Transcranial Magnetic Stimulation and Deep Brain Stimulation in the Treatment of Alcohol Dependence

ALBA FERRARA, L.; FERNANDEZ, F.; SALAS, R.; DE ERAUSQUIN, G.

Addictive Disorders & Their Treatment

Lipincott- Williams & Wilkins

Año: 2013

1531-5754

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.