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Targeting the Salience Network: A Mini-Review on a Novel Neuromodulation Approach for Treating Alcohol Use Disorder

Journal

FRONTIERS IN PSYCHIATRY
Volume 13, Issue -, Pages -

Publisher

FRONTIERS MEDIA SA
DOI: 10.3389/fpsyt.2022.893833

Keywords

alcohol use disorder; neuromodulation; transcranial magnetic stimulation; treatment; salience network; neurocircuitry

Categories

Funding

  1. Department of Veteran's Affairs (VA), Veteran's Health Administration, Office of Research and Development, Clinical Science Research and Development (CSR&D) Career Development Award [IK2 CX001356]
  2. Office of Mental Health and Suicide Prevention
  3. Sierra Pacific VISN 21 Mental Illness Research, Education, and Clinical Center (MIRECC)

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Alcohol use disorder (AUD) is difficult to treat, and two-thirds of individuals relapse after treatment. Recent studies have found that modulating the salience network (SN) through neuromodulation approaches, particularly by stimulating the anterior insula or dorsal anterior cingulate cortex, may be an effective therapeutic strategy.
Alcohol use disorder (AUD) continues to be challenging to treat despite the best available interventions, with two-thirds of individuals going on to relapse by 1 year after treatment. Recent advances in the brain-based conceptual framework of addiction have allowed the field to pivot into a neuromodulation approach to intervention for these devastative disorders. Small trials of repetitive transcranial magnetic stimulation (rTMS) have used protocols developed for other psychiatric conditions and applied them to those with addiction with modest efficacy. Recent evidence suggests that a TMS approach focused on modulating the salience network (SN), a circuit at the crossroads of large-scale networks associated with AUD, may be a fruitful therapeutic strategy. The anterior insula or dorsal anterior cingulate cortex may be particularly effective stimulation sites given emerging evidence of their roles in processes associated with relapse.

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