Peter Boris Centre for Addictions Research, Department of Psychiatry and Behavioural Neurosciences, St. Joseph's Healthcare Hamilton and McMaster University, 100 West 5th Street, Hamilton, Ontario, L8P 3R2, Canada.
Centre for Medicinal Cannabis Research, Michael G. DeGroote School of Medicine, McMaster University, L8S 4K1, Hamilton, Ontario, Canada.
Syst Rev. 2018 Jun 26;7(1):90. doi: 10.1186/s13643-018-0749-y.
BACKGROUND: Individuals with substance use and addictive disorders often display greater risk-taking behaviour, higher impulsivity, and altered reward processing compared to individuals without these disorders. While it is not known whether cognitive biases precede or result from addictive behaviour, they likely influence addiction-related decision-making, and may facilitate pathological behaviour. There is evidence that cognitive functions-including those shown to be altered in substance use and addictive disorders-can be influenced by neuromodulation techniques (specifically, transcranial direct current stimulation and transcranial magnetic stimulation). Much of this work has been conducted in healthy populations, however, making it unclear whether these methods can be used effectively to modulate cognitive functioning in individuals with substance use and addictive disorders. The purpose of the current review is to shed light on the potential effectiveness and feasibility of neuromodulation as a means to improve cognitive deficits in substance use disorders. METHODS: The review will identify and evaluate studies that have examined the effects of transcranial direct current stimulation (tDCS) or transcranial magnetic stimulation (TMS) on cognitive task performance in individuals with chronic substance use or dependence. Relevant studies will be identified through searches in PubMed, PsycINFO, Scopus, and Embase, and narrative review will be used to explore evidence that these techniques can be used successfully to modulate cognitive performance in populations exhibiting addictive behaviour. Assessing individual cognitive domains in turn (e.g. risk-taking, impulsivity, attention), we will critically evaluate the validity and reliability of relevant studies and draw conclusions about the strength of evidence for effective use of neuromodulation in that domain. This protocol is not yet registered with PROSPERO. DISCUSSION: To determine whether neuromodulation holds promise as an effective treatment for neurocognitive deficits in substance use and addictive disorders, it is essential to look carefully at previous studies using this approach in addiction samples. This review will provide an objective and informative description of what is currently known about the efficacy of these techniques, shed light on the feasibility and potential challenges of using neuromodulation in individuals who exhibit addictive behaviour, and identify the most valuable next steps for future research.
背景:与没有这些障碍的个体相比,有物质使用和成瘾障碍的个体通常表现出更大的冒险行为、更高的冲动性和改变的奖励处理。虽然尚不清楚认知偏差是先于还是后于成瘾行为发生,但它们可能会影响与成瘾相关的决策,并可能促进病理性行为。有证据表明,认知功能——包括在物质使用和成瘾障碍中被证明改变的那些功能——可以受到神经调节技术(特别是经颅直流电刺激和经颅磁刺激)的影响。然而,这项工作大多是在健康人群中进行的,因此尚不清楚这些方法是否可以有效地用于调节物质使用和成瘾障碍个体的认知功能。本综述的目的是阐明神经调节作为改善物质使用障碍认知缺陷的一种手段的潜在有效性和可行性。
方法:本综述将确定和评估研究,这些研究检查了经颅直流电刺激(tDCS)或经颅磁刺激(TMS)对慢性物质使用或依赖个体认知任务表现的影响。将通过在 PubMed、PsycINFO、Scopus 和 Embase 中进行搜索来识别相关研究,并使用叙述性综述来探讨这些技术可成功用于调节表现出成瘾行为的人群的认知表现的证据。依次评估个体认知领域(例如冒险、冲动、注意力),我们将批判性地评估相关研究的有效性和可靠性,并得出关于在该领域有效使用神经调节的证据强度的结论。本方案尚未在 PROSPERO 中注册。
讨论:为了确定神经调节是否有希望成为治疗物质使用和成瘾障碍神经认知缺陷的有效方法,必须仔细研究以前在成瘾样本中使用这种方法的研究。本综述将客观、详尽地描述目前已知的这些技术的疗效,阐明在表现出成瘾行为的个体中使用神经调节的可行性和潜在挑战,并确定未来研究最有价值的下一步。
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