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Neuromodulation interventions for addictive disorders: challenges promise and roadmap for future research

机译：成瘾性疾病的神经调节干预措施：挑战希望和未来研究的路线图

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Addictive disorders are a major public health concern, associated with high relapse rates, significant disability and substantial mortality. Unfortunately, current interventions are only modestly effective. Preclinical studies as well as human neuroimaging studies have provided strong evidence that the observable behaviours that characterize the addiction phenotype, such as compulsive drug consumption, impaired self-control, and behavioural inflexibility, reflect underlying dysregulation and malfunction in specific neural circuits. These developments have been accompanied by advances in neuromodulation interventions, both invasive as deep brain stimulation, and non-invasive such as repetitive transcranial magnetic stimulation and transcranial direct current stimulation. These interventions appear particularly promising as they may not only allow us to probe affected brain circuits in addictive disorders, but also seem to have unique therapeutic applications to directly target and remodel impaired circuits. However, the available literature is still relatively small and sparse, and the long-term safety and efficacy of these interventions need to be confirmed. Here we review the literature on the use of neuromodulation in addictive disorders to highlight progress limitations with the aim to suggest future directions for this field.
机译：成瘾性疾病是主要的公共卫生问题，与高复发率，严重残疾和高死亡率有关。不幸的是，当前的干预措施仅是适度的。临床前研究以及人类神经影像学研究提供了有力的证据，证明成瘾表型的可观察到的行为（例如强迫性药物消耗，自我控制受损和行为不灵活）反映了特定神经回路的潜在失调和功能障碍。这些发展伴随着神经调节干预的进步，包括侵入性的深部脑刺激和非侵入性的如重复经颅磁刺激和经颅直流电刺激。这些干预措施似乎特别有前途，因为它们不仅使我们能够探查成瘾性疾病中受影响的大脑回路，而且似乎具有独特的治疗应用，可以直接靶向和重塑受损的回路。然而，现有文献仍然相对较少且稀疏，因此需要确认这些干预措施的长期安全性和有效性。在这里，我们回顾了关于在成瘾性疾病中使用神经调节的文献，以强调进展的局限性，以期为该领域提出未来的方向。

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