Review: Non-Invasive Brain Stimulation in Behavioral Addictions: Insights from Direct Comparisons With Substance Use Disorders

Am J Addict. 2019 Nov;28(6):431-454. doi: 10.1111/ajad.12945. Epub 2019 Sep 12.


Background and objectives: Treatment models developed for substance use disorders (SUDs) are often applied to behavioral addictions (BAs), even though the correspondence between these forms of addiction is unclear. This is also the case for noninvasive brain stimulation (NIBS) techniques being investigated as potential treatment interventions for SUDs and BAs.

Objectives: to contribute to the development of more effective NIBS protocols for BAs.

Methods: Two literature searches using PubMed and Google Scholar were conducted identifying a total of 35 studies. The first search identified 25 studies examining the cognitive and neurophysiological overlap between BAs and SUDs. The second search yielded 10 studies examining the effects of NIBS in BAs.

Results: Impulsivity and cravings show behavioral and neurophysiologic overlaps between BAs and SUDs, however, other outcomes like working-memory abilities or striatal connectivity, differ between BAs and SUDs. The most-employed NIBS target in BAs was dorsolateral prefrontal cortex (DLPFC), which was associated with a decrease in cravings, and less frequently with a reduction of addiction severity.

Conclusions and scientific significance: Direct comparisons between BAs and SUDs revealed discrepancies between behavioral and neurophysiological outcomes, but overall, common and distinctive characteristics underlying each disorder. The lack of complete overlap between BAs and SUDs suggests that investigating the cognitive and neurophysiological features of BAs to create individual NIBS protocols that target risk-factors associated specifically with BAs, might be more effective than transferring protocols from SUDs to BAs. Individualizing NIBS protocols to target specific risk-factors associated with each BA might help to improve treatment interventions for BAs. (Am J Addict 2019;00:1-23).

Publication types

  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Behavior, Addictive / psychology
  • Behavior, Addictive / therapy*
  • Craving
  • Humans
  • Impulsive Behavior
  • Substance-Related Disorders / psychology
  • Substance-Related Disorders / therapy*
  • Transcranial Magnetic Stimulation / methods*
  • Treatment Outcome