Yavari Fatemeh, Shahbabaie Alireza, Leite Jorge, Carvalho Sandra, Ekhtiari Hamed, Fregni Felipe
Neurocognitive Laboratory, Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran.
Neurocognitive Laboratory, Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran; Translational Neuroscience Program, Institute for Cognitive Science Studies (ICSS), Tehran, Iran; Neuroimaging and Analysis Group, Research Center for Molecular and Cellular Imaging (RCMCI), Tehran University of Medical Sciences, Tehran, Iran.
Prog Brain Res. 2016;224:371-99. doi: 10.1016/bs.pbr.2015.08.007. Epub 2015 Nov 4.
Addiction is a chronic relapsing brain disease with significant economical and medical burden on the societies but with limited effectiveness in the available treatment options. Better understanding of the chemical, neuronal, regional, and network alterations of the brain due to drug abuse can ultimately lead to tailoring individualized and more effective interventions. To this end, employing new assessment and intervention procedures seems crucial. Noninvasive brain stimulation (NIBS) techniques including transcranial electrical and magnetic stimulations (tES and TMS) have provided promising opportunities for the addiction medicine in two main domains: (1) providing new insights into neurochemical and neural circuit changes in the human brain cortex and (2) understanding the role of different brain regions by using NIBS and modulating cognitive functions, such as drug craving, risky decision making, inhibitory control and executive functions to obtain specific treatment outcomes. In spite of preliminary positive results, there are several open questions, which need to be addressed before routine clinical utilization of NIBS techniques in addiction to medicine, such as how to account for interindividual differences, define optimal cognitive and neural targets, optimize stimulation protocols, and integrate NIBS with other therapeutic methods. Therefore, in this chapter we revise the available literature on the use of NIBS (TMS and tES) in the diagnostic, prognostic, and therapeutic aspects of the addiction medicine.
成瘾是一种慢性复发性脑部疾病，给社会带来了巨大的经济和医疗负担，但现有治疗方案的效果有限。更好地了解药物滥用导致的大脑化学、神经元、区域和网络变化，最终可以实现个性化且更有效的干预措施。为此，采用新的评估和干预程序似乎至关重要。非侵入性脑刺激（NIBS）技术，包括经颅电刺激和磁刺激（tES和TMS），在成瘾医学的两个主要领域提供了有前景的机会：（1）为人类大脑皮层的神经化学和神经回路变化提供新见解；（2）通过使用NIBS并调节认知功能，如药物渴望、风险决策、抑制控制和执行功能，以了解不同脑区的作用，从而获得特定的治疗效果。尽管有初步的积极结果，但在将NIBS技术常规应用于成瘾医学临床之前，仍有几个悬而未决的问题需要解决，例如如何考虑个体差异、定义最佳认知和神经靶点、优化刺激方案以及将NIBS与其他治疗方法相结合。因此，在本章中，我们回顾了关于NIBS（TMS和tES）在成瘾医学诊断、预后和治疗方面应用的现有文献。
