Repetitive Transcranial Magnetic Stimulation (rTMS) for Decreasing Gambling Craving in Patients with Gambling Disorder: A Call for Advanced Clinical Investigations

Authors

  • Chidiebere Emmanuel Okechukwu Department of Public Health and Infectious Diseases, Sapienza University of Rome

DOI:

https://doi.org/10.15540/nr.8.1.69

Keywords:

gambling craving, gambling disorder, repetitive transcranial magnetic stimulation, neuroregulation, neurotherapy

Abstract

Gambling disorder (GD) is an addictive behavioral disorder that alters the frontostriatal neural circuitry and prefrontal control of reward-associated brain areas.  An intrusion between prefrontal cortex and the mesolimbic reward pathway has been proposed as the major mechanism behind the pathogenesis of GD.  Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive treatment that utilizes magnetic fields to stimulate nerve cells linked to mood and behavioral control; this stimulation is usually applied either on the left or right side of the dorsolateral prefrontal cortex of the brain.  rTMS selectively modulates the activities of brain circuits and possess the ability to overturn the alterations in the neurocircuitry of the brain linked to the pathophysiology of GD.  rTMS adjusts impulsivity, cognitive/attentional control, cognitive plasticity, and decision-making, which are crucial in decreasing gambling craving and relapse.  However, innovative clinical investigations are needed to analyze and establish the impact of rTMS on gambling craving and cessation, using a larger sample size.

References

Cardullo, S., Gomez Perez, L. J., Marconi, L., Terraneo, A., Gallimberti, L., Bonci, A., & Madeo, G. (2019). Clinical improvements in comorbid gambling/cocaine use disorder (GD/CUD) patients undergoing repetitive transcranial magnetic stimulation (rTMS). Journal of Clinical Medicine, 8(6), 768. https://doi.org/10.3390/jcm8060768

Cowlishaw, S., Merkouris, S., Chapman, A., & Radermacher, H. (2014). Pathological and problem gambling in substance use treatment: A systematic review and meta-analysis. Journal of Substance Abuse Treatment, 46(2), 98–105. https://doi.org/10.1016/j.jsat.2013.08.019

Garza-Villarreal, E. A., Alcala-Lozano, R., Fernandez-Lozano, S., Morelos-Santana, E., Dávalos, A., Villicaña, V., … Gonzalez-Olvera, J. J. (2021). Clinical and functional connectivity outcomes of 5-Hz repeated transcranial magnetic stimulation as an add-on treatment in cocaine use disorder: A double-blind randomized controlled trial. Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, S2451-9022(21)00021-5. Advance online publication. https://doi.org/10.1016/j.bpsc.2021.01.003

Gay, A., Boutet, C., Sigaud, T., Kamgoue, A., Sevos, J., Brunelin, J., & Massoubre, C. (2017). A single session of repetitive transcranial magnetic stimulation of the prefrontal cortex reduces cue-induced craving in patients with gambling disorder. European Psychiatry, 41(1), 68–74. https://doi.org/10.1016/j.eurpsy.2016.11.001

Gómez Pérez, L. J., Cardullo, S., Cellini, N., Sarlo, M., Monteanni, T., Bonci, A., … Madeo, G. (2020). Sleep quality improves during treatment with repetitive transcranial magnetic stimulation (rTMS) in patients with cocaine use disorder: A retrospective observational study. BMC Psychiatry, 20(1), 153. https://doi.org/10.1186/s12888-020-02568-2

Lefaucheur, J.-P., André-Obadia, N., Antal, A., Ayache, S. S., Baeken, C., Benninger, D. H., … Garcia-Larrea, L. (2014). Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS). Clinical Neurophysiology, 125(11), 2150–2206. https://doi.org/10.1016/j.clinph.2014.05.021

Limbrick-Oldfield, E. H., van Holst, R. J., & Clark, L. (2013). Fronto-striatal dysregulation in drug addiction and pathological gambling: Consistent inconsistencies? NeuroImage: Clinical, 2, 385–393. https://doi.org/10.1016/j.nicl.2013.02.005

Okechukwu, C. E. (2019). Role of exercise in the treatment of gambling disorder. Nigerian Journal of Experimental and Clinical Biosciences, 7(1), 50–54. https://doi.org/10.4103/njecp.njecp_11_19

Pettorruso, M., Di Giuda, D., Martinotti, G., Cocciolillo, F., De Risio, L., Montemitro, C., … NST Study Group (2019). Dopaminergic and clinical correlates of high-frequency repetitive transcranial magnetic stimulation in gambling addiction: A SPECT case study. Addictive Behaviors, 93, 246–249. https://doi.org/10.1016/j.addbeh.2019.02.013

Pettorruso, M., Martinotti, G., Montemitro, C., De Risio, L., Spagnolo, P. A., Gallimberti, L., … Brainswitch Study Group (2020). Multiple sessions of high-frequency repetitive transcranial magnetic stimulation as a potential treatment for gambling addiction: A 3-month, feasibility study. European Addiction Research, 26(1), 52–56. https://doi.org/10.1159/000504169

Pettorruso, M., Miuli, A., Di Natale, C., Montemitro, C., Zoratto, F., De Risio, L., … di Giannantonio, M. (2021). Non-invasive brain stimulation targets and approaches to modulate gambling-related decisions: A systematic review. Addictive Behaviors, 112, 106657. https://doi.org/10.1016/j.addbeh.2020.106657

Zucchella, C., Mantovani, E., Federico, A., Lugoboni, F., & Tamburin, S. (2020). Non-invasive brain stimulation for gambling disorder: A systematic review. Frontiers in Neuroscience, 14, 729. https://doi.org/10.3389/fnins.2020.00729

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Published

2021-03-29

Issue

Vol. 8 No. 1 (2021)

Section

Correspondence and Commentary

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