Table 2.
Applicability of neuromodulation for the treatment of SUD.
| Neuromodulatory technique1 | SUD research | Region of interest or brain target | Evidence level |
|---|---|---|---|
| Transcranial Magnetic Stimulation (TMS) | Alcohol, cocaine, methamphetamine, opioid, cannabis, nicotine | DLPFC, Medial Prefrontal cortex, ACC | Multiple clinical trials, associated with reductions in substance craving and use |
| Low Intensity Focused Ultrasound (LIFU) | None | NAc | No published pre-clinical or clinical investigations |
| Deep Brain Stimulation (DBS) | Alcohol, heroin, nicotine | NAc | Multiple case reports, pre-clinical data, associated with reductions in substance craving and use |
| Transcranial Direct Current Stimulation (tDCS) | Alcohol, cocaine, cannabis, nicotine | DLPFC | Multiple clinical trials, associated with reductions in substance craving and use though inconsistent evidence for efficacy, likely due to varying study designs |
| Vagus Nerve Stimulation (VNS) | Pre-clinical only | Vagus nerve | Changes in cortical excitability, extinguishing responses to drug-associated environmental stimuli |
| Auricular Nerve Stimulation/Percutaneous Nerve Field Stimulation (PNFS) | Opioid Withdrawal | Percutaneous Nerve Field | One open label trial |
| Trigeminal Nerve Stimulation (TNS) | None | Trigeminal Nerve | No published pre-clinical or clinical investigations |
1
None of the above mentioned methods of neuromodulation have received FDA approval for SUD (with the exception of PNFS which received De novo 510(k) clearance for SUD) and none have been approved for insurance reimbursement.