally, neurobiological findings in support of a theoretical model are discussed to inform TMS as a treatment for co-occurring AUD + mTBI + PTSD. The peer-reviewed literature was identified by targeted literature searches using PubMed and supplemented by cross-referencing the bibliographies of relevant review articles. The existing evidence on rTMS as a treatment for these conditions in isolation, coupled with the overlapping neuropathology and symptomology of these conditions, suggests that rTMS may be well suited for the treatment of these conditions together.

Non-Invasive Brain Stimulation for the Treatment of Symptoms Following Traumatic Brain Injury

“…However, limiting TBI patients to low-frequency stimulation protocols may be unduly restrictive, especially given the low seizure risk in individuals with mild TBI and the fact that high-frequency stimulation may be the preferred treatment option for select TBI-related symptoms. For example, in a recent review of rTMS as a potential treatment for co-occurring alcohol abuse disorder, TBI, and post-traumatic stress disorder, Herrold and colleagues suggest that high-frequency, supra-threshold rTMS stimulation of the right DLPFC could help promote recovery ( 78 ). Nielson and colleagues accept that protocols exceeding their preliminary guidelines may be justifiable given appropriate compensatory steps to avoid seizure and sufficient expected benefits to warrant the risk.…”

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.…”

Neural correlates of cue‐ and stress‐induced craving in gambling disorders: implications for transcranial magnetic stimulation interventions

“…Dysfunctions in prefrontal control circuit in GD may underlie vulnerability to gambling-related cues and diminished cognitive control over gambling urge (van Holst et al, 2012;Limbrick-Oldfield et al, 2017), thus contributing to the transition to compulsive gambling (Leeman & Potenza, 2012;Goudriaan et al, 2014). These dysfunctions, and their association with craving and compulsive drug use, have been extensively reported in individuals with SUDs (Wilson et al, 2004;Goldstein & Volkow, 2011), whoalso exhibit executive functioning deficits similar to those observed in disordered gamblers (Goudriaan et al, 2006;Kalechstein et al, 2007;Albein-Urios et al, 2012).…”

“…Thus, targeting these regions via rTMS may represent an effective strategy to address core domains shared across different disorders, and characterized by common neural substrates (Herrold et al, 2014;Dunlop et al, 2015). Interestingly, transdiagnostic effects of rTMS of the DLPFC have been reported across several disorders, including depression, SUDs, and PTSD (Lefaucheur et al, 2014).…”