75 - Therapeutic Use of Noninvasive Neuromodulation for Addictions

Abstract

Substance use disorder (SUDs) represent one of the major health problems worldwide. However, despite decades of preclinical and clinical studies, several classes of abused drugs, including cocaine, have no US Food and Drug Administration (FDA)−approved treatment, nor pharmacotherapies, with relapse rates often higher than 75%. A myriad of studies in the field suggest a critical role in the addiction cycle of several areas, including the midbrain, amygdala, nucleus accumbens (NAc), prefrontal cortex (PFC), pre-supplementary motor area (SMA), and anterior cingulate cortex (ACC), just to name a few. Specifically related to this chapter are preclinical studies that have shown the effect of optogenetic stimulation of the prelimbic cortex in preventing compulsive drug seeking. In fact, noninvasive brain stimulation (NIBS) is an emerging treatment modality that allows the translation from preclinical research into clinical practice. Based on these premises, in this chapter we provide an overview of the use of noninvasive neuromodulation techniques, mainly transcranial magnetic stimulation (TMS) and transcranial electric stimulation (tES), in addictive disorders. These interventions appear to be very promising, as they may allow the rewiring and modulation of affected brain circuits in addictive disorders and reach populations that have low tolerance for traditional medications. We will also discuss the limitations of the current available studies with the aim to trace future directions in the field.