There is growing interest in non-invasive brain stimulation (NIBS) as a novel treatment option for substance-use disorders (SUDs). Recent momentum stems from a foundation of preclinical neuroscience demonstrating links between neural circuits and drug consuming behavior, as well as recent FDA-approval of NIBS treatments for mental health disorders that share overlapping pathology with SUDs. As with any emerging field, enthusiasm must be tempered by reason; lessons learned from the past should be prudently applied to future therapies. Here, an international ensemble of experts provides an overview of the state of transcranial-electrical (tES) and transcranial-magnetic (TMS) stimulation applied in SUDs. This consensus paper provides a systematic literature review on published data-emphasizing the heterogeneity of methods and outcome measures while suggesting strategies to help bridge knowledge gaps. The goal of this effort is to provide the community with guidelines for best practices in tES/TMS SUD research. We hope this will accelerate the speed at which the community translates basic neuroscience into advanced neuromodulation tools for clinical practice in addiction medicine.

No abstract

No abstract

No abstract

Background:Studies on incidence of childhood mental disorders are extremely rare globally and there are none from India. Incidence studies though more difficult and time consuming, provide invaluable information on the pattern and causes of occurrence of mental disorders allowing opportunity for early intervention and primary prevention.Aim:This study aimed at estimating the incidence of psychiatric disorders in school children.Materials and Methods:A representative sample of school children was assessed through a two stage evaluation process involving teacher's rating (N=963) and parent rating (N=873). Children who scored below the cut-off for psychiatric disorder (N=727) on both the screening instruments were re-contacted six years later. 186 children and their families were personally available for reevaluation. All the children and their parents were re-assessed on Parent Interview Schedule; Strengths and Difficulties Questionnaire: and detailed clinical assessment by a psychiatrist. Psychiatric diagnosis was made as per ICD 10 criteria. Data on children who were found to have psychiatric disorder were compared with those who did not have psychiatric disorders.Results:20 children out of 186 followed up had psychiatric disorder giving the annual incidence rate of 18/1000/yr. Children who had disorder at follow-up did not differ from those who did not on age, gender and psychological (temperament, parental handling, life stress and IQ) parameters at baseline.Discussion:Incidence figures cannot be compared due to lack of any comparable studies. Factors associated with occurrence of new cases of psychiatric disorder and implications for future studies are discussed.

Compulsivity and loss of behavioral control represent core symptoms in obsessive–compulsive disorder (OCD), substance use disorder (SUD), and internet gaming disorder (IGD). Despite elaborated animal models suggesting that compulsivity is mediated by cortico‐striatal circuits and a growing number of neuroimaging case–control studies, common neurofunctional alterations in these disorders have not been systematically examined. The present activation likelihood estimation (ALE) meta‐analysis capitalized on previous functional magnetic resonance imaging (fMRI) studies to determine shared neurofunctional alterations among the three disorders. Task‐based fMRI studies of individuals with SUD, OCD, or IGD were obtained. ALE was performed within each disorder. Next, contrast and conjunction meta‐analyses were performed to determine differential and common alterations. Task‐paradigm classes were group according to Research Domain Criteria (RDoC) domains to determine contributions of underlying behavioral domains. One hundred forty‐four articles were included representing data from n = 6897 individuals (SUD = 2418, controls = 2332; IGD = 361, controls = 360; OCD = 715, controls = 711) from case–control studies. Conjunction meta‐analyses revealed shared alterations in the anterior insular cortex between OCD and SUDs. SUD exhibited additionally pronounced dorsal‐striatal alterations compared with both, OCD and IGD. IGD shared frontal, particularly cingulate alterations with all SUDs, while IGD demonstrated pronounced temporal alterations compared with both, SUD and OCD. No robust overlap between IGD and OCD was observed. Across the disorders, neurofunctional alterations were mainly contributed by cognitive systems and positive valence RDoC domains. The present findings indicate that neurofunctional dysregulations in prefrontal regions engaged in regulatory‐control represent shared neurofunctional alterations across substance and behavioral addictions, while shared neurofunctional dysregulations in the anterior insula may mediate compulsivity in substance addiction and OCD.

Depression affects about 121 million people worldwide and prevalence of major depressive disorder (MDD) in US adults is 6.4%. Treatment resistant depression (TRD) accounts for approximately 12–20% of all depression patients and costs $29–$48 billion annually. Ketamine and repetitive transcranial magnetic stimulation (rTMS) have useful roles in TRD, but their utility in long term is unknown. As per the latest literature, the interventions using Yoga and meditation including the mindfulness based cognitive therapy (MBCT) have been useful in treatment of depression and relapse prevention. We present a review of rTMS, ketamine, and MBCT and also report efficacy of a depression specific, innovative, and translational model of Yoga and mindfulness based cognitive therapy (DepS Y-MBCT), developed by the first author. DepS Y-MBCT as an adjunctive treatment successfully ameliorated TRD symptoms in 27/32 patients in an open label pilot trial in TRD patients. Considering the limitations of existing treatment options, including those of ketamine and rTMS when used as the sole modality of treatment, we suggest a “tiered approach for TRD” by combining ketamine and rTMS (alone or along with antidepressants) for rapid remission of acute depression symptoms and to use DepS Y-MBCT for maintaining remission and preventing relapse.

No abstract