脑部刺激法治疗烟草依赖症
2012/12/13
摘要
背景：吸烟是导致全球可预防性死亡的主要原因，但许多吸烟者并不能简单的戒烟。心理社会治疗和药物治疗对戒烟的疗效也十分有限，因此，有必要寻找更为有效的戒烟措施。目前，越来越多研究关注脑部刺激法在成瘾性疾病治疗中的作用。
目的：本试验对已有的、评价脑部刺激对烟草依赖症治疗的研究进行回顾，并讨论有关该措施治疗成瘾症的未来研究方向。
方法：电子和人工检索相关文献。共找到15篇相关文献，研究的技术有经颅磁刺激（rTMS）、经颅电刺激（CES）、经颅直接电流刺激（tDCS）和深部脑刺激（DBS）。
结果：rTMS在烟草成瘾症治疗中的作用研究得最为深入。结果显示，针对背外侧前额叶皮层（DLPFC）的rTMS和tDCS，在抑制吸烟需求上具有最佳效果，这可能与大脑奖赏系统参与烟草依赖有关。rTMS能减少烟草需求，但未有研究显示，脑刺激技术能显著增加戒断率。通过优化刺激参数和增加治疗时间，有可能改善rTMS和tDCS的疗效。
结论：虽然需要更多的研究证实脑刺激技术在治疗烟草依赖中的疗效，但本综述显示，rTMS和tDCS可作为潜在新的烟草依赖症治疗手段。
（刘国梁 审校）
Brain Stimul. 2012 Jul 9. [Epub ahead of print]
Brain stimulation methods to treat tobacco addiction.
Wing VC, Barr MS, Wass CE, Lipsman N, Lozano AM, Daskalakis ZJ, George TP.
Source
Biobehavioural Addictions and Concurrent Disorders Research Laboratory (BACDRL), Brain Stimulation Clinic, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada; Schizophrenia Program, Brain Stimulation Clinic, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada; Division of Brain and Therapeutics, Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
Abstract
BACKGROUND: Tobacco smoking is the leading cause of preventable deaths worldwide, but many smokers are simply unable to quit. Psychosocial and pharmaceutical treatments have shown modest results on smoking cessation rates, but there is an urgent need to develop treatments with greater efficacy. Brain stimulation methods are gaining increasing interest as possible addiction therapeutics.
OBJECTIVES: The purpose of this paper is to review the studies that have evaluated brain stimulation techniques on tobacco addiction, and discuss future directions for research in this novel area of addiction interventions.
METHODS: Electronic and manual literature searches identified fifteen studies that administered repetitive transcranial magnetic stimulation (rTMS), cranial electrostimulation (CES), transcranial direct current stimulation (tDCS) or deep brain stimulation (DBS).
RESULTS: rTMS was found to be the most well studied method with respect to tobacco addiction. Results indicate that rTMS and tDCS targeted to the dorsolateral prefrontal cortex (DLPFC) were the most efficacious in reducing tobacco cravings, an effect that may be mediated through the brain reward system involved in tobacco addiction. While rTMS was shown to reduce consumption of cigarettes, as yet no brain stimulation technique has been shown to significantly increase abstinence rates. It is possible that the therapeutic effects of rTMS and tDCS may be improved by optimization of stimulation parameters and increasing the duration of treatment.
CONCLUSION: Although further studies are needed to confirm the ability of brain stimulation methods to treat tobacco addiction, this review indicates that rTMS and tDCS both represent potentially novel treatment modalities.
Brain Stimul. 2012 Jul 9. [Epub ahead of print]
背景：吸烟是导致全球可预防性死亡的主要原因，但许多吸烟者并不能简单的戒烟。心理社会治疗和药物治疗对戒烟的疗效也十分有限，因此，有必要寻找更为有效的戒烟措施。目前，越来越多研究关注脑部刺激法在成瘾性疾病治疗中的作用。
目的：本试验对已有的、评价脑部刺激对烟草依赖症治疗的研究进行回顾，并讨论有关该措施治疗成瘾症的未来研究方向。
方法：电子和人工检索相关文献。共找到15篇相关文献，研究的技术有经颅磁刺激（rTMS）、经颅电刺激（CES）、经颅直接电流刺激（tDCS）和深部脑刺激（DBS）。
结果：rTMS在烟草成瘾症治疗中的作用研究得最为深入。结果显示，针对背外侧前额叶皮层（DLPFC）的rTMS和tDCS，在抑制吸烟需求上具有最佳效果，这可能与大脑奖赏系统参与烟草依赖有关。rTMS能减少烟草需求，但未有研究显示，脑刺激技术能显著增加戒断率。通过优化刺激参数和增加治疗时间，有可能改善rTMS和tDCS的疗效。
结论：虽然需要更多的研究证实脑刺激技术在治疗烟草依赖中的疗效，但本综述显示，rTMS和tDCS可作为潜在新的烟草依赖症治疗手段。
（刘国梁 审校）
Brain Stimul. 2012 Jul 9. [Epub ahead of print]
Brain stimulation methods to treat tobacco addiction.
Wing VC, Barr MS, Wass CE, Lipsman N, Lozano AM, Daskalakis ZJ, George TP.
Source
Biobehavioural Addictions and Concurrent Disorders Research Laboratory (BACDRL), Brain Stimulation Clinic, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada; Schizophrenia Program, Brain Stimulation Clinic, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada; Division of Brain and Therapeutics, Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
Abstract
BACKGROUND: Tobacco smoking is the leading cause of preventable deaths worldwide, but many smokers are simply unable to quit. Psychosocial and pharmaceutical treatments have shown modest results on smoking cessation rates, but there is an urgent need to develop treatments with greater efficacy. Brain stimulation methods are gaining increasing interest as possible addiction therapeutics.
OBJECTIVES: The purpose of this paper is to review the studies that have evaluated brain stimulation techniques on tobacco addiction, and discuss future directions for research in this novel area of addiction interventions.
METHODS: Electronic and manual literature searches identified fifteen studies that administered repetitive transcranial magnetic stimulation (rTMS), cranial electrostimulation (CES), transcranial direct current stimulation (tDCS) or deep brain stimulation (DBS).
RESULTS: rTMS was found to be the most well studied method with respect to tobacco addiction. Results indicate that rTMS and tDCS targeted to the dorsolateral prefrontal cortex (DLPFC) were the most efficacious in reducing tobacco cravings, an effect that may be mediated through the brain reward system involved in tobacco addiction. While rTMS was shown to reduce consumption of cigarettes, as yet no brain stimulation technique has been shown to significantly increase abstinence rates. It is possible that the therapeutic effects of rTMS and tDCS may be improved by optimization of stimulation parameters and increasing the duration of treatment.
CONCLUSION: Although further studies are needed to confirm the ability of brain stimulation methods to treat tobacco addiction, this review indicates that rTMS and tDCS both represent potentially novel treatment modalities.
Brain Stimul. 2012 Jul 9. [Epub ahead of print]
上一篇：
吸烟者戒烟后体重增加：荟萃分析
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不含尼古丁的烟草成分的滥用可能性：乙醛、去
