Non-invasive Neuromodulation in Problem Gambling: What Are the Odds?

Purpose of Review: Non-invasive neuromodulation as a potential therapeutic target in addiction treatment is a fast-growing, but nascent research field. With gambling disorder as the first behavioral addiction, the goal of this review is to provide an overview of the current state-of-the-art of neuromodulation in substance use disorders and gambling disorder. Recent Findings: Only a few neuromodulation studies in gambling disorder are present, most of these are single-session studies. Effects of rTMS on craving have been described, but large placebo effects are also present, indicating a need for larger, blinded, multiple-session neuromodulation trials. Summary: The field of neuromodulation in gambling is in its infancy, given the limited number of studies, with small sample sizes. The effects that neuromodulation can have on diminishing craving and improving cognitive functions in substance use disorders are promising. As these factors also play a role in relapse in gambling disorder, these findings in SUDs indicate that investment in larger studies in gambling disorder, focusing on both clinically relevant outcome measures and on intermediate working mechanisms like craving and cognitive functions, is warranted.