Fig. 1.

The brain-based model of addiction proposes dysregulations in specific brain structures that manifest in cognitions and behavior related to each of three cyclical stages of addiction: Binge and Intoxication (Blue), Withdrawal and Negative Affect (Red), Preoccupation and Anticipation (Green). Repeated drug exposure increases cycle iterations and, with neuroplasticity, exacerbates dysregulations within and between stages. With sufficient exposure and iterations, an individual eventually meets criteria for a substance use disorder (SUD). Unique regions may become specifically malleable and thus targetable for modulation within each specific stage. For example, the anterior cingulate cortex (ACC) is implicated during the Preoccupation and Anticipation phase (Green; i.e., craving). Modulating and thus normalizing processing of the ACC may be uniquely possible during this specific stage. This perspective highlights potential target regions and thus generates testable hypotheses related to transcranial magnetic stimulation as a potential treatment for SUDs. (figure reprinted with permission from NEJM; Volkow et al., 2016).