Noninvasive brain stimulation treatments for addiction and major depression
Open accessAbstract
Major depressive disorder (MDD) and substance use disorders (SUDs) are prevalent, disabling, and challenging illnesses for which new treatment options are needed, particularly in comorbid cases. Neuroimaging studies of the functional architecture of the brain suggest common neural substrates underlying MDD and SUDs. Intrinsic brain activity is organized into a set of functional networks, of which two are particularly relevant to psychiatry. The salience network (SN) is crucial for cognitive control and response inhibition, and deficits in SN function are implicated across a wide variety of psychiatric disorders, including MDD and SUDs. The ventromedial network (VMN) corresponds to the classic reward circuit, and pathological VMN activity for drug cues/negative stimuli is seen in SUDs/MDD. Noninvasive brain stimulation (NIBS) techniques, including rTMS and tDCS, have been used to enhance cortico–striatal–thalamic activity through the core SN nodes in the dorsal anterior cingulate cortex, dorsolateral prefrontal cortex, and anterior insula. Improvements in both MDD and SUD symptoms ensue, including in comorbid cases, via enhanced cognitive control. Inhibition of the VMN also appears promising in preclinical studies for quenching the pathological incentive salience underlying SUDs and MDD. Evolving techniques may further enhance the efficacy of NIBS for MDD and SUD cases that are unresponsive to conventional treatments.
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TMS aimed at the cognitive-control circuit works especially well for depressed patients who also have substance use disorders.
“For example, targeting the neural circuit associated with cognitive control using transcranial magnetic stimulation reduces depressive symptoms by at least 55% and is particularly effective in depressed patients with comorbid substance use disorders (Dunlop et al., 2017).”
From The role of inflammation in core features of depression: Insights from paradigms using exogenously-induced inflammation. (2018) · cites this paper as Dunlop et al., 2017
Transcranial magnetic stimulation targeting the cognitive-control neural circuit reduces depressive symptoms by at least 55%.
“For example, targeting the neural circuit associated with cognitive control using transcranial magnetic stimulation reduces depressive symptoms by at least 55% and is particularly effective in depressed patients with comorbid substance use disorders (Dunlop et al., 2017).”
From The role of inflammation in core features of depression: Insights from paradigms using exogenously-induced inflammation. (2018) · cites this paper as Dunlop et al., 2017
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“Neuroimaging, in particular, provides robust and reproducible models of the functional neuroanatomy and the brain’s network architecture, which can serve as predictive correlates of clinical and functional outcomes (20).”
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- Authors
- Dunlop, K., Hanlon, C. A., & Downar, J.
- Affiliations
- University Health Network (CA)
- Medical University of South Carolina (US)
- Corresponding author
- Downar, Jonathan
- Venue
- Annals of the New York Academy of Sciences
- Publisher
- Wiley
- Published
- 2016-02-05
- Volume
- 1394
- Issue
- 1
- Pages
- 31-54
- ISSN
- 0077-8923 (ISSN-L)
- 1749-6632
- PMC
- PMC5434820
- OpenAlex
- W2264900518
- Cited by
- 171
- References
- 220
- Citations by year
- 2026: 10 · 2025: 18 · 2024: 19 · 2023: 20 · 2022: 24 · 2021: 14 · 2020: 15 · 2019: 22 · 2018: 13 · 2017: 10 · 2016: 5
- FWCI
- 1.46
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Annals of the New York Academy of Sciences (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Funders
- Canadian Institutes of Health Research
- Topics
- Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Health Sciences › Medicine › Neurology › Neurological disorders and treatments
- Keywords
- non-invasive brain stimulation, major depressive disorder, substance use disorders, addiction, salience network, reward systems, cognitive control, response inhibition, incentive salience, dorsal anterior cingulate cortex, dorsolateral prefrontal cortex, anterior insula, repetitive transcranial magnetic stimulation, transcranial direct current stimulation
- MeSH terms
- Mental Disorders, Brain, Depressive Disorder, Major, Major Depressive Disorder, Humans, Magnetic Resonance Imaging, Neural Pathways, Behavior, Addictive, Substance-Related Disorders, Transcranial Magnetic Stimulation, Transcranial Direct Current Stimulation
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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