IMR Press / JIN / Volume 22 / Issue 6 / DOI: 10.31083/j.jin2206164
Open Access Systematic Review
Transcranial Magnetic Stimulation for the Treatment of Gambling Disorder: A Systematic Review
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1 Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, 95123 Catania, Italy
2 Department of Educational Sciences, Section of Psychology, University of Catania, 95121 Catania, Italy
3 Center of Excellence for the Acceleration of Harm Reduction (COEHAR), University of Catania, 95121 Catania, Italy
4 Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
5 Department of Surgery and Medical-Surgical Specialties, University of Catania, 95123 Catania, Italy
6 Clinical Neurophysiology Research Unit, Oasi Research Institute-IRCCS, 94018 Troina, Italy
*Correspondence: c.concerto@policlinico.unict.it (Carmen Concerto)
These authors contributed equally.
J. Integr. Neurosci. 2023, 22(6), 164; https://doi.org/10.31083/j.jin2206164
Submitted: 28 June 2023 | Revised: 27 August 2023 | Accepted: 30 August 2023 | Published: 21 November 2023
Copyright: © 2023 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Background: Gambling Disorder (GD) is a behavioral addiction listed within the diagnostic category of substance-related and addictive disorders. Recently, transcranial magnetic stimulation (TMS), which non-invasively stimulates the brain and has neuromodulatory properties, has emerged as an innovative treatment tool for GD, thus offering a new option for the management of this complex disorder. The present review explored the efficacy of TMS as a possible non-pharmacological treatment for GD. Methods: An exhaustive search was performed across the MEDLINE, Web of Science, and EMBASE databases using a specific search string related to GD and TMS. A total of 20 papers were selected for full-text examination, out of which eight fulfilled the inclusion criteria and were therefore systematically analyzed in the present review. Results: This review included eight studies: three randomized-controlled trials (RCTs), three non-controlled studies, one case series, and one case report. Two cross-over RCTs described a decrease in craving after high-frequency (excitatory), repetitive transcranial magnetic stimulation (rTMS) over the left dorsolateral prefrontal cortex (DLPFC) and the medial prefrontal cortex (PFC), respectively; another study applying low-frequency (inhibitory) rTMS on the right DLPFC did not find any positive effect on craving. Among uncontrolled studies, one demonstrated the beneficial effect of high-frequency rTMS over the left DLPFC, while another showed the efficacy of a continuous theta burst stimulation protocol directed over the pre-supplementary motor area, bilaterally. Conclusion: The included studies showed the promising effect of excitatory stimulation over the left PFC. However, further investigation is needed, particularly in terms of standardizing stimulation protocols and psychometric assessments.

Keywords
gambling disorder 1
craving 2
repetitive transcranial magnetic stimulation 3
theta burst stimulation 4
Figures
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