Padula Claudia B, Tenekedjieva Lea-Tereza, McCalley Daniel M, Al-Dasouqi Hanaa, Hanlon Colleen A, Williams Leanne M, Kozel F Andrew, Knutson Brian, Durazzo Timothy C, Yesavage Jerome A, Madore Michelle R
Mental Illness Research Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA, United States.
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States.
Front Psychiatry. 2022 May 17;13:893833. doi: 10.3389/fpsyt.2022.893833. eCollection 2022.
Alcohol use disorder (AUD) continues to be challenging to treat despite the best available interventions, with two-thirds of individuals going on to relapse by 1 year after treatment. Recent advances in the brain-based conceptual framework of addiction have allowed the field to pivot into a neuromodulation approach to intervention for these devastative disorders. Small trials of repetitive transcranial magnetic stimulation (rTMS) have used protocols developed for other psychiatric conditions and applied them to those with addiction with modest efficacy. Recent evidence suggests that a TMS approach focused on modulating the salience network (SN), a circuit at the crossroads of large-scale networks associated with AUD, may be a fruitful therapeutic strategy. The anterior insula or dorsal anterior cingulate cortex may be particularly effective stimulation sites given emerging evidence of their roles in processes associated with relapse.
尽管有现有的最佳干预措施，酒精使用障碍（AUD）的治疗仍然具有挑战性，三分之二的患者在治疗后1年内会复发。成瘾的基于大脑的概念框架的最新进展使该领域转向采用神经调节方法来干预这些破坏性疾病。重复经颅磁刺激（rTMS）的小型试验使用了为其他精神疾病制定的方案，并将其应用于成瘾患者，疗效一般。最近的证据表明，一种专注于调节突显网络（SN）的经颅磁刺激方法可能是一种有效的治疗策略，突显网络是与酒精使用障碍相关的大规模网络交汇点的一个神经回路。鉴于有新证据表明前脑岛或背侧前扣带回皮质在复发相关过程中发挥作用，它们可能是特别有效的刺激部位。
