Biobehavioural Addictions and Concurrent Disorders Research Laboratory, Centre for Addiction and Mental Health, Toronto, ON, Canada.
Brain Stimul. 2013 May;6(3):221-30. doi: 10.1016/j.brs.2012.06.008. Epub 2012 Jul 9.
Tobacco smoking is the leading cause of preventable deaths worldwide, but many smokers are simply unable to quit. Psychosocial and pharmaceutical treatments have shown modest results on smoking cessation rates, but there is an urgent need to develop treatments with greater efficacy. Brain stimulation methods are gaining increasing interest as possible addiction therapeutics.
The purpose of this paper is to review the studies that have evaluated brain stimulation techniques on tobacco addiction, and discuss future directions for research in this novel area of addiction interventions.
Electronic and manual literature searches identified fifteen studies that administered repetitive transcranial magnetic stimulation (rTMS), cranial electrostimulation (CES), transcranial direct current stimulation (tDCS) or deep brain stimulation (DBS).
rTMS was found to be the most well studied method with respect to tobacco addiction. Results indicate that rTMS and tDCS targeted to the dorsolateral prefrontal cortex (DLPFC) were the most efficacious in reducing tobacco cravings, an effect that may be mediated through the brain reward system involved in tobacco addiction. While rTMS was shown to reduce consumption of cigarettes, as yet no brain stimulation technique has been shown to significantly increase abstinence rates. It is possible that the therapeutic effects of rTMS and tDCS may be improved by optimization of stimulation parameters and increasing the duration of treatment.
Although further studies are needed to confirm the ability of brain stimulation methods to treat tobacco addiction, this review indicates that rTMS and tDCS both represent potentially novel treatment modalities.
吸烟是全球可预防死亡的主要原因，但许多吸烟者根本无法戒烟。心理社会和药物治疗在戒烟率方面显示出适度的效果，但迫切需要开发更有效的治疗方法。脑刺激方法作为可能的成瘾治疗方法越来越受到关注。
本文旨在回顾评估脑刺激技术治疗烟草成瘾的研究，并讨论该领域成瘾干预的未来研究方向。
电子和手动文献检索确定了十五项研究，这些研究对重复经颅磁刺激（rTMS）、颅电刺激（CES）、经颅直流电刺激（tDCS）或深部脑刺激（DBS）进行了评估。
rTMS 是针对烟草成瘾研究最多的方法。结果表明，针对背外侧前额叶皮层（DLPFC）的 rTMS 和 tDCS 最有效地减少了烟草渴求，这种效果可能是通过参与烟草成瘾的大脑奖励系统介导的。虽然 rTMS 已被证明可减少香烟的消耗，但迄今为止，还没有任何脑刺激技术被证明可以显著提高戒烟率。rTMS 和 tDCS 的治疗效果可能通过优化刺激参数和增加治疗持续时间而得到改善。
尽管需要进一步的研究来确认脑刺激方法治疗烟草成瘾的能力，但本综述表明 rTMS 和 tDCS 都代表了潜在的新型治疗方式。
