• Drug Alcohol Depend · Nov 2018

    Effects of neuromodulation on cognitive performance in individuals exhibiting addictive behaviors: A systematic review.

    • Katherine R Naish, Lana Vedelago, James MacKillop, and Michael Amlung.
    • Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton and McMaster University, 100 West 5th Street, Hamilton, Ontario, L8P 3R2, Canada. Electronic address: naishek@mcmaster.ca.
    • Drug Alcohol Depend. 2018 Nov 1; 192: 338-351.

    BackgroundThere is growing interest in non-invasive brain stimulation techniques as treatments for addictive disorders. While multiple reviews have examined the effects of neuromodulation on craving and consumption, there has been no review of how neuromodulation affects cognitive functioning in addiction. This systematic review examined studies of the cognitive effects of transcranial direct current stimulation (tDCS) and transcranial magnetic stimulation (TMS) in individuals exhibiting addictive behavior.MethodsArticles were identified through searches in PubMed and PsycINFO conducted in October 2017. Eligible studies investigated the effects of tDCS or TMS on cognitive task performance in participants reporting substance use (e.g., alcohol, tobacco, or drugs) or addictive behaviors (e.g., gambling). Tasks were organized into five domains: (1) Inhibitory control, (2) Risk-taking, (3) Impulsive choice (delay discounting), (4) Executive function, and (5) Implicit biases.ResultsTwenty-four articles met the inclusion criteria. Fifty-seven percent of studies used tDCS and 43% used TMS, with nearly all studies (96%) targeting the dorsolateral prefrontal cortex. Ten studies reported significant within-subject modulation of cognitive functioning associated with active TMS or tDCS, with the same number reporting no change in cognitive performance. Of four studies that included both an experimental and control participant group, three showed between-group differences in the effects of neuromodulation.ConclusionsWhile positive effects in several studies suggest that tDCS and TMS improve cognitive functioning in addiction, there is substantial heterogeneity across studies. We discuss person-related and methodological factors that could explain inconsistencies, and propose individualized stimulation protocols may sharpen the cognitive effects of neuromodulation in addiction.Copyright © 2018 Elsevier B.V. All rights reserved.

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