Transcranial electrical and magnetic stimulation (tES and TMS) for addiction medicine: A consensus paper on the present state of the science and the road ahead

Hamed Ekhtiari, Hosna Tavakoli, Giovanni Addolorato, Chris Baeken, Antonello Bonci, Salvatore Campanella, Luis Castelo-Branco, Gaëlle Challet-Bouju, Vincent P Clark, Eric Claus, Pinhas N Dannon, Alessandra Del Felice, Tess den Uyl, Marco Diana, Massimo di Giannantonio, John R Fedota, Paul Fitzgerald, Luigi Gallimberti, Marie Grall-Bronnec, Sarah C Herremans, Martin J Herrmann, Asif Jamil, Eman Khedr, Christos Kouimtsidis, Karolina Kozak, Evgeny Krupitsky, Claus Lamm, William V Lechner, Graziella Madeo, Nastaran Malmir, Giovanni Martinotti, William M McDonald, Chiara Montemitro, Ester M Nakamura-Palacios, Mohammad Nasehi, Xavier Noël, Masoud Nosratabadi, Martin Paulus, Mauro Pettorruso, Basant Pradhan, Samir K Praharaj, Haley Rafferty, Gregory Sahlem, Betty Jo Salmeron, Anne Sauvaget, Renée S Schluter, Carmen Sergiou, Alireza Shahbabaie, Christine Sheffer, Primavera A Spagnolo, Vaughn R Steele, Ti-Fei Yuan, Josanne D M van Dongen, Vincent Van Waes, Ganesan Venkatasubramanian, Antonio Verdejo-García, Ilse Verveer, Justine W Welsh, Michael J Wesley, Katie Witkiewitz, Fatemeh Yavari, Mohammad-Reza Zarrindast, Laurie Zawertailo, Xiaochu Zhang, Yoon-Hee Cha, Tony P George, Flavio Frohlich, Anna E Goudriaan, Shirley Fecteau, Stacey B Daughters, Elliot A Stein, Felipe Fregni, Michael A Nitsche, Abraham Zangen, Marom Bikson, Colleen A Hanlon, Hamed Ekhtiari, Hosna Tavakoli, Giovanni Addolorato, Chris Baeken, Antonello Bonci, Salvatore Campanella, Luis Castelo-Branco, Gaëlle Challet-Bouju, Vincent P Clark, Eric Claus, Pinhas N Dannon, Alessandra Del Felice, Tess den Uyl, Marco Diana, Massimo di Giannantonio, John R Fedota, Paul Fitzgerald, Luigi Gallimberti, Marie Grall-Bronnec, Sarah C Herremans, Martin J Herrmann, Asif Jamil, Eman Khedr, Christos Kouimtsidis, Karolina Kozak, Evgeny Krupitsky, Claus Lamm, William V Lechner, Graziella Madeo, Nastaran Malmir, Giovanni Martinotti, William M McDonald, Chiara Montemitro, Ester M Nakamura-Palacios, Mohammad Nasehi, Xavier Noël, Masoud Nosratabadi, Martin Paulus, Mauro Pettorruso, Basant Pradhan, Samir K Praharaj, Haley Rafferty, Gregory Sahlem, Betty Jo Salmeron, Anne Sauvaget, Renée S Schluter, Carmen Sergiou, Alireza Shahbabaie, Christine Sheffer, Primavera A Spagnolo, Vaughn R Steele, Ti-Fei Yuan, Josanne D M van Dongen, Vincent Van Waes, Ganesan Venkatasubramanian, Antonio Verdejo-García, Ilse Verveer, Justine W Welsh, Michael J Wesley, Katie Witkiewitz, Fatemeh Yavari, Mohammad-Reza Zarrindast, Laurie Zawertailo, Xiaochu Zhang, Yoon-Hee Cha, Tony P George, Flavio Frohlich, Anna E Goudriaan, Shirley Fecteau, Stacey B Daughters, Elliot A Stein, Felipe Fregni, Michael A Nitsche, Abraham Zangen, Marom Bikson, Colleen A Hanlon

Abstract

There is growing interest in non-invasive brain stimulation (NIBS) as a novel treatment option for substance-use disorders (SUDs). Recent momentum stems from a foundation of preclinical neuroscience demonstrating links between neural circuits and drug consuming behavior, as well as recent FDA-approval of NIBS treatments for mental health disorders that share overlapping pathology with SUDs. As with any emerging field, enthusiasm must be tempered by reason; lessons learned from the past should be prudently applied to future therapies. Here, an international ensemble of experts provides an overview of the state of transcranial-electrical (tES) and transcranial-magnetic (TMS) stimulation applied in SUDs. This consensus paper provides a systematic literature review on published data - emphasizing the heterogeneity of methods and outcome measures while suggesting strategies to help bridge knowledge gaps. The goal of this effort is to provide the community with guidelines for best practices in tES/TMS SUD research. We hope this will accelerate the speed at which the community translates basic neuroscience into advanced neuromodulation tools for clinical practice in addiction medicine.

Keywords: Addiction; NIBS; Non-invasive brain stimulation; Psychiatry; Substance use disorder; Transcranial electrical stimulation; Transcranial magnetic stimulation; rTMS; tDCS; tES.

Conflict of interest statement

Declaration of Competing Interest

Flavio Frohlich is the founder, majority owner, and Chief Scientific Officer of Pulvinar Neuro LLC. Michael Nitsche is a member of the Scientific Advisory Board of Neuroelectrics. Colleen A. Hanlon has served as a consultant for Brain Research and Development Services (Brainsway). Other authors reported no conflict of interest.