非侵入性腦刺激於成癮醫學的進展

Development of Non-Invasive Brain Stimulation in Addiction Medicine

本文討論非侵入性腦刺激(non-invasive brain stimulation, NIBS)在成癮醫學的進展，成癮從傳統的煙、酒、非法物質濫用甚至賭博行為，成癮行為不僅傷害個人，也會影響周遭他人。過去人們用道德和刑罰阻止個人成癮行為造成的傷害，隨著行為神經科學進步，成癮醫學也成為一個新興領域。非侵入性腦刺激，包括經顱磁刺激或經顱電刺激，已應用在一些精神疾病的治療。雖然它們在成癮醬學中的治療應用，仍處於初期探勘階段，但越來越多的臨床試驗正在評估其潛力。本文回顧臨床文獻，介紹NIBS的技術、成癮的神經生物學基礎，以及近年NIBS於成癮疾病的治療進展。我們需理解目前這些試驗的不足，並謹慎結合現有的藥物與心理治療應用於臨床。

This article discusses the progress of non-invasive brain stimulation (NIBS) in addiction medicine. Personal addiction behavior, from traditional smoking and drinking to illegal substance abuse and even gambling, not only harms the individual but also affects others. In the past, people used morality and punishment to prevent harm caused by personal addiction behavior. With the advancement of behavioral neuroscience, addiction medicine has also become an emerging field. NIBS, including transcranial magnetic stimulation (TMS) or transcranial electrical stimulation (tES), is now being applied in the treatment of some mental illnesses. Although their use in addiction medicine is still in the early stages of exploration, more and more clinical trials are evaluating their potential. The article reviews the technical aspects of NIBS, the neurobiological basis of addiction, and recent progress in the treatment of addiction with NIBS. We need to understand the limitations of current trials and use caution in combining existing drugs and psychotherapy with NIBS in clinical practice.