It is important to find new treatments for addiction due to high relapse rates despite current interventions and due to expansion of the field with non-substance related addictive behaviors. Neuromodulation may provide a new type of treatment for addiction since it can directly target abnormalities in neurocircuits. We review literature on five neuromodulation techniques investigated for efficacy in substance related and behavioral addictions: transcranial direct current stimulation (tDCS), (repetitive) transcranial magnetic stimulation (rTMS), EEG, fMRI neurofeedback and deep brain stimulation (DBS) and additionally report on effects of these interventions on addiction-related cognitive processes. While rTMS and tDCS, mostly applied at the dorsolateral prefrontal cortex, show reductions in immediate craving for various addictive substances, placebo-responses are high and long-term outcomes are understudied. The lack in well-designed EEG-neurofeedback studies despite decades of investigation impedes conclusions about its efficacy. Studies investigating fMRI neurofeedback are new and show initial promising effects on craving, but future trials are needed to investigate long-term and behavioral effects. Case studies report prolonged abstinence of opioids or alcohol with ventral striatal DBS but difficulties with patient inclusion may hinder larger, controlled trials. DBS in neuropsychiatric patients modulates brain circuits involved in reward processing, extinction and negative-reinforcement that are also relevant for addiction. To establish the potential of neuromodulation for addiction, more randomized controlled trials are needed that also investigate treatment duration required for long-term abstinence and potential synergy with other addiction interventions. Finally, future advancement may be expected from tailoring neuromodulation techniques to specific patient (neurocognitive) profiles.

中文翻译：

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上瘾的有创和无创脑调制干预措施的疗效。

尽管有当前的干预措施，但由于复发率高，并且由于与非物质相关的成瘾行为的领域扩大，找到新的成瘾治疗方法非常重要。神经调节可以直接针对神经回路异常，因此可以提供一种新型的成瘾治疗方法。我们回顾了研究的五种神经调节技术的文献，这些技术针对与物质相关和行为成瘾的功效进行了研究：经颅直流电刺激（tDCS），（重复）经颅磁刺激（rTMS），EEG，fMRI神经反馈和深部脑刺激（DBS）这些干预措施对成瘾相关的认知过程的影响。尽管rTMS和tDCS主要应用于背外侧前额叶皮层，但显示出对各种成瘾性物质的即时渴望减少了，安慰剂反应高，长期疗效被低估。尽管进行了数十年的研究，但缺乏精心设计的EEG-神经反馈研究阻碍了有关其疗效的结论。研究功能磁共振成像神经反馈的研究是新的，并且显示出对渴望的最初有希望的影响，但是还需要进一步的试验来研究长期和行为的影响。案例研究报告，腹侧纹状体DBS禁食阿片类药物或酒精的时间延长，但患者入选困难可能会阻碍较大的对照试验。神经精神病患者的DBS调节参与奖励处理，消光和负强化的大脑回路，这也与成瘾有关。要确定神经调节对成瘾的潜力，还需要更多的随机对照试验来研究长期禁欲和与其他成瘾干预措施的潜在协同作用所需的治疗持续时间。最后，通过调整神经调节技术以适应特定患者（神经认知）特征，可以期待未来的发展。