PCSS-MAUD Webinar: Rewiring the Brain for Recovery - The Promise of Neuromodulation in Alcohol Use Disorder Treatment-Slides

Slides

Pdf Summary

This webinar reviewed how neuromodulation may improve treatment for alcohol use disorder (AUD) by targeting disrupted brain circuits involved in craving, reward, executive control, and relapse. The presenter explained that AUD appears to involve a common functional brain network, especially the dorsal anterior cingulate cortex, prefrontal cortex, insula, striatum, and related cortico-striatal circuits. This network-based view supports using brain stimulation to rebalance maladaptive connectivity and strengthen recovery-related control.<br /><br />The talk covered several neuromodulation modalities: invasive approaches such as deep brain stimulation (DBS), and non-invasive approaches including transcranial magnetic stimulation (TMS), transcranial direct current stimulation, and focused ultrasound (FUS). TMS was emphasized as the most studied approach in AUD, with evidence suggesting that stimulation of the dorsolateral prefrontal cortex can reduce craving and improve executive function, while medial prefrontal targeting may reduce cue reactivity and reward valuation. Multi-session protocols generally produced stronger and more durable benefits than single sessions. Some studies also showed that combining rTMS with cognitive behavioral therapy reduced relapse and that treating comorbid depression with TMS may indirectly improve alcohol-related outcomes.<br /><br />DBS of the nucleus accumbens has shown promise in small studies of treatment-resistant AUD, with reductions in craving and occasional improvements in abstinence, but evidence remains limited and invasive surgery carries risk. Focused ultrasound, especially low-intensity FUS, is presented as an emerging non-invasive way to reach deep reward circuits with millimeter precision, though it is still in early clinical development.<br /><br />Overall, the webinar concluded that neuromodulation may become an important adjunct to medications and psychotherapy for AUD, especially as targeting becomes more precise and personalized.

Keywords

alcohol use disorder

neuromodulation

brain stimulation

transcranial magnetic stimulation

deep brain stimulation

focused ultrasound

dorsolateral prefrontal cortex

craving

relapse prevention

cortico-striatal circuits