Abstract
BackgroundIndividuals 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.MethodsThe 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.DiscussionTo 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.
Highlights
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
We will evaluate the evidence that neuromodulation is effective in modulating cognitive functions in individuals who exhibit addictive behaviour
The proposed review will present the first systematic analysis of studies that have examined the effects of neuromodulation on cognitive functions in addictive populations
Summary
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 decisionmaking, and may facilitate pathological behaviour. The growing impact of substance use and addictive disorders (referred to hereafter as ‘SUAD’) is pronounced within high socio-demographic areas, where the number of years of life lost to substance abuse has increased by nearly 20% in the last two decades [28] In addition to their direct impact on individuals’ psychological and physical health, SUAD often leads to a loss of employment and breakdown of social relationships, as obtaining and using the drug—or engaging in gambling—takes precedence over work, family, and other obligations. It is not clear whether these characteristics develop as a result of, or precede, addictive behaviour [16], modification of such cognitive biases can reduce substance use behaviours [3, 4, 10, 30]
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