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Kim DJ, Jeong H, Kim SY, Kim YH, Yim HW. Efficacy of non-invasive brain stimulation in reducing craving in patients with alcohol use disorder: systematic review and meta-analysis. BMC Psychiatry 2025; 25:496. [PMID: 40380172 PMCID: PMC12085020 DOI: 10.1186/s12888-025-06883-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2024] [Accepted: 04/17/2025] [Indexed: 05/19/2025] Open
Abstract
BACKGROUND Craving plays a central role in reinforcing alcohol use disorder (AUD), and non-invasive brain stimulation (NIBS) has shown potential as a therapeutic intervention in AUD. We aim to evaluate the efficacy and safety following the application of NIBS in patients with AUD. METHODS A search of the PubMed, EMBASE, Cochrane Library and PsycINFO databases for articles published up to June 30, 2024 using predefined search terms identified a total of 20 randomized controlled trials (RCTs) and 22 units. The primary outcome of this study was the change in craving severity. The secondary outcome was the rate of adverse events. RESULTS Comparing the effect of alcohol craving severity reduction between the NIBS group and the sham group, the NIBS group showed a significant reduction in alcohol craving severity compared to the sham group (SMD = -0.211; 95% CI = -0.379 to -0.042). The I2 value was 22.2%, indicating a low level of heterogeneity (p = 0.17). Regarding safety, the NIBS group had an increased rate of adverse events compared to the sham group, but this was not significant (OR = 1.494; 95% CI = 0.834 to 2.675). In a subgroup analysis based on the types of NIBS, only transcranial direct current stimulation showed a significant effect (SMD = -0.214; 95% CI = -0.427 to -0.002). Subgroup analyses of stimulation parameters in NIBS showed that a significant reduction in craving severity was observed when NIBS was applied to the dorsolateral prefrontal cortex (SMD = -0.200; 95% CI = -0.381 to -0.019) and when multiple sessions were administered (SMD = -0.388; 95% CI = -0.620 to -0.156). In addition, a significant reduction in craving severity due to delayed effects was observed even 4 weeks after the last stimulation (SMD = -0.553; 95% CI = -0.979 to -0.126), but this finding should be interpreted with caution. CONCLUSIONS NIBS is effective in reducing the severity of craving in patients with AUD. This study provides the latest evidence on the effect of NIBS in reducing craving severity in AUD patients.
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Affiliation(s)
- Dae Jin Kim
- Department of Korean Medicine Policy, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Hyunsuk Jeong
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Su Yeon Kim
- Department of Evidence Development Support, National Evidence-Based Healthcare Collaborating Agency, Seoul, Republic of Korea
| | - Young Hwa Kim
- Divison of Control for Zoonotic and Vector-borne Disease, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Hyeon Woo Yim
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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Kang JU, Mattar L, Vergara J, Gobo VE, Rey HG, Heilbronner SR, Watrous AJ, Hayden BY, Sheth SA, Bartoli E. Parietal cortex is recruited by frontal and cingulate areas to support action monitoring and updating during stopping. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2025:2025.02.28.640787. [PMID: 40060422 PMCID: PMC11888462 DOI: 10.1101/2025.02.28.640787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/17/2025]
Abstract
Recent evidence indicates that the intraparietal sulcus (IPS) may play a causal role in action stopping, potentially representing a novel neuromodulation target for inhibitory control dysfunctions. Here, we leverage intracranial recordings in human subjects to establish the timing and directionality of information flow between IPS and prefrontal and cingulate regions during action stopping. Prior to successful inhibition, information flows primarily from the inferior frontal gyrus (IFG), a critical inhibitory control node, to IPS. In contrast, during stopping errors the communication between IPS and IFG is lacking, and IPS is engaged by posterior cingulate cortex, an area outside of the classical inhibition network and typically associated with default mode. Anterior cingulate and orbitofrontal cortex also display performance-dependent connectivity with IPS. Our functional connectivity results provide direct electrophysiological evidence that IPS is recruited by frontal and anterior cingulate areas to support action plan monitoring/updating, and by posterior cingulate during control failures.
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Affiliation(s)
- Jung Uk Kang
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, USA
| | - Layth Mattar
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, USA
| | - José Vergara
- Department of Neuroscience, Baylor College of Medicine, Houston, TX, USA
| | - Victoria E Gobo
- Department of Neuroscience, Baylor College of Medicine, Houston, TX, USA
| | - Hernan G Rey
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA
| | | | - Andrew J Watrous
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, USA
| | - Benjamin Y Hayden
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, USA
- Department of Neuroscience, Baylor College of Medicine, Houston, TX, USA
- Department of Electrical & Computer Engineering, Rice University, Houston, TX, USA
| | - Sameer A Sheth
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, USA
- Department of Neuroscience, Baylor College of Medicine, Houston, TX, USA
- Department of Electrical & Computer Engineering, Rice University, Houston, TX, USA
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Eleonora Bartoli
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, USA
- Department of Electrical & Computer Engineering, Rice University, Houston, TX, USA
- Lead contact
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Huang S, Liu X, Li Z, Si Y, Yang L, Deng J, Luo Y, Xue YX, Lu L. Memory Reconsolidation Updating in Substance Addiction: Applications, Mechanisms, and Future Prospects for Clinical Therapeutics. Neurosci Bull 2025; 41:289-304. [PMID: 39264570 PMCID: PMC11794923 DOI: 10.1007/s12264-024-01294-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Accepted: 05/09/2024] [Indexed: 09/13/2024] Open
Abstract
Persistent and maladaptive drug-related memories represent a key component in drug addiction. Converging evidence from both preclinical and clinical studies has demonstrated the potential efficacy of the memory reconsolidation updating procedure (MRUP), a non-pharmacological strategy intertwining two distinct memory processes: reconsolidation and extinction-alternatively termed "the memory retrieval-extinction procedure". This procedure presents a promising approach to attenuate, if not erase, entrenched drug memories and prevent relapse. The present review delineates the applications, molecular underpinnings, and operational boundaries of MRUP in the context of various forms of substance dependence. Furthermore, we critically examine the methodological limitations of MRUP, postulating potential refinement to optimize its therapeutic efficacy. In addition, we also look at the potential integration of MRUP and neurostimulation treatments in the domain of substance addiction. Overall, existing studies underscore the significant potential of MRUP, suggesting that interventions predicated on it could herald a promising avenue to enhance clinical outcomes in substance addiction therapy.
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Affiliation(s)
- Shihao Huang
- Department of Neurobiology, School of Basic Medical Sciences, National Institute on Drug Dependence, Peking University, Beijing, 100191, China
- Beijing Key Laboratory of Drug Dependence Research, Peking University, Beijing, 100191, China
| | - Xiaoxing Liu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, 100191, China
| | - Zhonghao Li
- Department of Neurobiology, School of Basic Medical Sciences, National Institute on Drug Dependence, Peking University, Beijing, 100191, China
- Beijing Key Laboratory of Drug Dependence Research, Peking University, Beijing, 100191, China
| | - Yue Si
- Department of Neurobiology, School of Basic Medical Sciences, National Institute on Drug Dependence, Peking University, Beijing, 100191, China
- Beijing Key Laboratory of Drug Dependence Research, Peking University, Beijing, 100191, China
| | - Liping Yang
- Department of Neurobiology, School of Basic Medical Sciences, National Institute on Drug Dependence, Peking University, Beijing, 100191, China
- Beijing Key Laboratory of Drug Dependence Research, Peking University, Beijing, 100191, China
| | - Jiahui Deng
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, 100191, China
| | - Yixiao Luo
- Department of Anesthesiology, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, 421001, China.
| | - Yan-Xue Xue
- Department of Neurobiology, School of Basic Medical Sciences, National Institute on Drug Dependence, Peking University, Beijing, 100191, China.
- Chinese Institute for Brain Research, Beijing, 102206, China.
| | - Lin Lu
- Department of Neurobiology, School of Basic Medical Sciences, National Institute on Drug Dependence, Peking University, Beijing, 100191, China.
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, 100191, China.
- Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, 100871, China.
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Olaitan GO, Lynch WJ, Venton BJ. The therapeutic potential of low-intensity focused ultrasound for treating substance use disorder. Front Psychiatry 2024; 15:1466506. [PMID: 39628494 PMCID: PMC11612502 DOI: 10.3389/fpsyt.2024.1466506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2024] [Accepted: 10/07/2024] [Indexed: 12/06/2024] Open
Abstract
Substance use disorder (SUD) is a persistent public health issue that necessitates the exploration of novel therapeutic interventions. Low-intensity focused ultrasound (LIFU) is a promising modality for precise and invasive modulation of brain activity, capable of redefining the landscape of SUD treatment. The review overviews effective LIFU neuromodulatory parameters and molecular mechanisms, focusing on the modulation of reward pathways in key brain regions in animal and human models. Integration of LIFU with established therapeutics holds promise for augmenting treatment outcomes in SUD. The current research examines LIFU's efficacy in reducing cravings and withdrawal symptoms. LIFU shows promise for reducing cravings, modulating reward circuitry, and addressing interoceptive dysregulation and emotional distress. Selecting optimal parameters, encompassing frequency, burst patterns, and intensity, is pivotal for balancing therapeutic efficacy and safety. However, inconsistencies in empirical findings warrant further research on optimal treatment parameters, physiological action mechanisms, and long-term effects. Collaborative interdisciplinary investigations are imperative to fully realize LIFU's potential in revolutionizing SUD treatment paradigms and enhancing patient outcomes.
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Affiliation(s)
- Greatness O. Olaitan
- Department of Chemistry, University of Virginia, Charlottesville, VA, United States
| | - Wendy J. Lynch
- Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA, United States
| | - B. Jill Venton
- Department of Chemistry, University of Virginia, Charlottesville, VA, United States
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Nikolova YS, Ruocco AC, Felsky D, Lange S, Prevot TD, Vieira E, Voineskos D, Wardell JD, Blumberger DM, Clifford K, Dharavath RN, Gerretsen P, Hassan AN, Jennings SK, Le Foll B, Melamed O, Orson J, Pangarov P, Quigley L, Russell C, Shield K, Sloan ME, Smoke A, Tang V, Cabrera DV, Wang W, Wells S, Wickramatunga R, Sibille E, Quilty LC. Cognitive Dysfunction in the Addictions (CDiA): A Neuron to Neighbourhood Collaborative Research Program on Executive Dysfunction and Functional Outcomes in Outpatients Seeking Treatment for Addiction. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.08.30.24312806. [PMID: 39252904 PMCID: PMC11383479 DOI: 10.1101/2024.08.30.24312806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 09/11/2024]
Abstract
Background Substance use disorders (SUDs) are pressing global public health problems. Executive functions (EFs) are prominently featured in mechanistic models of addiction. However, there remain significant gaps in our understanding of EFs in SUDs, including the dimensional relationships of EFs to underlying neural circuits, molecular biomarkers, disorder heterogeneity, and functional ability. To improve health outcomes for people with SUDs, interdisciplinary clinical, preclinical and health services research is needed to inform policies and interventions aligned with biopsychosocial models of addiction. Here, we introduce Cognitive Dysfunction in the Addictions (CDiA), an integrative team-science and translational research program, which aims to fill these knowledge gaps and facilitate research discoveries to enhance treatments for people living with SUDs. Methods The CDiA Program comprises seven complementary interdisciplinary projects that aim to progress understanding of EF in SUDs and investigate new biological treatment approaches. The projects draw on a diverse sample of adults aged 18-60 (target N=400) seeking treatment for addiction, who are followed prospectively over one year to identify EF domains crucial to recovery. Projects 1-3 investigate SUD symptoms, brain circuits, and blood biomarkers and their associations with both EF domains (inhibition, working memory, and set-shifting) and functional outcomes (disability, quality of life). Projects 4 and 5 evaluate interventions for addiction and their impacts on EF: a clinical trial of repetitive transcranial magnetic stimulation and a preclinical study of potential new pharmacological treatments in rodents. Project 6 links EF to healthcare utilization and is supplemented with a qualitative investigation of EF-related barriers to treatment engagement for those with substance use concerns. Project 7 uses innovative whole-person modeling to integrate the multi-modal data generated across projects, applying clustering and deep learning methods to identify patient subtypes and drive future cross-disciplinary initiatives. Discussion The CDiA program has promise to bring scientific domains together to uncover the diverse ways in which EFs are linked to SUD severity and functional recovery. These findings, supported by emerging clinical, preclinical, health service, and whole-person modeling investigations, will facilitate future discoveries about cognitive dysfunction in addiction and could enhance the future clinical care of individuals seeking treatment for SUDs.
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Affiliation(s)
- Yuliya S Nikolova
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Department of Psychological Clinical Science, University of Toronto, Toronto, Ontario, Canada
| | - Anthony C Ruocco
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Department of Psychological Clinical Science, University of Toronto, Toronto, Ontario, Canada
- Department of Psychology, University of Toronto Scarborough, Toronto, Ontario, Canada
| | - Daniel Felsky
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Shannon Lange
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Institute of Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Thomas D Prevot
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Department of Pharmacology and Toxicology, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Erica Vieira
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Daphne Voineskos
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Jeffrey D Wardell
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Department of Psychology, York University, Toronto, Ontario, Canada
| | - Daniel M Blumberger
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Kevan Clifford
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Ravinder Naik Dharavath
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Philip Gerretsen
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Ahmed N Hassan
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Sheila K Jennings
- Centre for Addiction & Mental Health, Toronto, Ontario, Canada
- Moms Stop the Harm, Victoria, British Columbia
| | - Bernard Le Foll
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Osnat Melamed
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Family and Community Medicine, University of Toronto
| | - Joshua Orson
- Centre for Addiction & Mental Health, Toronto, Ontario, Canada
| | - Peter Pangarov
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Leanne Quigley
- Ferkauf Graduate School of Psychology, Yeshiva University, New York, USA
| | - Cayley Russell
- Ontario CRISM Node Team, Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Kevin Shield
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Matthew E Sloan
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Department of Psychological Clinical Science, University of Toronto, Toronto, Ontario, Canada
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Pharmacology and Toxicology, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Ashley Smoke
- Centre for Addiction & Mental Health, Toronto, Ontario, Canada
- The Ontario Network of People Who Use Drugs, Toronto, Ontario, Canada
| | - Victor Tang
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Diana Valdes Cabrera
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Neuroscience and Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Wei Wang
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Samantha Wells
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Western University, London, Ontario, Canada
| | - Rajith Wickramatunga
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Etienne Sibille
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Department of Pharmacology and Toxicology, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Lena C Quilty
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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Li X, Kass G, Wiers CE, Shi Z. The Brain Salience Network at the Intersection of Pain and Substance use Disorders: Insights from Functional Neuroimaging Research. CURRENT ADDICTION REPORTS 2024; 11:797-808. [PMID: 39156196 PMCID: PMC11329602 DOI: 10.1007/s40429-024-00593-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2024] [Indexed: 08/20/2024]
Abstract
Purpose of Review The brain's salience network (SN), primarily comprising the anterior insula and anterior cingulate cortex, plays a key role in detecting salient stimuli and processing physical and socioemotional pain (e.g., social rejection). Mounting evidence underscores an altered SN in the etiology and maintenance of substance use disorders (SUDs). This paper aims to synthesize recent functional neuroimaging research emphasizing the SN's involvement in SUDs and physical/socioemotional pain and explore the therapeutic prospects of targeting the SN for SUD treatment. Recent Findings The SN is repeatedly activated during the experience of both physical and socioemotional pain. Altered activation within the SN is associated with both SUDs and chronic pain conditions, characterized by aberrant activity and connectivity patterns as well as structural changes. Among individuals with SUDs, functional and structural alterations in the SN have been linked to abnormal salience attribution (e.g., heightened responsiveness to drug-related cues), impaired cognitive control (e.g., impulsivity), and compromised decision-making processes. The high prevalence of physical and socioemotional pain in the SUD population may further exacerbate SN alterations, thus contributing to hindered recovery progress and treatment failure. Interventions targeting the restoration of SN functioning, such as real-time functional MRI feedback, neuromodulation, and psychotherapeutic approaches, hold promise as innovative SUD treatments. Summary The review highlights the significance of alterations in the structure and function of the SN as potential mechanisms underlying the co-occurrence of SUDs and physical/socioemotional pain. Future work that integrates neuroimaging with other research methodologies will provide novel insights into the mechanistic role of the SN in SUDs and inform the development of next-generation treatment modalities.
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Affiliation(s)
- Xinyi Li
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104 USA
| | - Gabriel Kass
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104 USA
| | - Corinde E. Wiers
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104 USA
| | - Zhenhao Shi
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104 USA
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Wesley MJ, Lile JA. Combining noninvasive brain stimulation with behavioral pharmacology methods to study mechanisms of substance use disorder. Front Neurosci 2023; 17:1150109. [PMID: 37554294 PMCID: PMC10405288 DOI: 10.3389/fnins.2023.1150109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 07/06/2023] [Indexed: 08/10/2023] Open
Abstract
Psychotropic drugs and transcranial magnetic stimulation (TMS) are effective for treating certain psychiatric conditions. Drugs and TMS have also been used as tools to explore the relationship between brain function and behavior in humans. Combining centrally acting drugs and TMS has proven useful for characterizing the neural basis of movement. This combined intervention approach also holds promise for improving our understanding of the mechanisms underlying disordered behavior associated with psychiatric conditions, including addiction, though challenges exist. For example, altered neocortical function has been implicated in substance use disorder, but the relationship between acute neuromodulation of neocortex with TMS and direct effects on addiction-related behaviors is not well established. We propose that the combination of human behavioral pharmacology methods with TMS can be leveraged to help establish these links. This perspective article describes an ongoing study that combines the administration of delta-9-tetrahydrocannabinol (THC), the main psychoactive compound in cannabis, with neuroimaging-guided TMS in individuals with problematic cannabis use. The study examines the impact of the left dorsolateral prefrontal cortex (DLPFC) stimulation on cognitive outcomes impacted by THC intoxication, including the subjective response to THC and the impairing effects of THC on behavioral performance. A framework for integrating TMS with human behavioral pharmacology methods, along with key details of the study design, are presented. We also discuss challenges, alternatives, and future directions.
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Affiliation(s)
- Michael J. Wesley
- Department of Behavioral Science, College of Medicine, University of Kentucky, Lexington, KY, United States
- Department of Psychiatry, College of Medicine, University of Kentucky, Lexington, KY, United States
- Department of Psychology, College of Arts and Sciences, University of Kentucky, Lexington, KY, United States
| | - Joshua A. Lile
- Department of Behavioral Science, College of Medicine, University of Kentucky, Lexington, KY, United States
- Department of Psychiatry, College of Medicine, University of Kentucky, Lexington, KY, United States
- Department of Psychology, College of Arts and Sciences, University of Kentucky, Lexington, KY, United States
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Su X, Wang X, Pan X, Zhang X, Lu X, Zhao L, Chen Y, Shang Y, Zhu L, Lu S, Zhu X, Wu F, Xiu M. Effect of Repetitive Transcranial Magnetic Stimulation in Inducing Weight Loss in Patients with Chronic Schizophrenia: A Randomized, Double-Blind Controlled 4-Week Study. Curr Neuropharmacol 2023; 21:417-423. [PMID: 35611778 PMCID: PMC10190142 DOI: 10.2174/1570159x20666220524123315] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 05/03/2022] [Accepted: 05/11/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES There is emerging evidence that high-frequency (HF) repetitive transcranial magnetic stimulation (rTMS) may promote weight loss in individuals with obesity in the general population. However, no study has been conducted on patients with schizophrenia (SZ). This study evaluated the efficacy of 10Hz rTMS in reducing body weight in patients with chronic SZ. METHODS Forty-seven SZ patients were randomly assigned to two groups: 10Hz rTMS or sham stimulation over DLPFC (applied once daily) for 20 consecutive treatments. Body weight was assessed at baseline, at the end of week 1, week 2, week 3 and week 4. Clinical symptoms were evaluated with the Positive and Negative Syndrome Scale (PANSS) at baseline and at the end of week 4. RESULTS We found that compared with patients in the sham group, 10Hz rTMS treatment significantly reduced body weight in patients with chronic SZ after a period of 4 weeks of stimulation. Interestingly, further analysis found that from the first week (5 sessions) of treatment, there was a significant difference in body weight between active and sham groups after controlling for baseline weight. However, active rTMS treatment did not improve the psychotic symptoms compared to sham stimulation. CONCLUSION Our results suggest that add-on HF rTMS could be an effective therapeutic strategy for body weight control in patients with chronic SZ.
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Affiliation(s)
- Xiuru Su
- Hebei Province Veterans Hospital, Baoding, China
| | - Xuan Wang
- Hebei Province Veterans Hospital, Baoding, China
| | - Xiuling Pan
- Hebei Province Veterans Hospital, Baoding, China
| | - Xuan Zhang
- Hebei Province Veterans Hospital, Baoding, China
| | - Xinyan Lu
- Hebei Province Veterans Hospital, Baoding, China
| | - Long Zhao
- Hebei Province Veterans Hospital, Baoding, China
| | - Yingnan Chen
- Hebei Province Veterans Hospital, Baoding, China
| | - Yujie Shang
- Hebei Province Veterans Hospital, Baoding, China
| | - Lin Zhu
- Hebei Province Veterans Hospital, Baoding, China
| | - Shulan Lu
- Hebei Province Veterans Hospital, Baoding, China
| | - Xiaolin Zhu
- Peking University HuiLong Guan Clinical Medical School, Beijing HuiLong Guan Hospital, Beijing, China
| | - Fengchun Wu
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
- Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Meihong Xiu
- Peking University HuiLong Guan Clinical Medical School, Beijing HuiLong Guan Hospital, Beijing, China
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Bai Y, Zhang M, Cui H, Shan X, Gu D, Wang Y, Tang M, Wang X, Jiang X, Zhang B. Addictive behavior and incident gallstone disease: A dose-response meta-analysis and Mendelian randomization study. Front Nutr 2022; 9:940689. [PMID: 36299995 PMCID: PMC9589252 DOI: 10.3389/fnut.2022.940689] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 09/20/2022] [Indexed: 11/20/2022] Open
Abstract
Background Previous studies have suggested associations between addictive behavior and gallstone disease (GSD) risk, yet conflicting results exist. It also remains unclear whether this association is causal or due to confounding or reverse associations. The present study aims to systematically analyze the epidemiological evidence for these associations, as well as estimate the potential causal relationships using Mendelian randomization (MR). Methods We analyzed four common addictive behaviors, including cigarette smoking, alcohol intake, coffee, and tea consumption (N = 126,906–4,584,729 participants) in this meta-analysis based on longitudinal studies. The two-sample MR was conducted using summary data from genome-wide associations with European ancestry (up to 1.2 million individuals). Results An observational association of GSD risk was identified for smoking [RR: 1.17 (95% CI: 1.06–1.29)], drinking alcohol [0.84 (0.78–0.91)], consuming coffee [0.86 (0.79–0.93)], and tea [1.08 (1.04–1.12)]. Also, there was a linear relationship between smoking (pack-years), alcohol drinking (days per week), coffee consumption (cups per day), and GSD risk. Our MRs supported a causality of GSD incidence with lifetime smoking [1.008 (1.003–1.013), P = 0.001], current smoking [1.007 (1.002–1.011), P = 0.004], problematic alcohol use (PAU) [1.014 (1.001–1.026), P = 0.029], decaffeinated coffee intake (1.127 [1.043–1.217], P = 0.002), as well as caffeine-metabolism [0.997 (0.995–0.999), P = 0.013], and tea consumption [0.990 (0.982–0.997), P = 0.008], respectively. Conclusion Our study suggests cigarette smoking, alcohol abuse, and decaffeinated coffee are causal risk factors for GSD, whereas tea consumption can decrease the risk of gallstones due to the effect of caffeine metabolism or polyphenol intake.
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Affiliation(s)
- Ye Bai
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Min Zhang
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Huijie Cui
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xuefeng Shan
- Department of Pharmacy, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Dongqing Gu
- Division of Non-Communicable Disease Epidemiology, The First Affiliated Hospital of Army Military Medical University, Chongqing, China
| | - Yutong Wang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Mingshuang Tang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xin Wang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China,*Correspondence: Xin Wang,
| | - Xia Jiang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China,Department of Clinical Neuroscience, Center for Molecular Medicine, Karolinska Institute, Stockholm, Sweden,Xia Jiang,
| | - Ben Zhang
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Chongqing Medical University, Chongqing, China,West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China,Ben Zhang,
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10
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Salerno L, Becheri L, Pallanti S. ADHD-Gaming Disorder Comorbidity in Children and Adolescents: A Narrative Review. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9101528. [PMID: 36291464 PMCID: PMC9600100 DOI: 10.3390/children9101528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/24/2022] [Accepted: 10/01/2022] [Indexed: 11/07/2022]
Abstract
Attention Deficit/Hyperactivity Disorder (ADHD) is a neurobiological condition characterized by developmentally inadequate levels of inattention, hyperactivity, and impulsivity, and a neurobiological disruption in brain neurotransmitters and circuitry causing abnormal responses to rewards. Playing electronic games generates a biological response that activates the neuronal circuits linked to pleasure and reward, and there is a growing attention to this type of activity, which can also turn into a mental health condition. The existence and the boundaries between the functional and the dysfunctional are still a source of debate, with the recognition of 'Internet Gaming Disorder' (IGD) as a condition belonging to the broader area of addiction requiring more in-depth study with respect to the DSM-5, while 'Gaming Disorder' (GD) was officially recognized as a new diagnosis by the World Health Organization (WHO) in the updated revision of the International Classification of Diseases (ICD-11). Notwithstanding, the suggested criteria for the diagnosis of Gaming Disorder are still debated. Since ADHD has been reported as a risk factor for developing addictions, this narrative review aims to provide the current state-of-the art of the knowledge about the comorbidity between ADHD and Gaming Disorder. For this aim, a literature search was conducted using a combination of specific keywords and the results are discussed within the R-Do-C framework and dimensions, and implications for treatment are considered.
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Affiliation(s)
- Luana Salerno
- INS, Istituto di Neuroscienze, 50121 Florence, Italy
| | | | - Stefano Pallanti
- INS, Istituto di Neuroscienze, 50121 Florence, Italy
- Department of Psychiatry, Albert Einstein College of Medicine, Bronx, NY 10461, USA
- Correspondence:
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11
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Liu Q, Yuan T. Noninvasive brain stimulation of addiction: one target for all? PSYCHORADIOLOGY 2021; 1:172-184. [PMID: 38666219 PMCID: PMC10917190 DOI: 10.1093/psyrad/kkab016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 11/11/2021] [Accepted: 11/19/2021] [Indexed: 04/28/2024]
Abstract
Noninvasive brain stimulation includes repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS), and emerges as a prospective approach for addiction treatment in clinical practices. The dorsolateral prefrontal cortex (DLPFC) is regarded as the most effective stimulation target, giving its important position in controlling cue-elicited drug craving and initiating drug abuse. In this paper, through literature searches (e.g. Pubmed, Google Scholar), 34 studies (2003-2021) were identified examining the effect of rTMS, tDCS on cravings, and consumption of substance use disorders, including tobacco, alcohol, opioids, and stimulants. We summarize the main methods, designs, and effects of rTMS or tDCS that are delivered to the DLPFC on different types of addiction. We conclude that targeting DLPFC might be effective for all types of drug addiction.
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Affiliation(s)
- Qingming Liu
- Center for Brain, Mind and Education, Shaoxing University, Shaoxing 312000, China
- School of Teacher Education, Shaoxing University, Shaoxing 312000, China
| | - Tifei Yuan
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 210109, China
- Co-innovation Center of Neuroregeneration, Nantong University, Nantong, Jiangsu 226019, China
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12
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Campanella S. Use of cognitive event-related potentials in the management of psychiatric disorders: Towards an individual follow-up and multi-component clinical approach. World J Psychiatry 2021; 11:153-168. [PMID: 34046312 PMCID: PMC8134870 DOI: 10.5498/wjp.v11.i5.153] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 03/05/2021] [Accepted: 04/14/2021] [Indexed: 02/06/2023] Open
Abstract
Relapse prevention remains a major challenge in psychiatry, thus indicating that the established treatment methods combining psychotherapy with neuropharmacological interventions are not entirely effective. In recent years, several intervention strategies have been devised that are aimed at improving psychiatric treatment by providing a complementary set of add-on tools that can be used by clinicians to improve current patient assessment. Among these, cognitive event-related potentials (ERPs) have been indexed as valuable biomarkers of the pathophysiological mechanisms of various mental illnesses. However, despite decades of research, their clinical utility is still controversial and a matter of debate. In this opinion review, I present the main arguments supporting the use of cognitive ERPs in the management of psychiatric disorders, stressing why it is currently still not the case despite the vast number of ERP studies to date. I also propose a clinically-oriented suitable way in which this technique could - in my opinion - be effectively incorporated into individual patient care by promotion of the use of individual ERP test-retest sessions and the use of a multi-component approach.
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Affiliation(s)
- Salvatore Campanella
- Laboratoire de Psychologie Médicale et d’Addictologie, ULB Neuroscience Institute (UNI), CHU Brugmann-Université Libre de Bruxelles (U.L.B.), Brussels 1020, Belgium
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13
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Rinehart L, Spencer S. Which came first: Cannabis use or deficits in impulse control? Prog Neuropsychopharmacol Biol Psychiatry 2021; 106:110066. [PMID: 32795592 PMCID: PMC7750254 DOI: 10.1016/j.pnpbp.2020.110066] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 07/12/2020] [Accepted: 08/05/2020] [Indexed: 12/16/2022]
Abstract
Impulse control deficits are often found to co-occur with substance use disorders (SUDs). On the one hand, it is well known that chronic intake of drugs of abuse remodels the brain with significant consequences for a range of cognitive behaviors. On the other hand, individual variation in impulse control may contribute to differences in susceptibility to SUDs. Both of these relationships have been described, thus leading to a "chicken or the egg" debate which remains to be fully resolved. Does impulsivity precede drug use or does it manifest as a function of problematic drug usage? The link between impulsivity and SUDs has been most strongly established for cocaine and alcohol use disorders using both preclinical models and clinical data. Much less is known about the potential link between impulsivity and cannabis use disorder (CUD) or the directionality of this relationship. The initiation of cannabis use occurs most often during adolescence prior to the brain's maturation, which is recognized as a critical period of development. The long-term effects of chronic cannabis use on the brain and behavior have started to be explored. In this review we will summarize these observations, especially as they pertain to the relationship between impulsivity and CUD, from both a psychological and biological perspective. We will discuss impulsivity as a multi-dimensional construct and attempt to reconcile the results obtained across modalities. Finally, we will discuss possible avenues for future research with emerging longitudinal data.
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Affiliation(s)
- Linda Rinehart
- University of Minnesota, Department of Psychiatry and Behavioral Sciences
| | - Sade Spencer
- University of Minnesota, Department of Pharmacology, Minneapolis, MN, USA.
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14
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Nik Jaafar NR, Bahar N, Ibrahim N, Baharudin A, Wan Ismail WS, Sim ST, Abdul Aziz M, Tan KA. Are Malaysian Youths Overdependent on the Internet?: A Narrative Review. Front Psychiatry 2021; 12:710790. [PMID: 34484002 PMCID: PMC8414518 DOI: 10.3389/fpsyt.2021.710790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 07/13/2021] [Indexed: 11/13/2022] Open
Abstract
Overdependence on the internet is a grave concern that has enveloped Malaysian youths which could lead to a variety of sequelae. This narrative review aims to determine the definition of internet overdependence and its associated factors, as well as the potential preventive and treatment strategies for internet overdependence. From the literature, internet overdependence is regarded as a 3-factor model encompassing salience, self-control failure, and serious consequences. Sociodemographic factors such as age, gender, and ethnicity, as well as psychosocial factors such as depression, anxiety, stress, and loneliness, were found to be associated with internet overdependence among Malaysian youths. A multimodal treatment approach is recommended by the implementation of various types of treatments, integrating disciplines such as pharmacology, psychotherapy, and family counseling. Despite various terminologies being used and unclear conceptualization of its nomenclature, overdependence on the internet is prevalent among youths in Malaysia. Future research should go toward establishing a clear definition of its terminology and attaining more robust evidence on treatment strategies.
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Affiliation(s)
- Nik Ruzyanei Nik Jaafar
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.,Malaysian Society of Internet Addiction Prevention, Serdang, Malaysia
| | - Norharlina Bahar
- Malaysian Society of Internet Addiction Prevention, Serdang, Malaysia.,Department of Psychiatry, Prince Court Medical Center, Kuala Lumpur, Malaysia
| | - Normala Ibrahim
- Malaysian Society of Internet Addiction Prevention, Serdang, Malaysia.,Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Azlin Baharudin
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.,Malaysian Society of Internet Addiction Prevention, Serdang, Malaysia
| | - Wan Salwina Wan Ismail
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.,Malaysian Society of Internet Addiction Prevention, Serdang, Malaysia
| | - Su Tein Sim
- Malaysian Society of Internet Addiction Prevention, Serdang, Malaysia.,AHL Specialist Clinic, Petaling Jaya, Malaysia
| | - Melisa Abdul Aziz
- Malaysian Society of Internet Addiction Prevention, Serdang, Malaysia.,Department of Psychiatry and Mental Health, Hospital Ampang, Kuala Lumpur, Malaysia
| | - Kit-Aun Tan
- Malaysian Society of Internet Addiction Prevention, Serdang, Malaysia.,Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
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15
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Cardullo S, Gómez Pérez LJ, Cuppone D, Sarlo M, Cellini N, Terraneo A, Gallimberti L, Madeo G. A Retrospective Comparative Study in Patients With Cocaine Use Disorder Comorbid With Attention Deficit Hyperactivity Disorder Undergoing an rTMS Protocol Treatment. Front Psychiatry 2021; 12:659527. [PMID: 33841218 PMCID: PMC8026860 DOI: 10.3389/fpsyt.2021.659527] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 02/22/2021] [Indexed: 12/03/2022] Open
Abstract
Background: Adult attention-deficit/hyperactivity disorder (ADHD) is associated with high comorbidity with other psychiatric diseases, including cocaine use disorder (CocUD). Given the common fronto-striatal dysfunction, ADHD patients often use cocaine as self-medication for ameliorating symptoms by increasing striatal dopamine release. Yet, comorbidity with ADHD is related to poor treatment outcomes. CocUD has been treated with transcranial magnetic stimulation (TMS), but no studies investigated the outcomes in patients comorbid with ADHD. Methods: Twenty-two ADHD/CocUD and 208 CocUD-only participants received a high-frequency (15 Hz) rTMS treatment stimulating the left-DLPFC. We investigated whether both groups of patients shared similar demographic and clinical characteristics at baseline. Then, we monitored the effect of treatment testing for potential differences between groups. Results: At baseline demographic, toxicology and clinical features were not different between the two groups except for global severity index (GSI from SCL-90): patients of ADHD/CocUD group reported higher general symptomatology compared to the CocUD-only group. Concerning the effect of treatment, both groups significantly improved over time regarding cocaine use, craving, and other negative affect symptoms. No differences were observed between groups. Conclusions: To our knowledge, this is the first study comparing the demographic characterization and rTMS clinical improvements of patients with a dual diagnosis of ADHD and CocUD against CocUD-only patients. Cocaine use and common self-reported withdrawal/abstinence symptoms appear to benefit from rTMS treatment with no differences between groups. Future studies are needed to further investigate these preliminary results.
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Affiliation(s)
| | | | - Diego Cuppone
- Fondazione Novella Fronda, Piazza Castello, Padova, Italy
| | - Michela Sarlo
- Department of Communication Sciences, Humanities and International Studies, University of Urbino Carlo Bo, Urbino, Italy
| | - Nicola Cellini
- Department of General Psychology, University of Padova, Padova, Italy.,Padova Neuroscience Center, University of Padova, Padova, Italy
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16
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Zucchella C, Mantovani E, Federico A, Lugoboni F, Tamburin S. Non-invasive Brain Stimulation for Gambling Disorder: A Systematic Review. Front Neurosci 2020; 14:729. [PMID: 33013280 PMCID: PMC7461832 DOI: 10.3389/fnins.2020.00729] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 06/18/2020] [Indexed: 12/18/2022] Open
Abstract
Background: Gambling disorder (GD) is the most common behavioral addiction and shares pathophysiological and clinical features with substance use disorders (SUDs). Effective therapeutic interventions for GD are lacking. Non-invasive brain stimulation (NIBS) may represent a promising treatment option for GD. Objective: This systematic review aimed to provide a comprehensive and structured overview of studies applying NIBS techniques to GD and problem gambling. Methods: A literature search using Pubmed, Web of Science, and Science Direct was conducted from databases inception to December 19, 2019, for studies assessing the effects of repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (t-DCS) on subjects with GD or problem gambling. Studies using NIBS techniques on healthy subjects and those without therapeutic goals but only aiming to assess basic neurophysiology measures were excluded. Results: A total of 269 articles were title and abstract screened, 13 full texts were assessed, and 11 were included, of which six were controlled and five were uncontrolled. Most studies showed a reduction of gambling behavior, craving for gambling, and gambling-related symptoms. NIBS effects on psychiatric symptoms were less consistent. A decrease of the behavioral activation related to gambling was also reported. Some studies reported modulation of behavioral measures (i.e., impulsivity, cognitive and attentional control, decision making, cognitive flexibility). Studies were not consistent in terms of NIBS protocol, site of stimulation, clinical and surrogate outcome measures, and duration of treatment and follow-up. Sample size was small in most studies. Conclusions: The clinical and methodological heterogeneity of the included studies prevented us from drawing any firm conclusion on the efficacy of NIBS interventions for GD. Further methodologically sound, robust, and well-powered studies are needed.
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Affiliation(s)
- Chiara Zucchella
- Neurology Unit, Department of Neurosciences, Verona University Hospital, Verona, Italy
| | - Elisa Mantovani
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Angela Federico
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Fabio Lugoboni
- Addiction Medicine Unit, Department of Medicine, Verona University Hospital, Verona, Italy
| | - Stefano Tamburin
- Neurology Unit, Department of Neurosciences, Verona University Hospital, Verona, Italy.,Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
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17
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Dormal V, Lannoy S, Bollen Z, D'Hondt F, Maurage P. Can we boost attention and inhibition in binge drinking? Electrophysiological impact of neurocognitive stimulation. Psychopharmacology (Berl) 2020; 237:1493-1505. [PMID: 32036388 DOI: 10.1007/s00213-020-05475-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 01/28/2020] [Indexed: 12/22/2022]
Abstract
RATIONALE Binge drinking (i.e. excessive episodic alcohol consumption) among young adults has been associated with deleterious consequences, notably at the cognitive and brain levels. These behavioural impairments and brain alterations have a direct impact on psychological and interpersonal functioning, but they might also be involved in the transition towards severe alcohol use disorders. Development of effective rehabilitation programs to reduce these negative effects as they emerge thus constitutes a priority in subclinical populations. OBJECTIVES The present study tested the behavioural and electrophysiological impact of neurocognitive stimulation (i.e. transcranial direct current stimulation (tDCS) applied during a cognitive task) to improve attention and inhibition abilities in young binge drinkers. METHODS Two groups (20 binge drinkers and 20 non-binge drinkers) performed two sessions in a counterbalanced order. Each session consisted of an inhibition task (i.e. Neutral Go/No-Go) while participants received left frontal tDCS or sham stimulation, immediately followed by an Alcohol-related Go/No-Go task, while both behavioural and electrophysiological measures were recorded. RESULTS No significant differences were observed between groups or sessions (tDCS versus sham stimulation) at the behavioural level. However, electrophysiological measurements during the alcohol-related inhibition task revealed a specific effect of tDCS on attentional resource mobilization (indexed by the N2 component) in binge drinkers, whereas later inhibition processes (indexed by the P3 component) remained unchanged in this population. CONCLUSIONS The present findings indicate that tDCS can modify the electrophysiological correlates of cognitive processes in binge drinking. While the impact of such brain modifications on actual neuropsychological functioning and alcohol consumption behaviours remains to be determined, these results underline the potential interest of developing neurocognitive stimulation approaches in this population.
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Affiliation(s)
- Valérie Dormal
- Louvain Experimental Psychopathology research group (LEP), Psychological Science Research Institute, Université catholique de Louvain, Place Cardinal Mercier, 10, 1348, Louvain-la-Neuve, Belgium
| | - Séverine Lannoy
- Louvain Experimental Psychopathology research group (LEP), Psychological Science Research Institute, Université catholique de Louvain, Place Cardinal Mercier, 10, 1348, Louvain-la-Neuve, Belgium
| | - Zoé Bollen
- Louvain Experimental Psychopathology research group (LEP), Psychological Science Research Institute, Université catholique de Louvain, Place Cardinal Mercier, 10, 1348, Louvain-la-Neuve, Belgium
| | - Fabien D'Hondt
- CNRS, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, University Lille, 59000, Lille, France.,Clinique de Psychiatrie, CURE, CHU Lille, 59000, Lille, France
| | - Pierre Maurage
- Louvain Experimental Psychopathology research group (LEP), Psychological Science Research Institute, Université catholique de Louvain, Place Cardinal Mercier, 10, 1348, Louvain-la-Neuve, Belgium.
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18
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Memory and Cognition-Related Neuroplasticity Enhancement by Transcranial Direct Current Stimulation in Rodents: A Systematic Review. Neural Plast 2020; 2020:4795267. [PMID: 32211039 PMCID: PMC7061127 DOI: 10.1155/2020/4795267] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 01/27/2020] [Accepted: 02/06/2020] [Indexed: 12/19/2022] Open
Abstract
Brain stimulation techniques, including transcranial direct current stimulation (tDCS), were identified as promising therapeutic tools to modulate synaptic plasticity abnormalities and minimize memory and learning deficits in many neuropsychiatric diseases. Here, we revised the effect of tDCS on the modulation of neuroplasticity and cognition in several animal disease models of brain diseases affecting plasticity and cognition. Studies included in this review were searched following the terms (“transcranial direct current stimulation”) AND (mice OR mouse OR animal) and according to the PRISMA statement requirements. Overall, the studies collected suggest that tDCS was able to modulate brain plasticity due to synaptic modifications within the stimulated area. Changes in plasticity-related mechanisms were achieved through induction of long-term potentiation (LTP) and upregulation of neuroplasticity-related proteins, such as c-fos, brain-derived neurotrophic factor (BDNF), or N-methyl-D-aspartate receptors (NMDARs). Taken into account all revised studies, tDCS is a safe, easy, and noninvasive brain stimulation technique, therapeutically reliable, and with promising potential to promote cognitive enhancement and neuroplasticity. Since the use of tDCS has increased as a novel therapeutic approach in humans, animal studies are important to better understand its mechanisms as well as to help improve the stimulation protocols and their potential role in different neuropathologies.
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19
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Spagnolo PA, Montemitro C, Pettorruso M, Martinotti G, Di Giannantonio M. Better Together? Coupling Pharmacotherapies and Cognitive Interventions With Non-invasive Brain Stimulation for the Treatment of Addictive Disorders. Front Neurosci 2020; 13:1385. [PMID: 31998061 PMCID: PMC6967837 DOI: 10.3389/fnins.2019.01385] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 12/09/2019] [Indexed: 01/11/2023] Open
Affiliation(s)
- Primavera A Spagnolo
- Human Motor Control Section, Medical Neurology Branch, National Institute on Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, United States
| | - Chiara Montemitro
- Department of Neuroscience, Imaging and Clinical Sciences, G. D'Annunzio University, Chieti, Italy.,Neuroimaging Research Branch, National Institute on Drug Abuse, Intramural Research Program, National Institutes of Health, Baltimore, MD, United States
| | - Mauro Pettorruso
- Department of Neuroscience, Imaging and Clinical Sciences, G. D'Annunzio University, Chieti, Italy
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging and Clinical Sciences, G. D'Annunzio University, Chieti, Italy
| | - Massimo Di Giannantonio
- Department of Neuroscience, Imaging and Clinical Sciences, G. D'Annunzio University, Chieti, Italy
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20
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Eskandari Z, Dadashi M, Mostafavi H, Armani Kia A, Pirzeh R. Comparing the Efficacy of Anodal, Cathodal, and Sham Transcranial Direct Current Stimulation on Brain-Derived Neurotrophic Factor and Psychological Symptoms in Opioid-Addicted Patients. Basic Clin Neurosci 2019; 10:641-650. [PMID: 32477481 PMCID: PMC7253809 DOI: 10.32598/bcn.10.6.1710.1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 03/10/2019] [Accepted: 08/31/2019] [Indexed: 12/22/2022] Open
Abstract
Introduction: Today, addiction to opioids is a serious problem all over the world. Unfortunately, the consumption of these drugs and the number of addicted people have drastically increased. This research aimed at comparing the efficacy of anodal, cathodal, and sham transcranial Direct Current Stimulation (tDCS) on the Brain-Derived Neurotrophic Factor (BDNF) and psychological symptoms in opioid-addicted patients. Methods: Thirty opioid-addicted patients were selected based on the Diagnostic and Statistical Manual of Mental Disorders, the Fifth Edition, through the convenience sampling method. They were then randomly assigned to 3 groups (10 in each group). The subjects were evaluated before and after tDCS by their serum level of BDNF, desires for drug questionnaire, and depression anxiety stress scale. The data were analyzed by the Kolmogorov-Smirnov test, one-way analysis of variance, as well as the Bonferroni test. Results: Stimulating the Dorsolateral Prefrontal Cortex (DLPFC) led to a significant change in increasing the level of BDNF (P=0.031) and reducing the degree of depression (P=0.018), anxiety (P=0.001), stress (P=0.012), and decreased the level of craving (P=0.001) in opioid-addicted patients. There was no significant difference between active stimulation groups (anodal left/cathodal right and anodal right/cathodal left). The stimulation of the right DLPFC (group B) significantly increased BDNF in comparison with the sham group (sham tDCS) and decreased anxiety and craving. Nonetheless, no change was observed in depression and stress. The stimulation of the left DLPFC (group A) significantly reduced depression, anxiety, stress, and craving compared with the sham group, while there was no change in BDNF. Conclusion: In addition to the conventional treatments of opioid-addicted patients, tDCS is an effective complementary treatment.
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Affiliation(s)
- Zakaria Eskandari
- Department of Clinical Psychology, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Mohsen Dadashi
- Department of Clinical Psychology, Faculty of Medicine, Social Determinants of Health Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Hossin Mostafavi
- Department of Clinical Psychology, Social Determinants of Health Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Alireza Armani Kia
- Department of Physiology, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Reza Pirzeh
- Department of Physiology, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
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21
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Ma T, Sun Y, Ku Y. Effects of Non-invasive Brain Stimulation on Stimulant Craving in Users of Cocaine, Amphetamine, or Methamphetamine: A Systematic Review and Meta-Analysis. Front Neurosci 2019; 13:1095. [PMID: 31680830 PMCID: PMC6813242 DOI: 10.3389/fnins.2019.01095] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 09/30/2019] [Indexed: 12/21/2022] Open
Abstract
Dopamine system plays a pivotal role in specific kinds of substance use disorders (SUD, i. e., cocaine and methamphetamine use disorders). Many studies addressed whether dopamine-involved craving could be alleviated by non-invasive brain stimulation (NIBS) techniques. Nevertheless, the outcomes were highly inconsistent and the stimulating parameters were highly variable. In the current study, we ran a meta-analysis to identify an overall effect size of NIBS and try to find stimulating parameters of special note. We primarily find 2,530 unduplicated studies in PubMed, Psychology and Behavioral Sciences Collection, PsycARTICLES, PsycINFO, and Google Scholar database involving “Cocaine”/“Amphetamine”/“Methamphetamine” binded with “TMS”/“tDCS”/“non-invasive stimulation” in either field. After visual screening, 26 studies remained. While 16 studies were further excluded due to the lack of data, invalid craving scoring or the absence of sham condition. At last, 16 units of analysis in 12 eligible studies were coded and forwarded to a random-effect analysis. The results showed a large positive main effect of stimulation (Hedge's g = 1.116, CI = [0.597, 1.634]). Further subgroup analysis found that only high-frequency repetitive transcranial magnetic stimulation (rTMS) could elicit a significant decrease in craving, while the outcome of low-frequency stimulation was relatively controversial. Moreover, univariate meta regression revealed that the number of pulses per session could impose negative moderation toward the intervention. No significant moderation effect was found in types of abuse, overall days of stimulation and other variables of stimulating protocol. In conclusion, this meta-analysis offered a persuasive evidence for the feasibility of using NIBS to remit substance addictive behavior directly based on dopamine system. We also give clear methodological guidance that researchers are expected to use high-frequency, sufficiently segmented rTMS to improve the efficacy in future treatments.
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Affiliation(s)
- Tianye Ma
- The Shanghai Key Lab of Brain Functional Genomics, Shanghai Changning-ECNU Mental Health Center, School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - Yurong Sun
- The Shanghai Key Lab of Brain Functional Genomics, Shanghai Changning-ECNU Mental Health Center, School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - Yixuan Ku
- School of Medicine, Tongji Hospital, Tongji University, Shanghai, China.,College of Psychology and Sociology, Shenzhen University, Shenzhen, China.,NYU Shanghai and Collaborative Innovation Center for Brain Science, NYU-ECNU Institute of Brain and Cognitive Science, Shanghai, China
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22
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Gomis-Vicent E, Thoma V, Turner JJD, Hill KP, Pascual-Leone A. Review: Non-Invasive Brain Stimulation in Behavioral Addictions: Insights from Direct Comparisons With Substance Use Disorders. Am J Addict 2019; 28:431-454. [PMID: 31513324 DOI: 10.1111/ajad.12945] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 06/01/2019] [Accepted: 07/27/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Treatment models developed for substance use disorders (SUDs) are often applied to behavioral addictions (BAs), even though the correspondence between these forms of addiction is unclear. This is also the case for noninvasive brain stimulation (NIBS) techniques being investigated as potential treatment interventions for SUDs and BAs. OBJECTIVES to contribute to the development of more effective NIBS protocols for BAs. METHODS Two literature searches using PubMed and Google Scholar were conducted identifying a total of 35 studies. The first search identified 25 studies examining the cognitive and neurophysiological overlap between BAs and SUDs. The second search yielded 10 studies examining the effects of NIBS in BAs. RESULTS Impulsivity and cravings show behavioral and neurophysiologic overlaps between BAs and SUDs, however, other outcomes like working-memory abilities or striatal connectivity, differ between BAs and SUDs. The most-employed NIBS target in BAs was dorsolateral prefrontal cortex (DLPFC), which was associated with a decrease in cravings, and less frequently with a reduction of addiction severity. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE Direct comparisons between BAs and SUDs revealed discrepancies between behavioral and neurophysiological outcomes, but overall, common and distinctive characteristics underlying each disorder. The lack of complete overlap between BAs and SUDs suggests that investigating the cognitive and neurophysiological features of BAs to create individual NIBS protocols that target risk-factors associated specifically with BAs, might be more effective than transferring protocols from SUDs to BAs. Individualizing NIBS protocols to target specific risk-factors associated with each BA might help to improve treatment interventions for BAs. (Am J Addict 2019;00:1-23).
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Affiliation(s)
- Elena Gomis-Vicent
- Department of Psychological Sciences, College of Applied Health and Communities, University of East London, London, United Kingdom
| | - Volker Thoma
- Department of Psychological Sciences, College of Applied Health and Communities, University of East London, London, United Kingdom
| | - John J D Turner
- Department of Psychological Sciences, College of Applied Health and Communities, University of East London, London, United Kingdom
| | - Kevin P Hill
- Division of Addiction Psychiatry, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Alvaro Pascual-Leone
- Department of Neurology, Berenson-Allen Center for Noninvasive Brain Stimulation and Division of Cognitive Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.,Institut Guttmann de Neurorehabilitació, Universitat Autonòma de Barcelona, Badalona, Barcelona, Spain
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23
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Ekhtiari H, Tavakoli H, Addolorato G, Baeken C, Bonci A, Campanella S, Castelo-Branco L, Challet-Bouju G, Clark VP, Claus E, Dannon PN, Del Felice A, den Uyl T, Diana M, di Giannantonio M, Fedota JR, Fitzgerald P, Gallimberti L, Grall-Bronnec M, Herremans SC, Herrmann MJ, Jamil A, Khedr E, Kouimtsidis C, Kozak K, Krupitsky E, Lamm C, Lechner WV, Madeo G, Malmir N, Martinotti G, McDonald WM, Montemitro C, Nakamura-Palacios EM, Nasehi M, Noël X, Nosratabadi M, Paulus M, Pettorruso M, Pradhan B, Praharaj SK, Rafferty H, Sahlem G, Salmeron BJ, Sauvaget A, Schluter RS, Sergiou C, Shahbabaie A, Sheffer C, Spagnolo PA, Steele VR, Yuan TF, van Dongen JDM, Van Waes V, Venkatasubramanian G, Verdejo-García A, Verveer I, Welsh JW, Wesley MJ, Witkiewitz K, Yavari F, Zarrindast MR, Zawertailo L, Zhang X, Cha YH, George TP, Frohlich F, Goudriaan AE, Fecteau S, Daughters SB, Stein EA, Fregni F, Nitsche MA, Zangen A, Bikson M, Hanlon CA. Transcranial electrical and magnetic stimulation (tES and TMS) for addiction medicine: A consensus paper on the present state of the science and the road ahead. Neurosci Biobehav Rev 2019; 104:118-140. [PMID: 31271802 PMCID: PMC7293143 DOI: 10.1016/j.neubiorev.2019.06.007] [Citation(s) in RCA: 197] [Impact Index Per Article: 32.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 05/30/2019] [Accepted: 06/08/2019] [Indexed: 12/21/2022]
Abstract
There is growing interest in non-invasive brain stimulation (NIBS) as a novel treatment option for substance-use disorders (SUDs). Recent momentum stems from a foundation of preclinical neuroscience demonstrating links between neural circuits and drug consuming behavior, as well as recent FDA-approval of NIBS treatments for mental health disorders that share overlapping pathology with SUDs. As with any emerging field, enthusiasm must be tempered by reason; lessons learned from the past should be prudently applied to future therapies. Here, an international ensemble of experts provides an overview of the state of transcranial-electrical (tES) and transcranial-magnetic (TMS) stimulation applied in SUDs. This consensus paper provides a systematic literature review on published data - emphasizing the heterogeneity of methods and outcome measures while suggesting strategies to help bridge knowledge gaps. The goal of this effort is to provide the community with guidelines for best practices in tES/TMS SUD research. We hope this will accelerate the speed at which the community translates basic neuroscience into advanced neuromodulation tools for clinical practice in addiction medicine.
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Affiliation(s)
| | - Hosna Tavakoli
- Institute for Cognitive Science Studies (ICSS), Iran; Iranian National Center for Addiction Studies (INCAS), Iran
| | - Giovanni Addolorato
- Alcohol Use Disorder Unit, Division of Internal Medicine, Gastroenterology and Hepatology Unit, Catholic University of Rome, A. Gemelli Hospital, Rome, Italy; Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Chris Baeken
- Department of Psychiatry and Medical Psychology, University Hospital Ghent, Ghent, Belgium
| | - Antonello Bonci
- Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, USA; Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | | | | | - Vincent P Clark
- University of New Mexico, USA; The Mind Research Network, USA
| | | | | | - Alessandra Del Felice
- University of Padova, Department of Neuroscience, Padova, Italy; Padova Neuroscience Center (PNC), University of Padova, Padova, Italy
| | | | - Marco Diana
- 'G. Minardi' Laboratory of Cognitive Neuroscience, Department of Chemistry and Pharmacy, University of Sassari, Italy
| | | | - John R Fedota
- Neuroimaging Research Branch, National Institute on Drug Abuse, Intramural Research Program, National Institutes of Health, Baltimore, MD, USA
| | | | - Luigi Gallimberti
- Novella Fronda Foundation, Human Science and Brain Research, Padua, Italy
| | | | - Sarah C Herremans
- Department of Psychiatry and Medical Psychology, University Hospital Ghent, Ghent, Belgium
| | - Martin J Herrmann
- Center of Mental Health, Department of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital of Würzburg, Würzburg, Germany
| | - Asif Jamil
- Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
| | | | | | - Karolina Kozak
- University of Toronto, Canada; Centre for Addiction and Mental Health (CAMH), Canada
| | - Evgeny Krupitsky
- V. M. Bekhterev National Medical Research Center for Psychiatry and Neurology, St.-Petersburg, Russia; St.-Petersburg First Pavlov State Medical University, Russia
| | - Claus Lamm
- Department of Basic Psychological Research and Research Methods, Faculty of Psychology, University of Vienna, Austria
| | | | - Graziella Madeo
- Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, USA
| | | | | | - William M McDonald
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Chiara Montemitro
- Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, USA; University G.d'Annunzio of Chieti-Pescara, Italy
| | | | - Mohammad Nasehi
- Cognitive and Neuroscience Research Center (CNRC), Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Xavier Noël
- Université Libre de Bruxelles (ULB), Belgium
| | | | | | | | | | - Samir K Praharaj
- Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Haley Rafferty
- Spaulding Rehabilitation Hospital, Harvard Medical School, USA
| | | | - Betty Jo Salmeron
- Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, USA
| | - Anne Sauvaget
- Laboratory «Movement, Interactions, Performance» (E.A. 4334), University of Nantes, 25 Bis Boulevard Guy Mollet, BP 72206, 44322, Nantes Cedex 3, France; CHU de Nantes Addictology and Liaison Psychiatry Department, University Hospital Nantes, Nantes Cedex 3, France
| | - Renée S Schluter
- Laureate Institute for Brain Research, USA; Institute for Cognitive Science Studies (ICSS), Iran
| | | | - Alireza Shahbabaie
- Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
| | | | | | - Vaughn R Steele
- Neuroimaging Research Branch, National Institute on Drug Abuse, Intramural Research Program, National Institutes of Health, Baltimore, MD, USA
| | - Ti-Fei Yuan
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, China
| | | | - Vincent Van Waes
- Laboratoire de Neurosciences Intégratives et Cliniques EA481, Université Bourgogne Franche-Comté, Besançon, France
| | | | | | | | - Justine W Welsh
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | | | | | - Fatemeh Yavari
- Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
| | - Mohammad-Reza Zarrindast
- Department of Pharmacology School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Laurie Zawertailo
- University of Toronto, Canada; Centre for Addiction and Mental Health (CAMH), Canada
| | - Xiaochu Zhang
- University of Science and Technology of China, China
| | | | - Tony P George
- University of Toronto, Canada; Centre for Addiction and Mental Health (CAMH), Canada
| | | | - Anna E Goudriaan
- Department of Psychiatry, Amsterdam Institute for Addiction Research, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Arkin, Department of Research and Quality of Care, Amsterdam, The Netherlands
| | | | | | - Elliot A Stein
- Neuroimaging Research Branch, National Institute on Drug Abuse, Intramural Research Program, National Institutes of Health, Baltimore, MD, USA
| | - Felipe Fregni
- Spaulding Rehabilitation Hospital, Harvard Medical School, USA
| | - Michael A Nitsche
- Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany; University Medical Hospital Bergmannsheil, Dept. Neurology, Bochum, Germany
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24
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Tsai ST, Liew HK, Li HM, Lin SZ, Chen SY. Harnessing Neurogenesis and Neuroplasticity with Stem Cell Treatment for Addictive Disorders. Cell Transplant 2019; 28:1127-1131. [PMID: 31271057 PMCID: PMC6767895 DOI: 10.1177/0963689719859299] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Drug and alcohol addiction has become an emerging public health issue and is a great
burden to patients, their families, and society. It is characterized by high relapse rates
and significant morbidity and mortality, and most available treatments result in only
modest improvement. These findings highlight the necessity for new approaches to treat
addiction. Scientific reports in the past two decades suggest that addiction involves
impaired neural plasticity and decreased hippocampal neurogenesis. Stem cell therapy and
its derived neurotrophic factors can potentially target the underlying pathophysiology of
addiction. Stem cell applications are showing promise in several preclinical studies and
may provide new and noninvasive treatment strategies. Future clinical research is
warranted to investigate whether stem cell-based therapy could support the treatment of
addiction.
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Affiliation(s)
- Sheng-Tzung Tsai
- Department of Neurosurgery, Buddhist Tzu Chi General Hospital, Tzu Chi University, Hualien.,Institute of Medical Sciences, Tzu Chi University, Hualien.,*Sheng-Tzung Tsai and Hock-Kean Liew contributed equally to this review
| | - Hock-Kean Liew
- Department of Medical Research, Buddhist Tzu Chi General Hospital, Hualien.,*Sheng-Tzung Tsai and Hock-Kean Liew contributed equally to this review
| | - Hao-Ming Li
- Department of Psychiatry, Buddhist Tzu Chi General Hospital, Tzu Chi University, Hualien
| | - Shinn-Zong Lin
- Department of Neurosurgery, Buddhist Tzu Chi General Hospital, Tzu Chi University, Hualien.,Department of Medical Research, Buddhist Tzu Chi General Hospital, Hualien
| | - Shin-Yuan Chen
- Department of Neurosurgery, Buddhist Tzu Chi General Hospital, Tzu Chi University, Hualien.,Institute of Medical Sciences, Tzu Chi University, Hualien
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25
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Claus ED, Klimaj SD, Chavez R, Martinez AD, Clark VP. A Randomized Trial of Combined tDCS Over Right Inferior Frontal Cortex and Cognitive Bias Modification: Null Effects on Drinking and Alcohol Approach Bias. Alcohol Clin Exp Res 2019; 43:1591-1599. [PMID: 31081924 DOI: 10.1111/acer.14111] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 05/07/2019] [Indexed: 01/12/2023]
Abstract
BACKGROUND Deriving novel treatments for alcohol use disorders (AUDs) is of critical importance, as existing treatments are only modestly effective for reducing drinking. Two promising strategies for treating AUDs include cognitive bias modification (CBM) and transcranial direct current stimulation (tDCS). While each strategy has shown positive results in reducing drinking or alcohol-related constructs (e.g., craving), initial tests of the combination of CBM and tDCS have shown mixed results. The present study investigated the degree to which combining CBM and tDCS (2.0 mA anodal current over F10) could reduce alcohol approach biases and alcohol consumption. METHODS Seventy-nine at-risk drinkers were randomized to 1 of 4 conditions in a 2 × 2 factorial design: verum CBM/verum tDCS, verum CBM/sham tDCS, sham CBM/verum tDCS, or sham CBM/sham tDCS. Participants completed a baseline assessment of alcohol approach bias and drinking quantity/frequency (i.e., drinks per drinking day [DDD] and percent heavy drinking days [PHDD]), 4 sessions of combined CBM and tDCS, and follow-up assessments of approach bias and alcohol consumption. RESULTS Results indicated that while participants did demonstrate significant alcohol approach biases at baseline, neither CBM, tDCS, nor the interaction reduced the bias at the follow-up. In addition, there was evidence of a trend toward reducing DDD from baseline to the 1-week/1-month follow-ups, but there was no significant effect of the intervention on either DDD or PHDD. CONCLUSIONS These results partially replicated null results presented in similar CBM/tDCS trials and suggest that this combination, at least with anodal stimulation over dorsolateral or inferior frontal sites, may have limited utility to reduce drinking.
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Affiliation(s)
- Eric D Claus
- The Mind Research Network, Albuquerque, New Mexico
| | | | - Roberta Chavez
- Center on Alcoholism, Substance Abuse, and Addiction, University of New Mexico, Albuquerque, New Mexico
| | - Amber D Martinez
- Center on Alcoholism, Substance Abuse, and Addiction, University of New Mexico, Albuquerque, New Mexico
| | - Vincent P Clark
- The Mind Research Network, Albuquerque, New Mexico.,Psychology Clinical Neuroscience Center, Department of Psychology, University of New Mexico, Albuquerque, New Mexico
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26
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Cardullo S, Gomez Perez LJ, Marconi L, Terraneo A, Gallimberti L, Bonci A, Madeo G. Clinical Improvements in Comorbid Gambling/Cocaine Use Disorder (GD/CUD) Patients Undergoing Repetitive Transcranial Magnetic Stimulation (rTMS). J Clin Med 2019; 8:jcm8060768. [PMID: 31151221 PMCID: PMC6616893 DOI: 10.3390/jcm8060768] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 05/24/2019] [Accepted: 05/28/2019] [Indexed: 12/12/2022] Open
Abstract
(1) Background: Pathological gambling behaviors may coexist with cocaine use disorder (CUD), underlying common pathogenic mechanisms. Repetitive transcranial magnetic stimulation (rTMS) has shown promise as a therapeutic intervention for CUD. In this case series, we evaluated the clinical effects of rTMS protocol stimulating the left dorsolateral prefrontal cortex (DLPFC) on the pattern of gambling and cocaine use. (2) Methods: Gambling severity, craving for cocaine, sleep, and other negative affect symptoms were recorded in seven patients with a diagnosis of gambling disorder (South Oaks Gambling Screen (SOGS) >5), in comorbidity with CUD, using the following scales: Gambling-Symptom Assessment Scale (G-SAS), Cocaine Craving Questionnaire (CCQ), Beck Depression Inventory-II (BDI-II), Self-rating Anxiety Scale (SAS), and Symptoms checklist-90 (SCL-90). The measures were assessed before the rTMS treatment and after 5, 30, and 60 days of treatment. Patterns of gambling and cocaine use were assessed by self-report and regular urine screens. (3) Results: Gambling severity at baseline ranged from mild to severe (mean ± Standard Error of the Mean (SEM), G-SAS score baseline: 24.42 ± 2.79). G-SAS scores significantly improved after treatment (G-SAS score Day 60: 2.66 ± 1.08). Compared to baseline, consistent improvements were significantly seen in craving for cocaine and in negative-affect symptoms. (4) Conclusions: The present findings provide unprecedent insights into the potential role of rTMS as a therapeutic intervention for reducing both gambling and cocaine use in patients with a dual diagnosis.
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Affiliation(s)
- Stefano Cardullo
- Human Science and Brain Research, Novella Fronda Foundation, Piazza Castello, 35141 Padua, Italy.
| | - Luis Javier Gomez Perez
- Human Science and Brain Research, Novella Fronda Foundation, Piazza Castello, 35141 Padua, Italy.
| | - Linda Marconi
- Human Science and Brain Research, Novella Fronda Foundation, Piazza Castello, 35141 Padua, Italy.
| | - Alberto Terraneo
- Human Science and Brain Research, Novella Fronda Foundation, Piazza Castello, 35141 Padua, Italy.
| | - Luigi Gallimberti
- Human Science and Brain Research, Novella Fronda Foundation, Piazza Castello, 35141 Padua, Italy.
| | - Antonello Bonci
- Human Science and Brain Research, Novella Fronda Foundation, Piazza Castello, 35141 Padua, Italy.
- Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD 21224, USA.
- Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
| | - Graziella Madeo
- Human Science and Brain Research, Novella Fronda Foundation, Piazza Castello, 35141 Padua, Italy.
- Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD 21224, USA.
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27
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Witkiewitz K, Stein ER, Votaw VR, Wilson AD, Roos CR, Gallegos SJ, Clark VP, Claus ED. Mindfulness-Based Relapse Prevention and Transcranial Direct Current Stimulation to Reduce Heavy Drinking: A Double-Blind Sham-Controlled Randomized Trial. Alcohol Clin Exp Res 2019; 43:1296-1307. [PMID: 30977904 DOI: 10.1111/acer.14053] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 04/01/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Mindfulness-based relapse prevention (MBRP) and transcranial direct current stimulation (tDCS) have independently shown benefits for treating alcohol use disorder (AUD). Recent work suggests tDCS may enhance mindfulness. The combination of MBRP and tDCS may provide synergistic benefits and may target both behavioral and neurobiological dysfunctions in AUD. The goal of this double-blind sham-controlled randomized trial was to examine the efficacy of a rolling group MBRP treatment combined with tDCS among individuals interested in reducing their drinking. METHODS Individuals who were interested in reducing their alcohol use (n = 84; 40.5% female; mean age = 52.3; 98.9% with current AUD) were randomized to receive active (2.0 milliamps) or sham (0.0 milliamps) anodal tDCS (5 cm × 3 cm electrode) of the right inferior frontal gyrus with the 5 cm × 3 cm cathodal electrode applied to the left upper arm, combined with 8 weeks of outpatient MBRP rolling group treatment. Assessments were conducted at baseline, posttreatment, and 2 months following treatment. The primary outcome was drinks per drinking day, and secondary outcomes were percent heavy drinking days, self-reported craving, alcohol cue reactivity in an alcohol cue task, and response inhibition in a stop signal reaction time task. RESULTS Results indicated significant reductions in drinks per drinking day over time, B(SE) = -0.535 (0.16), p = 0.001, and a significant dose effect for number of groups attended, B(SE) = -0.259 (0.11), p = 0.01. There were also significant effects of time and dose for number of groups attended on secondary outcomes of percent heavy drinking days and alcohol cue reactivity. There were no effects of active versus sham tDCS on primary or secondary outcomes. CONCLUSIONS Findings from the current study provide initial support for the effectiveness of rolling group MBRP as an outpatient treatment for drinking reduction. The current study did not find additive effects of this tDCS protocol in enhancing MBRP among individuals with drinking reduction goals.
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Affiliation(s)
- Katie Witkiewitz
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico
| | - Elena R Stein
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico
| | - Victoria R Votaw
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico
| | - Adam D Wilson
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico
| | - Corey R Roos
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico
| | - Stevi J Gallegos
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico
| | - Vincent P Clark
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico.,Mind Research Network, Albuquerque, New Mexico
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28
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Gupta N, Bansal H, Roy S. Theoretical optimization of high-frequency optogenetic spiking of red-shifted very fast-Chrimson-expressing neurons. NEUROPHOTONICS 2019; 6:025002. [PMID: 31001567 PMCID: PMC6458485 DOI: 10.1117/1.nph.6.2.025002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 03/15/2019] [Indexed: 05/03/2023]
Abstract
A detailed theoretical analysis and optimization of high-fidelity, high-frequency firing of the red-shifted very-fast-Chrimson (vf-Chrimson) expressing neurons is presented. A four-state model for vf-Chrimson photocycle has been formulated and incorporated in Hodgkin-Huxley and Wang-Buzsaki spiking neuron circuit models. The effect of various parameters that include irradiance, pulse width, frequency, expression level, and membrane capacitance has been studied in detail. Theoretical simulations are in excellent agreement with recently reported experimental results. The analysis and optimization bring out additional interesting features. A minimal pulse width of 1.7 ms at 23 mW / mm 2 induces a peak photocurrent of 1250 pA. Optimal irradiance ( 0.1 mW / mm 2 ) and pulse width ( 50 μ s ) to trigger action potential have been determined. At frequencies beyond 200 Hz, higher values of expression level and irradiance result in spike failure. Singlet and doublet spiking fidelity can be maintained up to 400 and 150 Hz, respectively. The combination of expression level and membrane capacitance is a crucial factor to achieve high-frequency firing above 500 Hz. Its optimization enables 100% spike probability of up to 1 kHz. The study is useful in designing new high-frequency optogenetic neural spiking experiments with desired spatiotemporal resolution, by providing insights into the temporal spike coding, plasticity, and curing neurodegenerative diseases.
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Affiliation(s)
- Neha Gupta
- Dayalbagh Educational Institute, Department of Physics and Computer Science, Agra, India
| | - Himanshu Bansal
- Dayalbagh Educational Institute, Department of Physics and Computer Science, Agra, India
| | - Sukhdev Roy
- Dayalbagh Educational Institute, Department of Physics and Computer Science, Agra, India
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29
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Schüller CB, Kuhn J, Jessen F, Hu X. Neuronal correlates of delay discounting in healthy subjects and its implication for addiction: an ALE meta-analysis study. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2019; 45:51-66. [PMID: 30632802 DOI: 10.1080/00952990.2018.1557675] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Delay discounting (DD) describes the phenomenon of devaluing future rewards in favor of immediate rewards. Increased DD is a key behavioral marker of addiction, and has been suggested as a target for interventions to alleviate addiction symptoms (e.g., preference for immediate drug use over larger-and-later rewards, and relapses) in patients with substance use disorders (SUD). OBJECTIVES Performed a meta-analysis on neuroimaging results of DD regarding specific contrasts in healthy participants. Reviewed the results of existing patient studies in light of the meta-analyses results. METHODS We conducted activation likelihood estimation meta-analyses on DD neuroimaging studies (25 studies, n = 583; 354 males and 229 females) regarding six analytic strategies. RESULTS The meta-analyses revealed various subdivisions of the cortical-basal ganglia circuits that are associated with different aspects of DD in healthy subjects. By comparing the meta-analyses results and patients' studies regarding each contrast, we highlighted three brain regions that may underlie excessive DD in patients. Decreased left inferior frontal gyrus (IFG) activity was related to less preference for delayed choices; reduced ventral striatum (VS) activity was associated with impaired valuation processes; and declined anterior cingulate cortex (ACC)/medial prefrontal cortex (mPFC) activity was associated with alterations in processing difficult choices. CONCLUSIONS We propose that neuromodulation (e.g. deep brain simulation) or behavioral interventions (e.g. episodic future imagination) targeting these key brain regions (IFG, VS, ACC/mPFC) may be effective for improving DD function in patients with SUD, enhancing valuations of future rewards and helping to resist the temptation of immediate drug use.
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Affiliation(s)
- Canan Beate Schüller
- a Department of Psychiatry and Psychotherapy, Medical Faculty , University of Cologne , Cologne , Germany
| | - Jens Kuhn
- a Department of Psychiatry and Psychotherapy, Medical Faculty , University of Cologne , Cologne , Germany.,b Department of Psychiatry, Psychotherapy and Psychosomatic , Johanniter Hospital Oberhausen , Oberhausen , Germany
| | - Frank Jessen
- a Department of Psychiatry and Psychotherapy, Medical Faculty , University of Cologne , Cologne , Germany.,c German Center for Neurodegenerative Diseases (DZNE) , Bonn , Germany
| | - Xiaochen Hu
- a Department of Psychiatry and Psychotherapy, Medical Faculty , University of Cologne , Cologne , Germany
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30
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Efficacy of Invasive and Non-Invasive Brain Modulation Interventions for Addiction. Neuropsychol Rev 2018; 29:116-138. [PMID: 30536145 PMCID: PMC6499746 DOI: 10.1007/s11065-018-9393-5] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 11/08/2018] [Indexed: 12/14/2022]
Abstract
It is important to find new treatments for addiction due to high relapse rates despite current interventions and due to expansion of the field with non-substance related addictive behaviors. Neuromodulation may provide a new type of treatment for addiction since it can directly target abnormalities in neurocircuits. We review literature on five neuromodulation techniques investigated for efficacy in substance related and behavioral addictions: transcranial direct current stimulation (tDCS), (repetitive) transcranial magnetic stimulation (rTMS), EEG, fMRI neurofeedback and deep brain stimulation (DBS) and additionally report on effects of these interventions on addiction-related cognitive processes. While rTMS and tDCS, mostly applied at the dorsolateral prefrontal cortex, show reductions in immediate craving for various addictive substances, placebo-responses are high and long-term outcomes are understudied. The lack in well-designed EEG-neurofeedback studies despite decades of investigation impedes conclusions about its efficacy. Studies investigating fMRI neurofeedback are new and show initial promising effects on craving, but future trials are needed to investigate long-term and behavioral effects. Case studies report prolonged abstinence of opioids or alcohol with ventral striatal DBS but difficulties with patient inclusion may hinder larger, controlled trials. DBS in neuropsychiatric patients modulates brain circuits involved in reward processing, extinction and negative-reinforcement that are also relevant for addiction. To establish the potential of neuromodulation for addiction, more randomized controlled trials are needed that also investigate treatment duration required for long-term abstinence and potential synergy with other addiction interventions. Finally, future advancement may be expected from tailoring neuromodulation techniques to specific patient (neurocognitive) profiles.
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31
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Costa TBBC, Lacerda ALT, Mas CD, Brietzke E, Pontes JGM, Marins LAN, Martins LG, Nunes MV, Pedrini M, Carvalho MSC, Mitrovitch MP, Hayashi MAF, Saldanha NL, Poppi RJ, Tasic L. Insights into the Effects of Crack Abuse on the Human Metabolome Using a NMR Approach. J Proteome Res 2018; 18:341-348. [PMID: 30387359 DOI: 10.1021/acs.jproteome.8b00646] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Approximately 255 million people consume illicit drugs every year, among which 18 million use cocaine. A portion of this drug is represented by crack, but it is difficult to estimate the number of users since most are marginalized. However, there are no recognized efficacious pharmacotherapies for crack-cocaine dependence. Inflammation and infection in cocaine users may be due to behavior adopted in conjunction with drug-related changes in the brain. To understand the metabolic changes associated with the drug abuse disorder and identify biomarkers, we performed a 1H NMR-based metabonomic analysis of 44 crack users' and 44 healthy volunteers' blood serum. The LDA model achieved 98% of accuracy. From the water suppressed 1H NMR spectra analyses, it was observed that the relative concentration of lactate was higher in the crack group, while long chain fatty acid acylated carnitines were decreased, which was associated with their nutritional behavior. Analyses of the aromatic region of CPMG 1H NMR spectra demonstrated histidine and tyrosine levels increased in the blood serum of crack users. The reduction of carnitine and acylcarnitines and the accumulation of histidine in the serum of the crack users suggest that histamine biosynthesis is compromised. The tyrosine level points to altered dopamine concentration.
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Affiliation(s)
- Tássia B B C Costa
- Institute of Chemistry , Universidade Estadual de Campinas (UNICAMP) , Campinas , Brazil
| | - Acioly L T Lacerda
- Center for Research and Clinical Trials Sinapse-Bairral , Instituto Bairral de Psiquiatria , Itapira , Brazil.,Universidade Federal de São Paulo (UNIFESP) , São Paulo , Brazil
| | - Caroline Dal Mas
- Universidade Federal de São Paulo (UNIFESP) , São Paulo , Brazil
| | - Elisa Brietzke
- Universidade Federal de São Paulo (UNIFESP) , São Paulo , Brazil
| | - João G M Pontes
- Institute of Chemistry , Universidade Estadual de Campinas (UNICAMP) , Campinas , Brazil
| | - Lucas A N Marins
- Universidade Federal de São Paulo (UNIFESP) , São Paulo , Brazil
| | - Lucas G Martins
- Institute of Chemistry , Universidade Estadual de Campinas (UNICAMP) , Campinas , Brazil
| | - Marcel V Nunes
- Center for Research and Clinical Trials Sinapse-Bairral , Instituto Bairral de Psiquiatria , Itapira , Brazil
| | - Mariana Pedrini
- Universidade Federal de São Paulo (UNIFESP) , São Paulo , Brazil
| | | | - Milan P Mitrovitch
- Center for Research and Clinical Trials Sinapse-Bairral , Instituto Bairral de Psiquiatria , Itapira , Brazil
| | | | - Natália L Saldanha
- Center for Research and Clinical Trials Sinapse-Bairral , Instituto Bairral de Psiquiatria , Itapira , Brazil
| | - Ronei J Poppi
- Institute of Chemistry , Universidade Estadual de Campinas (UNICAMP) , Campinas , Brazil
| | - Ljubica Tasic
- Institute of Chemistry , Universidade Estadual de Campinas (UNICAMP) , Campinas , Brazil
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32
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Campanella S, Schroder E, Vanderhasselt MA, Baeken C, Kornreich C, Verbanck P, Burle B. Short-Term Impact of tDCS Over the Right Inferior Frontal Cortex on Impulsive Responses in a Go/No-go Task. Clin EEG Neurosci 2018; 49:398-406. [PMID: 29788768 DOI: 10.1177/1550059418777404] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Inhibitory control, a process deeply studied in laboratory settings, refers to the ability to inhibit an action once it has been initiated. A common way to process data in such tasks is to take the mean response time (RT) and error rate per participant. However, such an analysis ignores the strong dependency between spontaneous RT variations and error rate. Conditional accuracy function (CAF) is of particular interest, as by plotting the probability of a response to be correct as a function of its latency, it provides a means for studying the strength of impulsive responses associated with a higher frequency of fast response errors. This procedure was applied to a recent set of data in which the right inferior frontal gyrus (rIFG) was modulated using transcranial direct current stimulation (tDCS). Healthy participants (n = 40) were presented with a "Go/No-go" task (click on letter M, not on letter W, session 1). Then, one subgroup (n = 20) was randomly assigned to one 20-minutes neuromodulation session with tDCS (anodal electrode, rIFG; cathodal electrode, neck); and the other group (n = 20) to a condition with sham (placebo) tDCS. All participants were finally confronted to the same "Go/No-go" task (session 2). The rate of commission errors (click on W) and speed of response to Go trials were similar between sessions 1 and 2 in both neuromodulation groups. However, CAF showed that active tDCS over rIFG leads to a reduction of the drop in accuracy for fast responses (suggesting less impulsivity and greater inhibitory efficiency), this effect being only visible for the first experimental block following tDCS stimulation. Overall, the present data indicate that boosting the rIFG may be useful to enhance inhibitory skills, but that CAF could be of the greatest relevance to monitor the temporal dynamics of the neuromodulation effect.
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Affiliation(s)
- Salvatore Campanella
- 1 Laboratoire de Psychologie Médicale et d'Addictologie, ULB Neuroscience Institute (UNI), CHU Brugmann-Université Libre de Bruxelles (U.L.B.), Brussels, Belgium
| | - Elisa Schroder
- 1 Laboratoire de Psychologie Médicale et d'Addictologie, ULB Neuroscience Institute (UNI), CHU Brugmann-Université Libre de Bruxelles (U.L.B.), Brussels, Belgium
| | - Marie-Anne Vanderhasselt
- 2 Department of Psychiatry and Medical Psychology, Ghent University, Ghent, Belgium.,3 Department of Psychiatry, University Hospital (UZBrussel), Brussels, Belgium.,4 Department of Experimental Clinical and Health Psychology, Ghent University, Belgium
| | - Chris Baeken
- 2 Department of Psychiatry and Medical Psychology, Ghent University, Ghent, Belgium.,3 Department of Psychiatry, University Hospital (UZBrussel), Brussels, Belgium
| | - Charles Kornreich
- 1 Laboratoire de Psychologie Médicale et d'Addictologie, ULB Neuroscience Institute (UNI), CHU Brugmann-Université Libre de Bruxelles (U.L.B.), Brussels, Belgium
| | - Paul Verbanck
- 1 Laboratoire de Psychologie Médicale et d'Addictologie, ULB Neuroscience Institute (UNI), CHU Brugmann-Université Libre de Bruxelles (U.L.B.), Brussels, Belgium
| | - Boris Burle
- 5 Aix-Marseille Universite', Centre National de la Recherche Scientifique, LNC Unite' Mixte de Recherche, Marseille, France
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33
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Yang M, Huang SC, Liao YH, Deng YM, Run HY, Liu PL, Liu XW, Liu TB, Xiao SY, Hao W. Clinical characteristics of poly-drug abuse among heroin dependents and association with other psychopathology in compulsory isolation treatment settings in China. Int J Psychiatry Clin Pract 2018; 22:129-135. [PMID: 29029570 DOI: 10.1080/13651501.2017.1383439] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To investigate clinical characteristics and associations of polydrug abuse among heroin-dependent patients in compulsory isolation settings in China. METHODS Structured interviews were conducted in 882 heroin-dependent patients in two compulsory isolation settings in Changsha, China. Descriptive statistics were employed to report prevalence and general information of polydrug abuse among the participants. Bivariate associations were examined between polydrug abuse and variables regarding demographics, heroin use profile and psychopathology. Multivariate logistic regressions were conducted to determine independent factors associated with polydrug abuse. RESULTS Of all the participants, 40.6% reported abuse of/dependence on at least one other type of drug/alcohol than heroin/opioids during the month preceding admission, with benzodiazepines and alcohol being the most common type of drugs abused apart from heroin. Antisocial and depressive personality disorders, as well as more severe heroin use patterns, including younger age at initiate use and larger amount used per day, were found to be independently associated with polydrug abuse. CONCLUSIONS The prevalence of polydrug abuse and its associated severe heroin use patterns and personality disorders suggests an urgent need of promoting treatment policies and strategies for heroin patients in China to address these issues.
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Affiliation(s)
- Mei Yang
- a Mental Health Institute , Second Xiangya Hospital, Central South University , Changsha , China.,b Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Medical Department of Shenzhen University , Shenzhen , China.,c Department of Social Medicine, School of Public Health , Central South University , Changsha , China
| | - Shu-Cai Huang
- d The Fourth People's Hospital of Wuhu , Wuhu , Anhui Province , China
| | - Yan-Hui Liao
- a Mental Health Institute , Second Xiangya Hospital, Central South University , Changsha , China
| | - Yi-Ming Deng
- b Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Medical Department of Shenzhen University , Shenzhen , China
| | - Hai-Yan Run
- b Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Medical Department of Shenzhen University , Shenzhen , China
| | - Ping-Liang Liu
- e Hunan Xinkaipu Compulsory Drug Rehabilitation Center , Changsha , China
| | - Xiong-Wen Liu
- e Hunan Xinkaipu Compulsory Drug Rehabilitation Center , Changsha , China
| | - Tie-Bang Liu
- b Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Medical Department of Shenzhen University , Shenzhen , China
| | - Shui-Yuan Xiao
- c Department of Social Medicine, School of Public Health , Central South University , Changsha , China
| | - Wei Hao
- a Mental Health Institute , Second Xiangya Hospital, Central South University , Changsha , China
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34
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Bolloni C, Badas P, Corona G, Diana M. Transcranial magnetic stimulation for the treatment of cocaine addiction: evidence to date. Subst Abuse Rehabil 2018; 9:11-21. [PMID: 29849473 PMCID: PMC5967377 DOI: 10.2147/sar.s161206] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
There is a common consensus in considering substance-use disorders (SUDs) a devastating chronic illness with social and psychological impact. Despite significant progress in understanding the neurobiology of SUDs, therapeutic advances have proceeded at a slower pace, in particular for cocaine-use disorder (CUD). Transcranial magnetic stimulation (TMS) is gaining support as a safe and cost-effective tool in the treatment of SUDs. In this review, we consider human studies that have investigated the efficacy of TMS in achieving therapeutic benefits in treating CUD. All studies conducted to date that have evaluated the therapeutic effect of TMS in CUD are included. We focus on the protocol of stimulation applied, emphasizing the neurophysiological effects of coils employed related to outcomes. Moreover, we examine the subjective and objective measurements used to assess the therapeutic effects along the timeline considered. The revision of scientific literatures underscores the therapeutic potential of TMS in treating CUD. However, the variability in stimulation protocols applied and the lack of methodological control do not allow us to draw firm conclusions, and further studies are warranted to examine the interaction between TMS patterns of stimulation relative to clinical outcomes in depth.
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Affiliation(s)
- Corinna Bolloni
- Laboratory of Cognitive Neuroscience, G Minardi Department of Chemistry and Pharmacy, University of Sassari, Sassari, Italy
| | - Paola Badas
- Laboratory of Cognitive Neuroscience, G Minardi Department of Chemistry and Pharmacy, University of Sassari, Sassari, Italy
| | - Giorgio Corona
- Laboratory of Cognitive Neuroscience, G Minardi Department of Chemistry and Pharmacy, University of Sassari, Sassari, Italy
| | - Marco Diana
- Laboratory of Cognitive Neuroscience, G Minardi Department of Chemistry and Pharmacy, University of Sassari, Sassari, Italy
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35
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Hallucinogen Persisting Perception Disorder: Etiology, Clinical Features, and Therapeutic Perspectives. Brain Sci 2018; 8:brainsci8030047. [PMID: 29547576 PMCID: PMC5870365 DOI: 10.3390/brainsci8030047] [Citation(s) in RCA: 91] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Revised: 03/12/2018] [Accepted: 03/13/2018] [Indexed: 12/23/2022] Open
Abstract
Hallucinogen Persisting Perception Disorder (HPPD) is a rare, and therefore, poorly understood condition linked to hallucinogenic drugs consumption. The prevalence of this disorder is low; the condition is more often diagnosed in individuals with a history of previous psychological issues or substance misuse, but it can arise in anyone, even after a single exposure to triggering drugs. The aims of the present study are to review all the original studies about HPPD in order to evaluate the following: (1) the possible suggested etiologies; (2) the possible hallucinogens involved in HPPD induction; (3) the clinical features of both HPPD I and II; (4) the possible psychiatric comorbidities; and (5) the available and potential therapeutic strategies. We searched PubMed to identify original studies about psychedelics and Hallucinogen Persisting Perception Disorder (HPPD). Our research yielded a total of 45 papers, which have been analyzed and tabled to provide readers with the most updated and comprehensive literature review about the clinical features and treatment options for HPPD.
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36
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Cousijn J, Luijten M, Feldstein Ewing SW. Adolescent resilience to addiction: a social plasticity hypothesis. THE LANCET. CHILD & ADOLESCENT HEALTH 2018; 2:69-78. [PMID: 30169197 PMCID: PMC6373770 DOI: 10.1016/s2352-4642(17)30148-7] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 09/20/2017] [Accepted: 09/28/2017] [Indexed: 12/12/2022]
Abstract
The prevalence of substance use disorders is highest during adolescence; however, many adolescents experience a natural resolution of their substance use by early adulthood, without any formal intervention. Something appears to be unique and adaptive about the adolescent brain. In this Review, we examine the roles of the social environment and neurocognitive development in adolescents' natural resilience to substance use disorders. At present, little is known about the neurocognitive mechanisms that underlie this adaptive phenomenon, since neurodevelopmental studies have mainly focused on the risk side of the substance use equation: escalation of substance use. To provide a framework for future studies, we put forth a social plasticity model that includes developmentally limited enhanced social attunement (ie, the need to harmonise with the social environment), affective processing, and brain plasticity, which underlie adolescents' capacity to learn from and adapt to their constantly evolving social environments.
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Affiliation(s)
- Janna Cousijn
- ADAPT Laboratory, Department of Psyc hology, and Amsterdam Brain and Cognition (ABC), University of Amsterdam, Netherlands.
| | - Maartje Luijten
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | - Sarah W Feldstein Ewing
- Division of Child and Adolescent Psychiatry, Oregon Health & Science University, Portland, OR, USA
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37
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Doucette WT, Dwiel L, Boyce JE, Simon AA, Khokhar JY, Green AI. Machine Learning Based Classification of Deep Brain Stimulation Outcomes in a Rat Model of Binge Eating Using Ventral Striatal Oscillations. Front Psychiatry 2018; 9:336. [PMID: 30123143 PMCID: PMC6085408 DOI: 10.3389/fpsyt.2018.00336] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 07/02/2018] [Indexed: 11/24/2022] Open
Abstract
Neuromodulation-based interventions continue to be evaluated across an array of appetitive disorders but broader implementation of these approaches remains limited due to variable treatment outcomes. We hypothesize that individual variation in treatment outcomes may be linked to differences in the networks underlying these disorders. Here, Sprague-Dawley rats received deep brain stimulation separately within each nucleus accumbens (NAc) sub-region (core and shell) using a within-animal crossover design in a rat model of binge eating. Significant reductions in binge size were observed with stimulation of either target but with significant variation in effectiveness across individuals. When features of local field potentials (LFPs) recorded from the NAc were used to classify the pre-defined stimulation outcomes (response or non-response) from each rat using a machine-learning approach (lasso), stimulation outcomes could be classified with greater accuracy than expected by chance (effect sizes: core = 1.13, shell = 1.05). Further, these LFP features could be used to identify the best stimulation target for each animal (core vs. shell) with an effect size = 0.96. These data suggest that individual differences in underlying network activity may relate to the variable outcomes of circuit based interventions, and measures of network activity could have the potential to individually guide the selection of an optimal stimulation target to improve overall treatment response rates.
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Affiliation(s)
- Wilder T Doucette
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, NH, United States.,The Dartmouth Clinical and Translational Science Institute, Dartmouth College, Hanover, NH, United States
| | - Lucas Dwiel
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, NH, United States
| | - Jared E Boyce
- Department of Psychological and Brain Sciences, Hanover, NH, United States
| | - Amanda A Simon
- Department of Psychological and Brain Sciences, Hanover, NH, United States
| | - Jibran Y Khokhar
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, NH, United States.,Department of Molecular and Systems Biology, Geisel School of Medicine at Dartmouth, Hanover, NH, United States.,Department of Biomedical Sciences, University of Guelph, Guelph, ON, Canada
| | - Alan I Green
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, NH, United States.,The Dartmouth Clinical and Translational Science Institute, Dartmouth College, Hanover, NH, United States.,Department of Molecular and Systems Biology, Geisel School of Medicine at Dartmouth, Hanover, NH, United States
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