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Tijdschrift voor Psychiatrie 55 (2013) 11, 841 - 852

Review article

Neuromodulation as an intervention for addiction: overview and future prospects

J. Luigjes, R. Breteler, S. Vanneste, D. de Ridder

background In recent years several neuromodulation techniques have been introduced as interventions for addiction.
aim To review and discuss studies that have investigated the effects of treating addiction by means of electroencephalography (eeg) neurofeedback, real-time functional magnetic resonance imaging (rt-fmri) neurofeedback, transcranial magnetic stimulation/transcranial direct current stimulation (tms/tdcs) and deep brain stimulation (dbs).
method We reviewed the literature, focusing on Dutch studies in particular.
results Studies using eeg neurofeedback were shown to have positive effects on drug use, treatment compliance, and cue reactivity in patients with cocaine and alcohol dependence. A pilot study investigating the effects of rt-fmri neurofeedback on nicotine dependent patients showed that modulation of the anterior cingulate cortex can decrease smokers’ craving for nicotine. In several studies decreased craving was found in alcohol dependent patients after tms or tdcs stimulation of the anterior cingulate cortex or the dorsolateral prefrontal cortex. The first dbs pilot studies suggest that the nucleus accumbens is a promising target region for the treatment of alcohol and heroin dependence.
conclusion Neuromodulation provides us with a unique opportunity to directly apply neuroscienctific knowledge to the treatment of addiction. However, more research is needed to ensure the efficacy, safety and feasibility of the various neuromodulation techniques that are now available.

keywords addiction, DBS, EEG neurofeedback, neuromodulation, rt-fMRI neurofeedback