Treatment of Behavioral Addictions and Substance Use Disorders: a Focus on the Effects of Theta-Burst Stimulation Over the Pre-SMA

Behavioral addictions (BA) and substance use disorders (SUDs) share core features, including impaired control and craving, leading to significant personal and societal impacts. Previous research has identified the pre-supplementary motor area (pre-SMA) as a critical node in GD-related neurocircuitry, making it a potential target for interventions also in SUDs. Theta-burst stimulation (TBS) offers a non-invasive method to modulate pre-SMA activity. This study included 58 participants diagnosed with GD or SUDs. They underwent bilateral pre-SMA continuous TBS (cTBS) sessions targeting craving, impulsivity, and addiction severity. Standardized scales and questionnaires were employed to assess the outcomes. cTBS parameters included 20 daily sessions with 80% resting motor threshold (RMT). Both GD and SUD groups exhibited significant reductions in addiction severity and craving following cTBS. Impulsivity decreased significantly in SUD but not in GD. The study's findings underscore the potential of pre-SMA TBS as an adjunctive treatment for GD and SUDs. The observed improvements in addiction severity and craving emphasize the shared neuronal mechanisms underlying these disorders. However, the nuanced differences, especially in impulsivity, indicate the need for further research to tailor interventions precisely.