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Repetitive Transcranial Magnetic Stimulation in Addiction

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Book cover Non Invasive Brain Stimulation in Psychiatry and Clinical Neurosciences

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Abstract

Although in the last two decades important advances have been made in understanding the neurobiological underpinnings of addictive disorders (ADs), this knowledge has not yet been translated into effective treatments, especially on the long term. Recent findings report that repetitive transcranial magnetic stimulation (rTMS), including theta burst stimulation (TBS) and deep TMS (dTMS), has emerged as a potential treatment for ADs due to its promising results in terms of craving reduction, and given its ability to induce neuroplasticity and modulate brain activity. Based on this rationale and the current evidence, rTMS can be classified as probably effective in the treatment of addiction, with promising effect size for high-frequency rTMS stimulation protocol of the DLPFC, mainly in nicotine and cocaine/stimulant-use disorders, and with some noteworthy pilot data in the area of gambling disorder. However, double-blind, sham-controlled studies are mostly needed in order to confirm these potential benefits. Interestingly, most of the efforts for rTMS in addiction have been focused on increasing activity in the DLPFC. However, decreasing activity in the MPFC and ventral striatum may also be a feasible and fruitful target to consider. Future research should identify potential parameters (i.e., duration, number of stimulation treatments, stimulation frequency, intensity, brain region of target) of stimulation in rTMS studies for the most effective and safe treatment of drug addiction. The personalization of rTMS treatments, as well as the optimization of stimulation protocols, is the main issue that will involve future research in this area.

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Authors and Affiliations

  1. Department of Neuroscience, Imaging and Clinical Sciences, “G. D’Annunzio” University, Chieti, Italy

    Giovanni Martinotti, Mauro Pettorruso, Chiara Montemitro & Massimo Di Giannantonio

  2. Department of Pharmacy, Pharmacology and Clinical Sciences, University of Hertfordshire, Herts, UK

    Giovanni Martinotti

  3. SRP “Villa Maria Pia”, Rome, Italy

    Giovanni Martinotti

  4. Neuroimaging Research Branch, National Institute on Drug Abuse, Intramural Research Program, National Institutes of Health, Baltimore, MD, USA

    Chiara Montemitro & Elliot Stein

  5. Laureate Institute for Brain Research, Tulsa, OK, USA

    Hamed Ekhtiari

  6. Medical University of South Carolina (MUSC), Charleston, SC, USA

    Colleen A. Hanlon

  7. National Institute on Neurological Disorders and Stroke, National Institute of Health, Bethesda, MD, USA

    Primavera A. Spagnolo

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  1. Giovanni Martinotti
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  6. Primavera A. Spagnolo
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  7. Elliot Stein
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  8. Massimo Di Giannantonio
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Correspondence to Giovanni Martinotti .

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Editors and Affiliations

  1. ASST Fatebenefratelli Sacco, University of Milan, MILANO, Milano, Italy

    Bernardo Dell'Osso

  2. University of Rome Tor Vergata, Roma, Italy

    Giorgio Di Lorenzo

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Martinotti, G. et al. (2020). Repetitive Transcranial Magnetic Stimulation in Addiction. In: Dell'Osso, B., Di Lorenzo, G. (eds) Non Invasive Brain Stimulation in Psychiatry and Clinical Neurosciences. Springer, Cham. https://doi.org/10.1007/978-3-030-43356-7_11

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  • DOI: https://doi.org/10.1007/978-3-030-43356-7_11

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