Salling Michael C, Martinez Diana
Department of Anesthesiology, Columbia University, New York, NY, USA.
Department of Psychiatry, Columbia University, New York, NY, USA.
Neuropsychopharmacology. 2016 Nov;41(12):2798-2809. doi: 10.1038/npp.2016.80. Epub 2016 May 31.
Localized stimulation of the human brain to treat neuropsychiatric disorders has been in place for over 20 years. Although these methods have been used to a greater extent for mood and movement disorders, recent work has explored brain stimulation methods as potential treatments for addiction. The rationale behind stimulation therapy in addiction involves reestablishing normal brain function in target regions in an effort to dampen addictive behaviors. In this review, we present the rationale and studies investigating brain stimulation in addiction, including transcranial magnetic stimulation, transcranial direct current stimulation, and deep brain stimulation. Overall, these studies indicate that brain stimulation has an acute effect on craving for drugs and alcohol, but few studies have investigated the effect of brain stimulation on actual drug and alcohol use or relapse. Stimulation therapies may achieve their effect through direct or indirect modulation of brain regions involved in addiction, either acutely or through plastic changes in neuronal transmission. Although these mechanisms are not well understood, further identification of the underlying neurobiology of addiction and rigorous evaluation of brain stimulation methods has the potential for unlocking an effective, long-term treatment of addiction.
通过对人脑进行局部刺激来治疗神经精神疾病已有20多年的历史。尽管这些方法在治疗情绪和运动障碍方面得到了更广泛的应用,但最近的研究探索了脑刺激方法作为成瘾的潜在治疗手段。成瘾刺激疗法背后的基本原理是重建目标区域的正常脑功能,以抑制成瘾行为。在这篇综述中,我们阐述了成瘾脑刺激的基本原理和相关研究,包括经颅磁刺激、经颅直流电刺激和深部脑刺激。总体而言,这些研究表明脑刺激对药物和酒精的渴望有急性影响,但很少有研究调查脑刺激对实际药物和酒精使用或复发的影响。刺激疗法可能通过直接或间接调节成瘾相关脑区来发挥作用,这种调节可以是急性发生的,也可以通过神经元传递的可塑性变化来实现。尽管这些机制尚未完全明确,但进一步确定成瘾的潜在神经生物学机制以及对脑刺激方法进行严格评估,有可能找到一种有效的成瘾长期治疗方法。