Brain Stimulation in Alcohol Use Disorders: Investigational and Therapeutic Tools

Genane Loheswaran; Mera S Barr; Tarek K Rajji; Reza Zomorrodi; Bernard Le Foll; Zafiris J Daskalakis

doi:10.1016/j.bpsc.2015.09.005

Brain Stimulation in Alcohol Use Disorders: Investigational and Therapeutic Tools

Biol Psychiatry Cogn Neurosci Neuroimaging. 2016 Jan;1(1):5-13. doi: 10.1016/j.bpsc.2015.09.005. Epub 2015 Oct 14.

Authors

Genane Loheswaran¹, Mera S Barr², Tarek K Rajji², Reza Zomorrodi³, Bernard Le Foll³, Zafiris J Daskalakis⁴

Affiliations

¹ Translational Addiction Research Laboratory, University of Toronto, Toronto, Ontario, Canada; Temerty Centre for Therapeutic Brain Intervention, University of Toronto, Toronto, Ontario, Canada.
² Temerty Centre for Therapeutic Brain Intervention, University of Toronto, Toronto, Ontario, Canada; Biobehavioural Addictions and Concurrent Disorders Laboratory, University of Toronto, Toronto, Ontario, Canada.
³ Translational Addiction Research Laboratory, University of Toronto, Toronto, Ontario, Canada.
⁴ Temerty Centre for Therapeutic Brain Intervention, University of Toronto, Toronto, Ontario, Canada; Biobehavioural Addictions and Concurrent Disorders Laboratory, University of Toronto, Toronto, Ontario, Canada. Electronic address: Jeff.Daskalakis@camh.ca.

PMID: 29560895
DOI: 10.1016/j.bpsc.2015.09.005

Abstract

Alcohol use disorders (AUDs) are a major health and social problem worldwide. Brain stimulation holds great promise as an investigational tool to help us understand the pathophysiology of alcohol dependence and as a therapeutic tool to treat AUDs. Numerous studies suggest that glutamatergic, gamma-aminobutyric acidergic, and dopaminergic neurotransmission are altered by alcohol consumption and among patients with AUDs. Alcohol's disruption of neurotransmission is likely to play an important role in its detrimental effects on neuroplasticity, which, in turn, may contribute to the pathophysiology of alcohol dependence. Specifically, aberrant neuroplasticity in the brain reward circuitry is a potential mechanism underlying the pathophysiology of alcohol dependence. The dorsolateral prefrontal cortex (DLPFC), a part of the brain's reward circuitry, is directly accessible to noninvasive brain stimulation and may represent a potential target for the treatment of AUDs. While the literature suggests that impairments in neuroplasticity are likely to be present in the DLPFC and brain reward circuitry in alcohol-dependent patients, this is yet to be directly evaluated in humans. Findings from numerous neuromodulatory brain stimulation studies demonstrate that altering neuroplasticity in the DLPFC in alcohol-dependent patients holds promise as a treatment for alcohol dependence, but the optimal neuromodulatory parameters are yet to be identified. Gaining a better understanding of alcohol dependence vis à vis neuroplasticity in the DLPFC and brain reward circuitry can help us optimize the treatment of alcohol dependence using neuromodulatory brain stimulation in the DLPFC.

Keywords: Addiction; Alcohol; Alcohol use disorders; Brain stimulation; Plasticity; Transcranial magnetic stimulation.

Publication types

Review