TY - JOUR
T1 - Transcranial magnetic stimulation and deep brain stimulation in the treatment of alcohol dependence
AU - Alba-Ferrara, Lucia M.
AU - Fernandez, Francisco
AU - Salas, Ramiro
AU - De Erausquin, Gabriel A.
N1 - Publisher Copyright:
Copyright © 2013 by Lippincott Williams & Wilkins.
PY - 2014
Y1 - 2014
N2 - Alcohol dependence is a major social, economic, and public health problem. Alcoholism can lead to damage of the gastrointestinal, nervous, cardiovascular, and respiratory systems and it can be lethal, costing hundreds of billions to the health care system. Despite the existence of cognitive-behavioral therapy, psychosocial interventions, and spiritually integrated treatment to treat it, alcohol dependence has a high relapse rate and poor prognosis, albeit with high interindividual variability. In this review, we discuss the use of 2 neuromodulation techniques, namely repetitive transcranial magnetic stimulation and deep brain stimulation, and their advantages and disadvantages compared with first-line pharmacological treatment for alcohol dependence. We also discuss repetitive transcranial magnetic stimulation and deep brain stimulation targets for alcohol dependence treatment, considering experimental animal and human evidence, with careful consideration of methodological issues preventing the identification of feasible targets for neuromodulation treatments, as well as interindividual variability factors influencing alcoholism prognosis. Finally, we anticipate future research aiming to tailor the treatment to each individual patient by combining neurofunctional, neuroanatomic, and neurodisruptive techniques optimizing the outcome.
AB - Alcohol dependence is a major social, economic, and public health problem. Alcoholism can lead to damage of the gastrointestinal, nervous, cardiovascular, and respiratory systems and it can be lethal, costing hundreds of billions to the health care system. Despite the existence of cognitive-behavioral therapy, psychosocial interventions, and spiritually integrated treatment to treat it, alcohol dependence has a high relapse rate and poor prognosis, albeit with high interindividual variability. In this review, we discuss the use of 2 neuromodulation techniques, namely repetitive transcranial magnetic stimulation and deep brain stimulation, and their advantages and disadvantages compared with first-line pharmacological treatment for alcohol dependence. We also discuss repetitive transcranial magnetic stimulation and deep brain stimulation targets for alcohol dependence treatment, considering experimental animal and human evidence, with careful consideration of methodological issues preventing the identification of feasible targets for neuromodulation treatments, as well as interindividual variability factors influencing alcoholism prognosis. Finally, we anticipate future research aiming to tailor the treatment to each individual patient by combining neurofunctional, neuroanatomic, and neurodisruptive techniques optimizing the outcome.
KW - Addiction
KW - Alcoholism
KW - DBS
KW - Habenula
KW - Liver transplant
KW - Nucleus accumbens
KW - RTMS
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U2 - 10.1097/ADT.0b013e31829cf047
DO - 10.1097/ADT.0b013e31829cf047
M3 - Article
C2 - 25598743
AN - SCOPUS:84914674000
SN - 1531-5754
VL - 13
SP - 159
EP - 169
JO - Addictive Disorders and their Treatment
JF - Addictive Disorders and their Treatment
IS - 4
ER -