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首页> 外文期刊>The European Journal of Neuroscience >Neural correlates of cue- and stress-induced craving in gambling disorders: implications for transcranial magnetic stimulation interventions
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Neural correlates of cue- and stress-induced craving in gambling disorders: implications for transcranial magnetic stimulation interventions

机译：赌博疾病中的提示和应激诱导的神经相关性：用于经颅磁刺激干预的影响

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摘要

Gambling disorder (GD), currently considered a behavioral addiction, shows substantial similarities with substance use disorders (SUDs) in terms of neurobiology and phenomenology. These similarities have been recognized in the DSM-5, although several relevant differences still exist in the diagnostic criteria, in particular, with regard to the role of cue- and stress- induced craving. Craving, recently included as a new criterion for SUDs diagnosis only, is a key construct also in the pathophysiology of GD. Furthermore, brain imaging studies indicate that similar alterations in cortico-limbic-striatal and prefrontal control circuits underlie the emergence of craving states in both disorders. This has important implications for the identification of neurobiologically based anti-craving interventions, which may be used for both GD and SUDs. In this regard, a novel neuromodulation intervention, named repetitive transcranial magnetic stimulation (rTMS), is emerging as a promising treatment for craving in SUDs, and could potentially be effective also in treating gambling urges. Here, we review the clinical neurobiological research on GD, with a specific emphasis on the neural circuits implicated in cue- and stress-craving, taking SUDs as the major comparative example. Furthermore, we describe the studies that have evaluated rTMS as a therapeutic tool for targeting and restoring the neural alterations underlying gambling urge. The manuscript concludes discussing some of the limitations of the current studies, and suggests directions for future rTMS research in GD.
机译：目前被认为是行为成瘾的赌博障碍（GD）显示出与神经生物学和现象学方面的物质使用障碍（SUDS）的大量相似性。这些相似之处已经在DSM-5中得到了认可，尽管在诊断标准中仍存在若干相关差异，特别是关于提示和应力诱导的渴望的作用。渴望，最近仅作为苏打诊断的新标准，是GD病理生理学的关键构建。此外，脑成像研究表明，皮质 - 肢体纹纹和前额相控制电路的类似改变是两种疾病中渴望状态的出现。这对鉴定基于神经生理学的抗渴望干预具有重要意义，这可以用于GD和SUD。在这方面，新的神经调节干预被称为重复的经颅磁刺激（RTMS），作为渴望泡沫的有希望的治疗，并且可能在治疗赌博的冲动方面是有效的。在这里，我们审查了对GD的临床神经生物学研究，特别强调了神经电路，涉及提示和应力渴望，作为主要的比较例。此外，我们描述了评估RTMS作为靶向和恢复赌博呼吁的神经改变的治疗工具的研究。手稿的结论是讨论了当前研究的一些局限性，并建议未来RTMS研究的指示。

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