Table 3 Deep Brain Stimulation (DBS) [Total N = 48; Total Studies = 7].
From: A systematic review and meta-analysis of neuromodulation therapies for substance use disorders
Author | Sample | Study Design | Targeted Region | # of Treatments | Craving, Consumption, and/or Abstinence Effect Size (Hedge’s g) [95% CI] | Secondary Outcome(s) Effect Size (Hedge’s g) [95% CI] | Results |
|---|---|---|---|---|---|---|---|
Alcohol: Continuous Active Stimulation Total N = 28; 4 Studies | |||||||
Voges et al. [142] | N = 5 | Case reports of alcohol-dependent male participants. | NAc | Continuous | Craving Post vs. Pre: −3.96 [−6.71 – −1.21] Abstinence NA | None | A significant ↓ in alcohol craving was observed in all participants. 2/5 patients remained completely abstinent for > 4 years. |
Muller et al. [143] | N = 5 | Case reports of alcohol-dependent male participants. | NAc | Continuous | Craving Post vs. Pre: −2.11 [−3.66 – −0.57] Abstinence NA | None | All participants reported a persistent disappearance of alcohol craving. 2/5 participants remained abstinent post-treatment, and the remaining 3 showed a marked reduction of alcohol consumption. |
Davidson et al. [144] | N = 6 | A phase 1 pilot study with alcohol-dependent female participants. | NAc | Continuous | Consumption Post vs. Pre: −2.01 [−3.40 – −0.62] | Molecular & Functional Imaging NA | DBS led to a significant ↓ in alcohol consumption 1-year post-treatment in all participants, as well as a ↓ in alcohol-related compulsivity. Clinical improvements were correlated with a reduction in NAc metabolism and disrupted functional connectivity between the NAc and visual association cortex. |
Bach et al. [145] | N = 12 | A double-blind, randomized, sham-controlled multi-center study with treatment-resistant alcohol-dependent participants. | NAc | Continuous | Craving Post vs. Pre: −1.36 [−2.62 – −0.11] Active vs. Sham: −0.61 [−1.77–0.55] Abstinent Days Post vs. Pre: 1.12 [−0.10–2.33] Active vs. Sham: 0.93 [−0.26–2.12] | None | While there was no difference in continuous abstinence between treatment groups at 6-months, active DBS led to a significantly higher proportion of abstinent days over the 6-month period and lower craving scores, compared to sham. |
Tobacco: Continuous Active Stimulation Total N = 10; 1 Study | |||||||
Kuhn et al. [146] | N = 10 | A retrospective, self-report, longitudinal study with tobacco-dependent participants | NAc | Continuous | Dependence Post vs. Pre: −0.40 [−1.28–0.49] | None | 3/10 participants quit smoking post-treatment. |
Opioid: Continuous Active Stimulation Total N = 10; 2 Studies | |||||||
Kuhn et al. [147] | N = 2 | Case reports of heroin-dependent participants | NAc | Continuous | Craving NA | Depressive Symptoms NA | A significant ↓ in craving and depressive symptoms was observed 1-year post-DBS in both participants. |
Chen et al. [148] | N = 8 | An open-label study with heroin-dependent participants | NAc/ALIC | Continuous | Craving Post vs. Pre: −5.75 [−7.97 – −3.53] Abstinence NA | None | Simultaneous and continuous DBS to the NAc and ALIC led to high abstinence rates (62.5%) and a ↓ in opioid craving, 2 years post-treatment. 5/8 participants remained abstinent for more than 3 years. Moreover, improved quality of life and alleviated mental disorders were observed. |
