A2 Vertaisarvioitu katsausartikkeli tieteellisessä lehdessä
Converging Evidence for Frontopolar Cortex as a Target for Neuromodulation in Addiction Treatment
Tekijät: Soleimani Ghazaleh, Joutsa Juho, Moussawi Khaled, Siddiqi Shan H, Kuplicki Rayus, Bikson Marom, Paulus Martin P, Fox Michael D, Hanlon Colleen A, Ekhtiari Hamed
Julkaisuvuosi: 2024
Journal: American Journal of Psychiatry
Tietokannassa oleva lehden nimi: The American journal of psychiatry
Lehden akronyymi: Am J Psychiatry
Vuosikerta: 181
Numero: 2
Aloitussivu: 100
Lopetussivu: 114
ISSN: 0002-953X
eISSN: 1535-7228
DOI: https://doi.org/10.1176/appi.ajp.20221022
Verkko-osoite: https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.20221022
Rinnakkaistallenteen osoite: https://pmc.ncbi.nlm.nih.gov/articles/PMC11318367/
Noninvasive brain stimulation technologies such as transcranial electrical and magnetic stimulation (tES and TMS) are emerging neuromodulation therapies that are being used to target the neural substrates of substance use disorders. By the end of 2022, 205 trials of tES or TMS in the treatment of substance use disorders had been published, with heterogeneous results, and there is still no consensus on the optimal target brain region. Recent work may help clarify where and how to apply stimulation, owing to expanding databases of neuroimaging studies, new systematic reviews, and improved methods for causal brain mapping. Whereas most previous clinical trials targeted the dorsolateral prefrontal cortex, accumulating data highlight the frontopolar cortex as a promising therapeutic target for transcranial brain stimulation in substance use disorders. This approach is supported by converging multimodal evidence, including lesion-based maps, functional MRI-based maps, tES studies, TMS studies, and dose-response relationships. This review highlights the importance of targeting the frontopolar area and tailoring the treatment according to interindividual variations in brain state and trait and electric field distribution patterns. This converging evidence supports the potential for treatment optimization through context, target, dose, and timing dimensions to improve clinical outcomes of transcranial brain stimulation in people with substance use disorders in future clinical trials.
