Neurostimulation in Addictive Disorder

SOURCE: Indian Journal of Psychiatry. Conference: 73rd Annual National Conference of Indian Psychiatric Society, ANCIPS 2022. Visakhapatnam India. 64(SUPPL 3) (pp S626-S627), 2022.


AUTHORS: Mukherjee D.; Shukla L.; Narasimha V.L.

ABSTRACT: In 2016, globally, 4*2% of all DALYs were attributable to alcohol use alone. Likewise, 1*3% of all DALYs were attributable to illicit drug use as a risk factor. Tobacco smoking was ranked among the five leading risk factors by DALYs in 109 countries and territories in 2015. Several treatment modalities, both pharmacological and psycho-social management in addiction, have been tried. Despite that, a very high treatment failure rate and poor retention are rules rather than exceptions. “”Brain disease addiction model”” is encouraging other modes of treatment like Neuromodulation. Neuromodulation exploits the knowledge of neuroanatomy as well as neurocircuitry in addiction. Different Neuromodulation techniques are available like Repetitive Transcranial Magnetic Stimulation (rTMS),
Transcranial Direct Current Stimulation (tDCS), Deep Brain Stimulation (DBS), Transcranial electrical stimulation (TES). Apart from DBS, all other techniques are considered non-invasive. Almost all the techniques have sizable evidence for other neuropsychiatric disorders. Over the past two decades, there has been significant interest concerning neuromodulation-based intervention in addictive disorders. Good quality researches are rising worldwide. Evidence is promising yet preliminary. In-depth discussion and research on the exact mechanism of the interventions, the role of optimal stimulation parameters, targeted brain region, and session interval are vital for further improvement. Hence, we will discuss these neurostimulation modalities in detail under the following scheme. Scheme of presentation: 1. Addiction: problem statement, a brief history of evolution neurostimulation and its relevance in addiction (neurobiological underpinning) 2. Brief description and mechanism of action of different neurostimulations 3. Neurostimulation: research evidence and future direction.