University Niccolò Cusano, Rome, Italy.
University Niccolò Cusano, Rome, Italy.
Neurosci Lett. 2022 Apr 23;777:136588. doi: 10.1016/j.neulet.2022.136588. Epub 2022 Mar 24.
Substance and behavioral addiction is a global health problem related to cognitive functioning and emotional responses like top-down control and craving. The present review discusses the role of non-invasive brain stimulation (NIBS) and cognitive-behavioral therapy (CBT) as evidence-based treatments for addiction disorders. The discussion spans between several evidence for both therapies, also considering the difference and heterogeneity among clinical protocols. Nowadays, literature is consistent in indicating the neurostimulation of the prefrontal cortex as effective for different kinds of addiction, corroborating the evidence that they rely on a common network in the brain. Likewise, within the CBT studies it is possible to observe a wide range of interventions that are overall effective in regulating the executive functions associated with addiction disorders. Nevertheless, the integration of NIBS and CBT in addictions has been scarcely considered in literature so far. For this reason, the present article is meant to foster empirical research in this field by highlighting the findings supporting these evidence-based interventions, both as stand-alone and integrated treatments. To this aim, psychological and neurophysiological mechanisms of NIBS and CBT in addictions are reviewed, and the rationale of their integration discussed. In particular, as evidence suggest these treatments affect top-down and bottom-up processes in different ways, with NIBS reducing craving and CBT boosting motivation and coping, we suggest their combination might better target the different components of addiction to promote abstinence.
物质和行为成瘾是一个与认知功能和情绪反应有关的全球健康问题，如自上而下的控制和渴望。本综述讨论了非侵入性脑刺激 (NIBS) 和认知行为疗法 (CBT) 作为成瘾障碍的循证治疗方法的作用。讨论跨越了这两种疗法的几个证据，同时也考虑了临床方案之间的差异和异质性。如今，文献一致表明，前额叶皮层的神经刺激对不同类型的成瘾有效，这证实了它们依赖于大脑中一个共同的网络。同样，在 CBT 研究中，可以观察到一系列广泛的干预措施，这些干预措施总体上有效地调节了与成瘾障碍相关的执行功能。然而，迄今为止，NIBS 和 CBT 在成瘾中的整合在文献中很少被考虑。出于这个原因，本文旨在通过强调支持这些循证干预措施的发现，促进该领域的实证研究，这些干预措施既可以作为独立的治疗方法，也可以作为综合治疗方法。为此，本文综述了 NIBS 和 CBT 在成瘾中的心理和神经生理机制，并讨论了它们整合的原理。特别是，由于有证据表明这些治疗方法以不同的方式影响自上而下和自下而上的过程，NIBS 降低了渴望，CBT 提高了动机和应对能力，因此我们建议将它们结合起来可能会更好地针对成瘾的不同成分，促进戒除。
